CPNRE Therapeutic Nurse-Client Relationship 4 — Questions and Answers
Question 1: A client tells the nurse, 'I feel like you're the only one who really understands me. Can we be friends after I'm discharged?' How should the nurse respond?
- Explain that professional boundaries prevent a personal friendship but that the therapeutic relationship has value. (Correct answer)
- Accept the offer of friendship since it indicates a trusting therapeutic relationship.
- Tell the client that feelings of closeness are signs of dependency and must be addressed.
- Refer the client to another nurse to manage the boundary issue.
Correct answer: Explain that professional boundaries prevent a personal friendship but that the therapeutic relationship has value.
The nurse acknowledges the client's feelings while clearly maintaining professional boundaries and explaining the distinct nature of the therapeutic relationship.
Question 2: During a home visit, a client offers the nurse a gift of homemade cookies as a gesture of gratitude. What is the most appropriate response?
- Accept the gift graciously to avoid hurting the client's feelings.
- Decline and explain the agency's gift policy, acknowledging the client's gratitude verbally. (Correct answer)
- Accept the gift and document it in the client's chart.
- Decline without explanation to reinforce professional distance.
Correct answer: Decline and explain the agency's gift policy, acknowledging the client's gratitude verbally.
The nurse follows agency policy on gifts, validates the client's intent, and maintains the therapeutic relationship by acknowledging gratitude in other ways.
Question 3: Which behavior best demonstrates the nurse's use of empathy in the therapeutic relationship?
- Telling the client, 'I know exactly how you feel because I went through the same thing.'
- Saying, 'It sounds like this situation has been very overwhelming for you.' (Correct answer)
- Assuring the client that everything will be fine.
- Changing the subject when the client becomes emotional.
Correct answer: Saying, 'It sounds like this situation has been very overwhelming for you.'
Empathy involves reflecting the client's emotional experience accurately without projecting personal feelings or offering false reassurance.
Question 4: A nurse notices personal feelings of frustration when caring for a non-compliant client. What is the most therapeutic action?
- Transfer care of the client to a colleague.
- Reflect on the feelings and seek supervision or peer support to maintain professional care. (Correct answer)
- Remind the client that non-compliance makes the nurse's job difficult.
- Ignore the feelings and continue care as usual.
Correct answer: Reflect on the feelings and seek supervision or peer support to maintain professional care.
Self-awareness and use of supervision are essential to prevent countertransference from compromising the therapeutic relationship.
Question 5: A client with depression refuses to participate in group therapy. Which response best upholds the therapeutic relationship while supporting autonomy?
- Insist the client attend since it is part of the care plan.
- Explore the client's concerns about group therapy and discuss alternatives together. (Correct answer)
- Document the refusal and take no further action.
- Inform the client that refusal will delay discharge.
Correct answer: Explore the client's concerns about group therapy and discuss alternatives together.
Exploring the client's perspective respects autonomy and keeps communication open within the therapeutic relationship.
Question 6: Which phase of the therapeutic relationship involves establishing trust, clarifying roles, and setting mutual goals?
- Termination phase
- Working phase
- Orientation phase (Correct answer)
- Evaluation phase
Correct answer: Orientation phase
The orientation phase focuses on establishing rapport, clarifying the nurse and client roles, and collaboratively setting goals for the relationship.
Question 7: A nurse is preparing for the termination phase with a long-term client. Which action is most important?
- Avoid discussing the ending to prevent causing distress.
- Begin planning for termination well in advance and discuss the client's feelings about it. (Correct answer)
- Introduce a new nurse without informing the current client.
- Encourage the client to stay in contact after discharge.
Correct answer: Begin planning for termination well in advance and discuss the client's feelings about it.
Anticipatory planning and open discussion of termination help the client process the transition and consolidate gains from the therapeutic work.
CPNRE Therapeutic Nurse-Client Relationship 4
A client tells the nurse, 'I feel like you're the only one who really understands me.
Can we be friends after I'm discharged?' How should the nurse respond?