RPN Therapeutic Nurse-Client Relationships 3 — Questions and Answers
Question 1: A client who experienced childhood abuse becomes very attached to the RPN and requests personal contact information. The nurse should FIRST:
- Acknowledge the relationship's value while clarifying professional boundaries (Correct answer)
- Immediately report the request to a supervisor and avoid further contact
- Provide a personal email address to maintain trust
- Transfer care to another nurse to prevent boundary issues
Correct answer: Acknowledge the relationship's value while clarifying professional boundaries
Acknowledging the therapeutic bond while reinforcing limits maintains safety and models healthy relational boundaries.
Question 2: Which of the following BEST describes 'transference' in the context of a therapeutic nurse-client relationship?
- The client unconsciously redirects feelings from past relationships onto the nurse (Correct answer)
- The nurse unconsciously projects personal feelings onto the client
- The client transfers medical information to a new care team
- The nurse transfers a client to a different unit for specialized care
Correct answer: The client unconsciously redirects feelings from past relationships onto the nurse
Transference occurs when clients displace emotions from significant past figures onto the nurse, which requires clinical awareness.
Question 3: An RPN notices personal feelings of irritation toward a demanding client. The MOST appropriate action is to:
- Reflect on the feelings and discuss them with a supervisor or in clinical supervision (Correct answer)
- Limit interactions with the client to avoid expressing irritation
- Tell the client that their behavior is difficult to manage
- Request an immediate reassignment to another client
Correct answer: Reflect on the feelings and discuss them with a supervisor or in clinical supervision
Countertransference must be acknowledged and processed through supervision to prevent it from affecting client care.
Question 4: Which communication technique involves repeating the last word or phrase a client uses to encourage them to continue?
- Reflection (Correct answer)
- Clarification
- Summarization
- Confrontation
Correct answer: Reflection
Reflection echoes the client's words to signal active listening and invite further exploration of their thoughts.
Question 5: A client says, 'I feel like nothing matters anymore.' The RPN responds, 'It sounds like you're feeling hopeless.' This is an example of:
- Empathic reflection (Correct answer)
- Projection
- Advice-giving
- False reassurance
Correct answer: Empathic reflection
Empathic reflection names the underlying emotion to demonstrate understanding and validate the client's experience.
Question 6: Which of the following behaviors represents a boundary violation by the RPN?
- Accepting an expensive gift from a client after discharge (Correct answer)
- Using the client's preferred name throughout care
- Disclosing that the nurse also works the night shift
- Sitting at the same level as the client during a conversation
Correct answer: Accepting an expensive gift from a client after discharge
Accepting expensive gifts from clients blurs professional limits and compromises the therapeutic relationship.
Question 7: The orientation phase of the therapeutic relationship is characterized by:
- Establishing trust, defining roles, and agreeing on goals (Correct answer)
- Implementing interventions and problem-solving
- Evaluating goal attainment and preparing for discharge
- Reviewing the nurse's own assumptions before meeting the client
Correct answer: Establishing trust, defining roles, and agreeing on goals
The orientation phase lays the relational foundation through trust-building, role clarification, and collaborative goal-setting.
RPN Therapeutic Nurse-Client Relationships 3
A client who experienced childhood abuse becomes very attached to the RPN and requests personal contact information.
The nurse should FIRST: