RPN Therapeutic Nurse-Client Relationships 2 — Questions and Answers
Question 1: A client becomes tearful and says, 'Nobody cares if I live or die.' Which response by the RPN best demonstrates therapeutic communication?
- "That must be a very lonely feeling. Can you tell me more about what's been happening?" (Correct answer)
- "Of course people care about you — your family is right outside."
- "You shouldn't feel that way; things will get better soon."
- "I care about you, and I'm sure your friends do too."
Correct answer: "That must be a very lonely feeling. Can you tell me more about what's been happening?"
Reflecting the feeling and inviting elaboration acknowledges the client's experience without dismissing or minimizing it.
Question 2: Which behavior by the RPN is MOST likely to undermine the therapeutic relationship?
- Sharing personal opinions about the client's life choices (Correct answer)
- Maintaining consistent scheduling of interactions
- Using silence when the client pauses to reflect
- Summarizing what the client has shared at the end of a conversation
Correct answer: Sharing personal opinions about the client's life choices
Offering unsolicited personal opinions shifts the focus to the nurse's values, breaching professional boundaries and client autonomy.
Question 3: A client refuses to speak during a scheduled session. The MOST appropriate RPN action is to:
- Sit quietly with the client and indicate availability without pressure (Correct answer)
- Remind the client that participation is required for discharge
- Leave the room and document the client as non-compliant
- Ask closed-ended questions to prompt engagement
Correct answer: Sit quietly with the client and indicate availability without pressure
Maintaining a non-pressured presence communicates acceptance and keeps the therapeutic space open for the client.
Question 4: The concept of 'unconditional positive regard' in the therapeutic relationship means the nurse:
- Accepts the client as a person of worth regardless of behavior (Correct answer)
- Agrees with all decisions the client makes
- Avoids setting any behavioral limits during interactions
- Praises the client at every session to build confidence
Correct answer: Accepts the client as a person of worth regardless of behavior
Unconditional positive regard means valuing the client intrinsically without making acceptance contingent on behavior or compliance.
Question 5: Which phase of the nurse-client relationship involves mutually identifying problems and setting goals?
- Working phase (Correct answer)
- Orientation phase
- Termination phase
- Pre-interaction phase
Correct answer: Working phase
The working phase is when the nurse and client collaborate on goal-directed problem solving and therapeutic work.
Question 6: A client asks the RPN, 'Do you think I should leave my husband?' The BEST therapeutic response is:
- "That's a significant decision. What are your thoughts about it?" (Correct answer)
- "Based on what you've told me, leaving sounds like the safer choice."
- "I can't give you personal advice, so let's change the subject."
- "Most people in your situation would consider leaving."
Correct answer: "That's a significant decision. What are your thoughts about it?"
Redirecting the question back to the client promotes autonomy and avoids imposing the nurse's values.
Question 7: During which phase of the therapeutic relationship is the nurse most focused on reviewing accomplishments and managing feelings about ending?
- Termination phase (Correct answer)
- Working phase
- Orientation phase
- Pre-interaction phase
Correct answer: Termination phase
The termination phase involves evaluating goal achievement and addressing the client's emotional response to ending the relationship.
RPN Therapeutic Nurse-Client Relationships 2
A client becomes tearful and says, 'Nobody cares if I live or die.' Which response by the RPN best demonstrates therapeutic communication?