CPNRE - Canadian Practical Nurse Registration Examination Therapeutic Nurse-Client Relationship Questions and Answers 1 — Questions and Answers
Question 1: During the orientation phase of the nurse-client relationship, what is the practical nurse's primary goal?
- To evaluate the effectiveness of the nursing care plan.
- To establish trust and define the parameters of the relationship. (Correct answer)
- To promote the client's independence and self-care abilities.
- To explore the client's feelings and identify solutions to problems.
Correct answer: To establish trust and define the parameters of the relationship.
The orientation phase is the initial encounter where the primary goal is to build rapport, establish trust, and clearly define the roles, rules, and boundaries of the professional relationship. This sets the foundation for the subsequent working and termination phases. Evaluating the care plan and exploring solutions occur in the working phase, while promoting independence is a key goal of the termination phase.
Question 2: A client who is being discharged at the end of the week tells the practical nurse, "I'm really going to miss our talks. Can I get your phone number so we can keep in touch?" Which of the following responses by the nurse is most appropriate?
- "I'm not allowed to do that, but I can give you the number for the hospital's support line."
- "I will miss our talks too. Let's focus on how you will use the skills you've learned once you are discharged." (Correct answer)
- "Of course. It's important to have support, and I'd be happy to hear from you."
- "It's against hospital policy, but perhaps we can connect on social media instead."
Correct answer: "I will miss our talks too. Let's focus on how you will use the skills you've learned once you are discharged."
This response correctly navigates the termination phase by acknowledging the client's feelings while gently redirecting the focus back to the client's progress and future independence, which is the primary goal of this phase. Providing personal contact information or connecting on social media is a breach of professional boundaries. While offering a support line is helpful, the best response also validates the client's feelings about the relationship ending.
Question 3: Which of the following statements by a practical nurse best demonstrates empathy rather than sympathy?
- "I'm so sorry you're going through this; it must be awful."
- "Don't worry, I'm sure everything will turn out fine in the end."
- "This must be a very frightening experience for you. Let's talk about what is making you most anxious." (Correct answer)
- "I know a lot of people in your situation, and they have managed to get through it."
Correct answer: "This must be a very frightening experience for you. Let's talk about what is making you most anxious."
Empathy involves understanding and acknowledging the client's feelings from their perspective. This statement validates the client's fear and opens a dialogue to explore their specific concerns. Sympathy, in contrast, is feeling pity or sorrow for the client's situation, as shown in the 'I'm so sorry' response. Offering false reassurance or comparing the client to others are non-therapeutic techniques that diminish the client's individual experience.
Question 4: A practical nurse is in the working phase of a therapeutic relationship with a client recovering from major surgery. Which action is the priority for the nurse during this phase?
- Setting the goals and outlining the expected duration of the relationship.
- Summarizing the progress made and preparing the client for discharge.
- Gathering initial assessment data and establishing a contract for care.
- Assisting the client to actively problem-solve and practice new coping skills. (Correct answer)
Correct answer: Assisting the client to actively problem-solve and practice new coping skills.
The working phase is where the bulk of the therapeutic work occurs. The priority is to actively engage the client in exploring their problems, trying new solutions, and learning new skills to promote change and recovery. Gathering data and setting goals occur in the orientation phase, and summarizing progress is characteristic of the termination phase.
Question 5: Which of the following is considered a non-therapeutic communication technique that can block further discussion with a client?
- Using silence to allow the client time to reflect.
- Asking open-ended questions to encourage elaboration.
- Providing false reassurance by saying "Everything will be just fine." (Correct answer)
- Paraphrasing the client's statement to show understanding.
Correct answer: Providing false reassurance by saying "Everything will be just fine."
Providing false reassurance is a non-therapeutic technique because it dismisses the client's legitimate feelings and concerns, discouraging them from further expression. It can be perceived as the nurse not taking their situation seriously. Using silence, asking open-ended questions, and paraphrasing are all therapeutic techniques designed to encourage communication.
Question 6: A client expresses anger and frustration about a delayed diagnostic test, stating, "No one here cares about what happens to me!" Which response by the practical nurse best maintains the therapeutic relationship?
- "I can see you are very upset. Let's talk about what is frustrating you the most." (Correct answer)
- "The staff is very busy, but I'm sure the doctor is doing what's best for you."
- "You shouldn't feel that way; we are all working hard to help you."
- "Why are you getting so angry? It won't make the test happen any faster."
Correct answer: "I can see you are very upset. Let's talk about what is frustrating you the most."
This response uses the therapeutic techniques of acknowledging the client's feelings and offering to explore the source of their frustration. This validates their experience and keeps communication open. Defending the staff, telling the client how to feel, and asking 'why' questions are all non-therapeutic techniques that can make the client defensive and block further communication.
CPNRE - Canadian Practical Nurse Registration Examination Therapeutic Nurse-Client Relationship Questions and Answers 1
During the orientation phase of the nurse-client relationship, what is the practical nurse's primary goal?