Chapter 7: Relationship Development

Question 1

attitude

Answer 1

a frame of reference around which an individual organizes knowledge about his or her world.

Question 2

belief

Answer 2

An idea that one holds to be true. Only when the belief is acted on does it become a value.

Question 3

7 Nurse subroles

Answer 3

The Stranger
The Resource Person
The Teacher
The Leader
The Surrogate
The Technical Expert
The Counselor

Question 4

The Stranger

Answer 4

A nurse is at first a stranger to the client. The client is also a stranger to the nurse.

Question 5

The Resource Person

Answer 5

The nurse provides information related to the client’s health care.

Question 6

The Teacher

Answer 6

The nurse identifies learning needs and provides information required by the client or family to improve the health situation.

Question 7

The Leader

Answer 7

Democratic leadership in nursing situations implies that the patient will be permitted to be an active participant in designing nursing plans for him.
Autocratic leadership promotes overvaluation of the nurse and clients’ substitution of the nurse’s goals for their own.
Laissez-faire leaders convey a lack of personal interest in the client.

Question 8

The Surrogate

Answer 8

For the client, the nurse fulfills basic needs, which is associated with mothering.

Question 9

The Technical Expert

Answer 9

The nurse possesses the clinical skills necessary to perform the interventions that are in the client’s best interest.

Question 10

The Counselor

Answer 10

The nurse uses “interpersonal techniques” to help clients learn to adapt to difficulties or changes in life experiences.

Question 11

nurse therapist

Answer 11

having graduate preparation in psychiatric/mental health nursing

Question 12

values

Answer 12

abstract standards, positive or negative, that represent an individual’s ideal mode of conduct and ideal goals.

Question 13

therapeutic use of self

Answer 13

the ability to use one’s personality consciously and in full awareness in an attempt to establish relatedness and to structure nursing intervention

Question 14

value system

Answer 14

Established very early in life by the primary caregivers. It is culturally oriented; it may change; and it consists of beliefs, attitudes, and values.

Question 15

Rational beliefs

Answer 15

Ideas for which objective evidence exists to substantiate their truth.

Question 16

Irrational beliefs

Answer 16

Ideas held as true despite the existence of objective contradictory evidence. Delusions can be a form of irrational beliefs.

Question 17

Faith “blind beliefs”

Answer 17

An ideal that an individual holds as true for which no objective evidence exists.

Question 18

Stereotype

Answer 18

A socially shared belief that describes a concept in an oversimplified or undifferentiated matter.

Question 19

The Open or Public Self

Answer 19

aspects of the self about which both the individual and others are aware.

Question 20

The Unknowing Self

Answer 20

the part of the self that is known to others but remains hidden from the awareness of the individual.

Question 21

The Private Self

Answer 21

the part of the self that is known to the individual, but which the individual deliberately and consciously conceals from others.

Question 22

The Unknown Self

Answer 22

the part of the self that is unknown to both the individual and to others.

Question 23

Rapport

Answer 23

implies special feelings on the part of both the client and the nurse based on acceptance, warmth, friendliness, common interest, a sense of trust, and a non- judgmental attitude

Question 24

Trust

Answer 24

feel confidence in that person’s presence, reliability, integrity, veracity, and sincere desire to provide assistance when requested

Question 25

self- confidence

Answer 25

derived out of knowledge gained through achievement of personal and professional goals, as well as the ability to integrate these roles and to function as a unified whole.

Question 26

concrete thinking

Answer 26

focuses thought processes on specifics rather than generalities, and immediate issues rather than eventual outcomes

Question 27

confidentiality

Answer 27

what is discussed will not be repeated outside the boundaries of the health-care team

Question 28

unconditional positive regard

Answer 28

believe in the dignity and worth of an individual regardless of his or her unacceptable behavior

Question 29

genuineness

Answer 29

nurse’s ability to be open, honest, and “real” in interactions with the client

Question 30

congruence

Answer 30

Consistence

Question 31

self-disclosure

Answer 31

It should never be undertaken for the purpose of meeting the nurse’s needs.

Question 32

4 Phases of Relationship Development

Answer 32

(1) the preinteraction phase
(2) the orientation (introductory) phase
(3) the working phase
(4) the termination phase

Question 33

Preinteraction phase

Answer 33

Obtain information about the client from chart, significant others, or other health team members.
Examine one’s own feelings, fears, and anxieties about working with a particular client.

Question 34

working phase

Answer 34

Maintain trust and rapport.
Promote client’s insight and perception of reality.
Use problem-solving model to work toward achievement of established goals.
Overcome resistance behaviors.
Continuously evaluate progress toward goal attainment.

Question 35

termination phase

Answer 35

Therapeutic conclusion of relationship occurs when:
Progress has been made toward attainment of the goals.
A plan of action for more adaptive coping with future stressful situations has been established.
Feelings about termination of the relationship are recognized and explored.

Question 36

Transference

Answer 36

occurs when the client unconsciously transfers to the nurse feelings formed toward a person from his or her past

Question 37

boundary

Answer 37

border or a limit

Question 38

Material boundaries

Answer 38

physical property that can be seen, such as fences that border land

Question 39

Countertransference

Answer 39

refers to the nurse’s behavioral and emotional response to the client. These responses may be related to unresolved feelings toward significant others from the nurse’s past, or they may be generated in response to transference feelings on the part of the client.

Question 40

Personal boundaries

Answer 40

boundaries that individuals define for themselves.

Question 41

Professional boundaries

Answer 41

limit and outline expectations for appropriate professional relationships with clients

Question 42

Gift-giving

Answer 42

Attention should be given to what the gift-giving means to the client, as well as to institutional policy

Question 43

Touch

Answer 43

when it is used appropriately, it can have a therapeutic effect on the client

Question 44

Friendship or romantic association

Answer 44

If the nurse is unable to accomplish this separation, he or she should withdraw from the nurse-client relationship

Question 45

Gift-giving

Answer 45

Attention should be given to what the gift-giving means to the client, as well as to institutional policy.

Question 46

Touch

Answer 46

Be aware of the meaning to the patient and the patient’s culture. When it is used appropriately, it can have a therapeutic effect on the client

Question 47

Friendship or romantic association

Answer 47

If the nurse is unable to accomplish a separation, he or she should withdraw from the nurse-client relationship

Question 48

Concerns associated with professional boundaries

Answer 48

self-disclosure
gift-giving
touch
developing a friendship or romantic association

Question 49

breach of professional boundaries

Answer 49

The nurse repeatedly requests to be assigned to a specific client.
The nurse shares the details of her divorce with the client.
The nurse makes arrangements to meet the client outside of the therapeutic environment.

Question 50

orientation phase

Answer 50

Creating an environment for the establishment of trust and rapport.
Establish contract for intervention.
Gather assessment data.
Identify client’s strengths and weaknesses.

Question 51

therapeutic relationship

Answer 51

an interaction between two people (usually a caregiver and a care receiver) in which input from both participants contributes to a climate of healing, growth promotion, and illness prevention.