RPN Therapeutic Nurse-Client Relationships 5 — Questions and Answers
Question 1: An RPN is preparing to meet a new client with a history of violent behavior. During the pre-interaction phase, the nurse should:
- Examine personal biases and anxieties to prevent them from affecting care (Correct answer)
- Review only the medical chart and skip psychological preparation
- Arrange for security to be present during the first meeting
- Ask a colleague to conduct the initial interaction instead
Correct answer: Examine personal biases and anxieties to prevent them from affecting care
The pre-interaction phase requires the nurse to reflect on personal reactions that could interfere with therapeutic engagement.
Question 2: A client states, 'I don't want to talk about my past.' The RPN should respond by:
- Respecting the limit and exploring what the client is willing to discuss (Correct answer)
- Explaining that discussing the past is necessary for effective treatment
- Documenting the client's refusal and ending the session
- Gently persisting because disclosure is therapeutic
Correct answer: Respecting the limit and exploring what the client is willing to discuss
Respecting boundaries demonstrates that the nurse values the client's autonomy, which itself builds therapeutic trust.
Question 3: Which of the following is an example of a non-therapeutic communication technique?
- Giving false reassurance such as, 'Everything will work out fine.' (Correct answer)
- Using open-ended questions to invite exploration
- Restating the client's words to confirm understanding
- Using silence to allow the client time to think
Correct answer: Giving false reassurance such as, 'Everything will work out fine.'
False reassurance dismisses the client's concerns and blocks genuine exploration of fears or needs.
Question 4: A client who has been making progress suddenly says, 'There's no point in continuing; I'll never get better.' The RPN should:
- Acknowledge the discouragement and explore what triggered the change in outlook (Correct answer)
- Remind the client of the progress already made to restore motivation
- Adjust the treatment goals to be less demanding
- Notify the physician that the client is non-compliant with therapy
Correct answer: Acknowledge the discouragement and explore what triggered the change in outlook
Exploring the trigger for hopelessness provides therapeutically useful information and validates the client's current experience.
Question 5: The therapeutic technique of 'confrontation' is MOST appropriately used to:
- Point out discrepancies between what a client says and what they do (Correct answer)
- Challenge the client's beliefs when the nurse disagrees
- Insist the client acknowledge maladaptive behavior
- Correct misinformation provided to the care team
Correct answer: Point out discrepancies between what a client says and what they do
Therapeutic confrontation highlights inconsistencies to promote client insight without blame or judgment.
Question 6: To promote a therapeutic environment, the RPN should schedule client interactions:
- At consistent, pre-agreed times to build trust and predictability (Correct answer)
- Only when the client requests contact to respect autonomy
- Randomly throughout the shift to observe natural behavior
- Immediately after medications are given for maximum cooperation
Correct answer: At consistent, pre-agreed times to build trust and predictability
Consistency and predictability in scheduling reinforce safety and trust, foundational elements of therapeutic relationships.
Question 7: Which of the following BEST describes the nurse's role during the working phase of the therapeutic relationship?
- Collaborating with the client to implement interventions and evaluate progress toward goals (Correct answer)
- Introducing oneself and establishing the purpose and expectations of the relationship
- Reviewing accomplishments and facilitating the client's transition to independence
- Gathering data and reviewing the client's health history before the first meeting
Correct answer: Collaborating with the client to implement interventions and evaluate progress toward goals
The working phase is action-oriented, centered on implementing planned interventions and continuously evaluating outcomes.
RPN Therapeutic Nurse-Client Relationships 5
An RPN is preparing to meet a new client with a history of violent behavior.
During the pre-interaction phase, the nurse should: