Psychiatric Nursing Chapter 5 Quiz
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Questions and Answers

What type of distance is considered appropriate for conversations with acquaintances?

  • Intimate distance
  • Social distance (correct)
  • Public distance
  • Personal distance

Which location is most suitable for meeting a patient exhibiting hostility?

  • A quiet corner of the day room (correct)
  • The patient’s room with the door shut
  • The unit’s treatment room
  • The nurse’s station

Which component of nonverbal communication involves how a person appears physically?

  • Physical appearance and dress (correct)
  • Body movement and posture
  • Vocal cues or paralanguage
  • Facial expressions

What therapeutic communication technique involves allowing the patient to take control of the discussion?

<p>Using silence (C)</p> Signup and view all the answers

Which distance is used for speaking to someone from a significant distance away?

<p>Public distance (B)</p> Signup and view all the answers

Which therapeutic communication technique focuses on acknowledging a patient's presence?

<p>Giving recognition (C)</p> Signup and view all the answers

What body language sign relates closely to a person's posture and movements?

<p>Body movement and posture (B)</p> Signup and view all the answers

Which of the following is NOT considered a component of nonverbal communication?

<p>Written words (B)</p> Signup and view all the answers

What therapeutic communication technique involves asking a patient to compare similarities and differences?

<p>Encouraging comparison (B)</p> Signup and view all the answers

Which technique involves putting into words what the patient has only implied?

<p>Verbalizing the implied (D)</p> Signup and view all the answers

Which therapeutic communication technique focuses on clarifying misconceptions expressed by the patient?

<p>Presenting reality (B)</p> Signup and view all the answers

Which technique encourages a patient to verbalize their thoughts or experiences further?

<p>Exploring (B)</p> Signup and view all the answers

Which communication method is used to validate and clarify vague statements made by a patient?

<p>Seeking clarification and validation (D)</p> Signup and view all the answers

What technique directs the patient's feelings back to them for recognition?

<p>Reflecting (D)</p> Signup and view all the answers

Which therapeutic technique assists patients in acknowledging their feelings expressed indirectly?

<p>Attempting to translate words into feelings (B)</p> Signup and view all the answers

What does 'focusing' in therapeutic communication entail?

<p>Taking notice of a single idea or word (B)</p> Signup and view all the answers

What is the primary foundation of psychiatric nursing?

<p>The nurse-patient relationship (B)</p> Signup and view all the answers

Which of the following best describes the therapeutic nurse-patient relationship?

<p>It is based on mutual learning. (D)</p> Signup and view all the answers

In therapeutic relationships, goals are typically achieved through which model?

<p>Problem-solving model (B)</p> Signup and view all the answers

What is the role of 'therapeutic use of self' in nursing?

<p>It enhances care delivery. (A)</p> Signup and view all the answers

Which is NOT a step in the problem-solving model used in therapeutic relationships?

<p>Assess medical history extensively (B)</p> Signup and view all the answers

Why is it important for both the nurse and patient to view each other as unique individuals?

<p>To achieve mutual needs satisfaction (A)</p> Signup and view all the answers

What is a potential outcome when positive feedback is provided to a patient during treatment?

<p>It encourages patient empowerment. (D)</p> Signup and view all the answers

What is a key aspect of promoting growth in therapeutic relationships?

<p>Encouraging healthy coping strategies (D)</p> Signup and view all the answers

Which nontherapeutic communication technique can make a patient feel insignificant?

<p>Belittling feelings expressed (D)</p> Signup and view all the answers

What is the effect of defending a patient's criticism?

<p>It implies the patient cannot express feelings. (A)</p> Signup and view all the answers

Which technique involves pushing for answers to topics a patient is unwilling to discuss?

<p>Probing (D)</p> Signup and view all the answers

What impact do closed-ended questions have during a patient assessment?

<p>They provide minimal information. (C)</p> Signup and view all the answers

Why should a nurse avoid requesting an explanation from a patient?

<p>It implies the patient must defend their actions. (D)</p> Signup and view all the answers

What is a potential consequence of introducing an unrelated topic during a discussion with a patient?

<p>It shifts focus from the patient's issues. (C)</p> Signup and view all the answers

Which of the following techniques helps the nurse to gather comprehensive information from the patient?

<p>Open-ended questions (D)</p> Signup and view all the answers

What is the main drawback of making stereotyped comments and clichés during patient interactions?

<p>They are seen as meaningless by patients. (B)</p> Signup and view all the answers

What is the primary focus during the working phase of the nurse-patient relationship?

<p>Promoting the patient’s insight and perception of reality (D)</p> Signup and view all the answers

Which of the following best describes transference in a therapeutic nurse-patient relationship?

<p>Patient expressing feelings towards the nurse based on past relationships (B)</p> Signup and view all the answers

What is a primary goal in the termination phase of the nurse-patient relationship?

<p>To explore feelings about the relationship ending (B)</p> Signup and view all the answers

In the context of countertransference, which of the following accurately describes the nurse's behavior?

<p>The nurse's personal feelings affecting their response to the patient (C)</p> Signup and view all the answers

What should the nurse focus on in the preinteraction phase of the nurse-patient relationship?

<p>Clarifying their personal beliefs and attitudes (C)</p> Signup and view all the answers

Which action is NOT appropriate for the nurse to take when dealing with resistance behaviors in patients?

<p>Ignore the resistance to maintain a therapeutic environment (D)</p> Signup and view all the answers

When a patient expresses threats of self-harm and harm to others, what should be prioritized in the nurse-patient relationship?

<p>Developing a safety plan for the patient (A)</p> Signup and view all the answers

In the therapeutic relationship, how should ongoing progress toward goal achievement be approached?

<p>With continuous evaluation and adjustments (D)</p> Signup and view all the answers

What is the most supportive response a nurse can give to a patient expressing fear for their safety?

<p>This is a difficult transition. Let's formulate a plan to keep you all safe in the community. (C)</p> Signup and view all the answers

Which communication technique involves downplaying a patient's feelings and could discourage them from expressing further emotions?

<p>Giving false reassurance (B)</p> Signup and view all the answers

What does the technique of 'rejecting' imply in nurse-patient communication?

<p>The nurse refuses to acknowledge the patient's feelings. (C)</p> Signup and view all the answers

Which statement exemplifies 'giving advice' in nontherapeutic communication?

<p>You should definitely seek more help. (C)</p> Signup and view all the answers

Which nursing action exemplifies a nontherapeutic approach by passing judgment on a patient's behavior?

<p>I disapprove of how you handled that. (D)</p> Signup and view all the answers

What impact does agreeing or disagreeing have on the nurse-patient relationship?

<p>It establishes the nurse's authority over the patient's opinions. (B)</p> Signup and view all the answers

Which therapeutic technique is aimed at promoting a patient's self-direction?

<p>Asking open-ended questions (B)</p> Signup and view all the answers

What is the effect of a nurse using 'approving or disapproving' techniques with a patient?

<p>It enables the patient to feel judged and restricted. (B)</p> Signup and view all the answers

Flashcards

Offering general leads

Encouraging the patient to expand on their thoughts or feelings.

Placing events in time or sequence

Putting events in order to understand their relationship to each other.

Making observations

Stating what you see or hear.

Encouraging description of perceptions

Asking the patient to describe what they are sensing.

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Encouraging comparison

Asking the patient to compare and contrast ideas, experiences, or relationships.

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Restating

Repeating the patient's words to confirm understanding.

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Reflecting

Reflecting the patient's feelings back to them for recognition and acceptance.

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Focusing

Focusing on a specific idea or even a single word.

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Intimate Distance

The closest distance people feel comfortable with during interactions. Think of cuddling or whispering.

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Personal Distance

The distance ideal for personal conversations and interactions between family or close friends. Think of talking to a loved one at home.

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Social Distance

The distance for interactions with acquaintances or colleagues. Think of talking to someone at a party.

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Public Distance

The farthest distance you'd use to communicate and maintain privacy in a public space. Think of a presentation or giving instructions to a group.

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Nonverbal Communication

Any non-verbal cues like facial expressions, body language or tone of voice that communicate meaning.

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Therapeutic Communication Techniques

Strategies used to facilitate positive and constructive interactions. Think of active listening and showing empathy.

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Using Silence

Using silence during a conversation, allowing the patient to lead the discussion and feel in control.

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Accepting

Demonstrating acceptance and positive regard towards patients.

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Therapeutic Communication

A type of communication where the nurse expresses understanding, empathy, and support without judgment or advice.

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False Reassurance

A technique used to assure a patient without evidence. It can minimize and disregard the patient's true feelings and perceptions.

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Rejecting (Communication)

When a nurse disregards the patient's thoughts, feelings, or opinions.

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Approving/Disapproving (Communication)

Describes the act of passing judgment on the patient's behavior.

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Agreeing/Disagreeing (Communication)

A technique where the nurse indicates agreeing or disagreeing with the patient's ideas or opinions.

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Giving Advice (Communication)

When the nurse takes control of the situation by suggesting a specific action without exploring the patient's perspective.

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Reflection (Communication)

A communication technique where the nurse reflects on the patient's feelings and encourages them to express themselves.

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Formulating a Plan of Action

A communication technique where the nurse collaborates with the patient to develop a plan.

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Working Phase

The phase in a therapeutic nurse-patient relationship where the nurse and patient work together to achieve established goals.

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Transference

The unconscious transfer of feelings or behaviors from a past relationship to the current relationship with the nurse.

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Countertransference

The nurse's emotional and behavioral responses to the patient, often influenced by the nurse's own experiences and subconscious.

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Termination Phase

The final phase of a therapeutic nurse-patient relationship, focusing on concluding the relationship, ensuring progress towards goals, and preparing the patient for independent functioning.

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Preinteraction Phase

The phase in which the nurse prepares for the initial interaction with the patient. This involves self-reflection and identifying potential biases that may affect the nurse's ability to care for the patient.

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Patient Insight

The patient's ability to understand their own thoughts, feelings, and behaviors, and how they impact their environment.

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Patient Perception of Reality

The patient's perception of reality, encompassing their understanding and interpretation of their situation, experiences, and relationships.

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Problem-Solving Model

Using a structured, step-by-step approach to solve problems and achieve goals.

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Probing

Pushing for answers on topics the patient doesn't want to discuss, making them feel used and only valued for the information shared.

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Defending

Defending against a patient's criticism implies they can't express their thoughts or feelings.

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Requesting an explanation

Asking 'Why?' puts pressure on the patient to justify their behavior or emotions.

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Indicating an external source of power

Suggesting the cause of a patient's thoughts or behaviors lies outside themselves, encouraging blame-shifting.

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Belittling feelings expressed

Making the patient feel insignificant and unimportant by minimizing their emotions.

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Stereotyped comments, clichés, and trite expressions

Using common phrases or clichés that are meaningless in a therapeutic relationship.

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Using denial

Shutting down discussion and preventing exploration of difficult areas by dismissing the patient's reality.

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Interpreting

Offering interpretations of the patient's experience, which can come across as judgmental or dismissive.

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Therapeutic nurse-patient relationship

The connection between a nurse and patient where both individuals gain through shared learning experiences.

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Therapeutic use of self

The capacity of a nurse to use their unique traits and skills to help patients succeed.

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Interpersonal communication techniques

Verbal and nonverbal techniques that nurses utilize to guide patients toward a healthy resolution.

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Viewing the patient as a unique human being

Involves recognizing and openly acknowledging a patient's unique qualities and worth.

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Identify what is troubling the patient

The nurse helps the patient identify their own difficulties and initiate open communication.

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Promote discussion of desired changes

Focuses on understanding the patient's aspirations and assisting them in achieving these goals.

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Discuss alternative strategies for creating changes

The step where the nurse and patient work together to discover feasible alternatives.

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Study Notes

Chapter 5: Relationship Development and Therapeutic Communication

  • Psychiatric nursing is built on the nurse-patient relationship.
  • A therapeutic interpersonal relationship is the process where nurses provide care for patients needing psychosocial intervention.
  • Mutual learning occurs in this relationship.
  • Therapeutic use of self is the instrument for delivering psychosocial care.
  • Interpersonal communication techniques are the tools of psychosocial intervention.

The Therapeutic Nurse-Patient Relationship

  • Therapeutic relationships only occur when both participants view each other as unique human beings.
  • Both participants' needs are met within the relationship.
  • These relationships are goal-oriented and focus on learning and growth promotion.
  • Goals are achieved through the problem-solving model.

The Problem-Solving Model

  • Identify the patient's concerns.
  • Encourage discussion of desired changes.
  • Discuss aspects that can't realistically be changed and adaptive coping strategies.
  • Discuss alternative strategies for creating desired change.
  • Weigh the benefits and consequences of each alternative.
  • Guide the patient to select an alternative.
  • Encourage the patient to implement the change.
  • Provide positive feedback for the patient's change attempts.
  • Help the patient evaluate the change's outcome and adjust as needed.

Therapeutic Use of Self

  • Using one's personality consciously and with full awareness to create relatedness.
  • Nurses must demonstrate self-awareness, self-understanding, and their philosophy of life, death and the human condition.

Conditions Essential to Development of a Therapeutic Relationship

  • Rapport
  • Trust
  • Respect
  • Genuineness
  • Empathy

Phase 1: Preinteraction Phase

  • Gather information about the patient from the chart, significant others, or other health team members.
  • Examine one's own feelings, fears, and anxieties about working with a particular patient.

Phase 2: Orientation Phase

  • Create an environment for trust and rapport.
  • Establish a contract for intervention.
  • Gather assessment data.
  • Identify the patient's strengths and limitations.
  • Formulate nursing diagnoses.
  • Set mutually agreeable goals.
  • Develop a realistic plan of action.
  • Explore the feelings of both the patient and the nurse.

Phase 3: Working Phase

  • Maintain trust and rapport.
  • Promote the patient's insight and perception of reality.
  • Follow the problem-solving model for goal achievement.
  • Overcome resistance behaviors.
  • Continuously evaluate progress toward goal attainment.
  • Transference: Patient unconsciously displaces feelings from the past onto the nurse.
  • Countertransference: The nurse's response (behavioral and emotional) to the patient.

Phase 4: Termination Phase

  • Therapeutic conclusion of the relationship occurs when progress has been made towards goals, a plan is in place for continued care and coping during stressful situations, and feelings about termination are acknowledged and explored..

Clicker Question 1

  • The primary nursing goal when establishing a therapeutic relationship with a patient is to promote patient growth.

Clicker Question 2

  • The appropriate preinteraction action for a patient threatening self-harm is to explore personal thoughts and feelings that may affect care provision.

Clicker Question 3

  • The most appropriate location for a meeting with a patient exhibiting hostility is a quiet corner of the day room.

Clicker Question 4

  • The most supportive nursing statement for a battered wife fearing a move-out is to formulate a plan for her safety.

Clicker Question 5

  • When obtaining patient data, open-ended questions facilitate accurate and complete information.

Interpersonal Communication

  • A transaction between sender and receiver, both participating simultaneously.
  • Both participants perceive and listen to each other and engage in creating meaning in the relationship.

Impact of Preexisting Conditions

  • Values, attitudes, and beliefs, shaped by learned ways of thinking, influence communication.
  • Culture and religion provide a foundation for thought and action.
  • Social status, gender, age, and developmental level can shape communication style.
  • Communication is also affected by the environment, with territory, density, and distance playing roles. (Intimate distance, personal distance, social distance, public distance)

Nonverbal Communication

  • Components of nonverbal communication include physical appearance, body movement/posture, touch, facial expressions, eye behavior, and vocal cues/paralanguage.

Therapeutic Communication Techniques

  • Using silence, accepting, giving recognition, offering self, giving broad openings.
  • Offering general leads, placing events in time, making observations, encouraging perceptions description, encouraging comparisons, restating, reflecting.
  • Focusing, exploring, seeking clarification and validation, presenting reality, voicing doubt, verbalizing the implied, attempting to translate words into feelings, formulating a plan of action.

Nontherapeutic Communication Techniques

  • Giving false reassurance, rejecting, approving/disapproving, agreeing/disagreeing, giving advice, probing, defending, requesting explanation, indicating external power, belittling feelings, making stereotyped comments.
  • Using denial, interpreting, introducing unrelated topics

Active Listening

  • Active listening involves paying attention to both verbal and nonverbal cues.
  • Nonverbal behaviors, such as sitting squarely facing the patient, observing an open posture, leaning forward, establishing eye contact, and relaxing, facilitate listening.

Motivational Interviewing

  • A patient-centered style of communication promoting behavioral changes.
  • It guides the patient to explore their motivation and the advantages/disadvantages of their decisions.
  • It uses active listening and therapeutic communication techniques.

Process Recordings

  • Written reports of verbal nurse-patient interactions.
  • Used as a tool to improve communication techniques.

Feedback

  • Descriptive rather than evaluative.
  • Specific rather than general.
  • Directed toward modifiable behavior.
  • Imparts information rather than offers advice.
  • Well-timed.

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Chapter 5 Relationship Development and Therapeutic Communication PDF

Description

Test your knowledge on the principles of relationship development and therapeutic communication in psychiatric nursing. This quiz covers key aspects like the therapeutic nurse-patient relationship and the problem-solving model. Assess your understanding of interpersonal communication techniques that facilitate psychosocial care.

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