ATI LPN
Psychiatric Nursing: Contemporary Practice 6th Edition
Chapter 9 : Communication and the Therapeutic Relationship Questions
Question 1 of 5
The nurse is in the orientation phase of the nurse-patient relationship with a patient diagnosed with a mental disorder. When interviewing the patient during this first encounter, which information would be most important for the nurse to obtain about the patient?
Correct Answer: C
Rationale: In the orientation phase, establishing trust and understanding the patient?s perspective is critical. The patient?s perception of the problem provides insight into their mental health needs and guides the therapeutic relationship. Allergies, hospitalizations, and family history are important but secondary in this initial phase.
Question 2 of 5
A patient is a successful insurance salesman; however, because of market changes, his level of sales has dropped. His boss tells him he will consequently be receiving a $2,000 per year cut in his salary. When the patient arrives home from work, the family dog runs to greet him as he always does, barking and jumping up and down and begging for attention. The patient yells at the dog, 'Get away from me; I can?t take your barking right now.' The patient?s response reflects a defense mechanism because it was which of the following?
Correct Answer: B
Rationale: The patient?s response reflects displacement, a defense mechanism where emotions (anxiety about the pay cut) are redirected to a less threatening target (the dog). This is automatic and protects the patient from directly confronting anxiety. The response is not intentional training, avoidance of coping, or rationalization.
Question 3 of 5
Termination takes place during the resolution phase of a nurse-patient relationship. During the termination process, a patient brings up resolved problems and presents them as new issues to work toward. The nurse interprets the patient?s action as indicating which of the following?
Correct Answer: D
Rationale: Bringing up resolved issues as new problems during termination suggests the patient is reluctant to end the therapeutic relationship, a common reaction to avoid closure. Anger, need for more therapy, or perceived ineffectiveness are less likely interpretations without additional evidence.
Question 4 of 5
When engaged in a nontherapeutic relationship, which of the following would the nurse identify as occurring first?
Correct Answer: A
Rationale: A nontherapeutic relationship begins with the nurse?s failure to recognize the patient?s individual needs, undermining trust and rapport. This precedes patient avoidance, perceptions of rudeness, or feelings of hopelessness, which are outcomes of the initial failure.
Question 5 of 5
While providing care to a patient with a mental disorder, the patient asks the nurse, 'Does mental illness run in your family?' Which response by the nurse would be most inappropriate?
Correct Answer: C
Rationale: Self-disclosure, especially personal details like a family member?s mental illness, is inappropriate in therapeutic communication unless it directly benefits the patient. Option C risks shifting focus to the nurse. Other responses redirect to the patient?s concerns or provide general information, maintaining therapeutic focus.