RPN Therapeutic Nurse-Client Relationships 4 — Questions and Answers
Question 1: A culturally diverse client avoids direct eye contact during conversation. The RPN should:
- Recognize this as potentially culturally appropriate and adapt accordingly (Correct answer)
- Document the behavior as a sign of depression
- Encourage the client to make eye contact to improve communication
- Consult psychiatry about possible dissociative symptoms
Correct answer: Recognize this as potentially culturally appropriate and adapt accordingly
Eye contact norms vary by culture; imposing Western communication standards can undermine trust and misrepresent behavior.
Question 2: Which of the following is an example of the therapeutic technique 'offering general leads'?
- "Go on" or "Tell me more." (Correct answer)
- "Why did you make that decision?"
- "You seem angry about what happened."
- "Let me explain what I think is best for you."
Correct answer: "Go on" or "Tell me more."
General leads use brief prompts to encourage the client to continue without directing or interrupting their train of thought.
Question 3: A client with anxiety repeatedly seeks reassurance from the RPN throughout the shift. The MOST therapeutic response is to:
- Set consistent limits while helping the client identify anxiety-management strategies (Correct answer)
- Provide frequent reassurance to decrease the client's distress
- Ignore the reassurance-seeking to extinguish the behavior
- Delegate the client to a psychiatric nurse immediately
Correct answer: Set consistent limits while helping the client identify anxiety-management strategies
Repeated reassurance reinforces anxiety-driven cycles; teaching coping strategies addresses the underlying need.
Question 4: The nurse's use of 'self-disclosure' in a therapeutic context is BEST described as:
- Sharing brief, purposeful personal information only when it benefits the client (Correct answer)
- Discussing personal life events to make the client feel comfortable
- Avoiding any mention of the nurse's personal life under all circumstances
- Revealing feelings of frustration when a client is non-compliant
Correct answer: Sharing brief, purposeful personal information only when it benefits the client
Therapeutic self-disclosure is selective and intentional, used to normalize or illustrate a point that advances client goals.
Question 5: When terminating the therapeutic relationship, a client regresses to earlier maladaptive behaviors. The RPN should FIRST:
- Acknowledge the behavior, link it to termination anxiety, and continue the closure process (Correct answer)
- Extend the relationship indefinitely to prevent the client from feeling abandoned
- Document non-compliance and notify the care team
- Refer the client to a psychiatrist for regression management
Correct answer: Acknowledge the behavior, link it to termination anxiety, and continue the closure process
Regression at termination is common; naming the connection to ending helps the client process and integrate the experience.
Question 6: A client asks the RPN, 'Am I the sickest patient you've had?' The BEST therapeutic response is:
- "I'm wondering what makes you ask that question." (Correct answer)
- "No, I've had much sicker patients than you."
- "Yes, your situation is quite serious."
- "I'm not allowed to discuss other patients."
Correct answer: "I'm wondering what makes you ask that question."
Exploring the meaning behind the question is more therapeutically useful than answering at face value.
Question 7: Which of the following BEST illustrates the concept of 'empathy' rather than 'sympathy' in nursing?
- "I can hear how frightening this diagnosis must feel for you." (Correct answer)
- "I feel so sorry for everything you're going through right now."
- "I know exactly how you feel — I lost someone too."
- "Don't worry; many people go through this and do just fine."
Correct answer: "I can hear how frightening this diagnosis must feel for you."
Empathy communicates understanding of the client's experience from their perspective without merging with or minimizing it.
RPN Therapeutic Nurse-Client Relationships 4
A culturally diverse client avoids direct eye contact during conversation.
The RPN should: