Exam 1: week 2

Question 1

What is the best treatment for most psychiatric problems

Answer 1

A combination of medications and psychotherapy

Question 2

Can basic RNs work in psychotherapy

Answer 2

No, basic RNs do counseling
advanced practice RNs can do psychotherapy

Question 3

What are the three types of relationships

Answer 3

Social
Intimate
Therapeutic

Question 4

What is a social relationship

Answer 4

Initiated for the purpose of friendship, socialization, enjoyment, or accomplishment of a task
- not helpful to your patients
- mutual needs are met
- uses small talk

Question 5

What is a therapeutic relationship

Answer 5

Needs of patient identified and explored
- Clear boundaries established
- Problem-solving approaches taken
- New coping skills developed
- Behavioral change encouraged

Question 6

What are boundaries

Answer 6

The expected legal, ethical, and professional standards that separate nurses from patients

Question 7

Why are boundaries so important in the nurse- patient relationship

Answer 7

• protects patients
• ensures patient confidentiality

Question 8

What is considered boundary crossing

Answer 8

• when the relationship crosses over into a personal context
• when the nurses needs are met at the expense of the patient

Question 9

How does one determine their values and beliefs

Answer 9

• reflects ones culture/subculture
• derived from a range of choices
• chosen from many role models and influences

Question 10

What are the phases of Peplau’s nurse-patient relationship model

Answer 10

• preorientation phase
• orientation phase
• working phase
• termination phase

Question 11

What is happening during the preorientation phase

Answer 11

1. Develop self awareness
2. Prepare for your assignment
   - research patients history
   - set ground rules before the first meeting

Question 12

What is happening during the orientation phase

Answer 12

First meeting with patient
- establish rapport
- set parameters of relationship
- formal/informal contract
- confidentiality
- terms of termination

Question 13

What is happening during the working phase

Answer 13

• gather more data
• promote problem solving skills and self-esteem
• change behavior
• evaluate problems and goals

Question 14

What is happening during the termination phase

Answer 14

• summarize goals
• incorporate learned healthy behaviors into real life

Question 15

What are attending behaviors

Answer 15

A special kind of listening that means just being with the patient during a difficult time; this includes:
- eye contact
- body language
- vocal qualities

Question 16

What is the difference between sympathy and empathy

Answer 16

Sympathy is feeling bad for someone who is in pain
- sorry you feel that way
- understanding from your own perspective
- giving unsolicited advice
Empathy is understanding someone’s pain
- put yourself in their shoes
- really listening to the person

Question 17

What are the characteristics of therapeutic communication

Answer 17

• patient-centered
• goal-directed
• scientifically based

Question 18

In what ways does therapeutic communication benefit the patient

Answer 18

• helps patient feel safe and protected
• patient is more satisfied with their care
• increased recovery rates
• improved adherence to treatment

Question 19

What are the characteristics of the transactional model of communication

Answer 19

Communicator- the person communicating
Message- what they are communicating
Channel- how they are communicating
Feedback- how the nurse responds
Encoding/Decoding- implied/inferred messages
Context- situation of communication
Environmental Noise- distractions (physical or physiological)

Question 20

What are the characteristics of Peplau’s interpersonal communication theory

Answer 20

Clarity
Continuity
Nondirective listening

Question 21

What is clarity when talking about communication

Answer 21

ensuring that the meaning of the message is accurately understood by both parties

Question 22

What is continuity when talking about communication

Answer 22

continuous treatment which promotes connection between both parties

Question 23

What is nondirective listening when talking about communication

Answer 23

Nurse provides nonjudgmental feedback which allows patients to clarify their thoughts

Question 24

What are some factors that can effect communication between the nurse and the patient

Answer 24

Personal factors (depression, cognition, language barriers)
Environmental factors (noise, privacy)
Relationship factors (equality between nurse/patient; patients are vulnerable and you are seen to have more power than them)

Question 25

What are some types of non-verbal communication

Answer 25

- tone of voice - physical appearance - facial expressions - body posture - eye contact - hand gestures

Question 26

What is a double-bind message

Answer 26

Given by a person in power: - contradictory messages - no-win situation (sarcastically saying "yeah ill do whatever you want" in order to try and maintain power or control)

Question 27

What are some therapeutic communication techniques

Answer 27

- Silence - active listening - clarifying techniques - asking questions

Question 28

What kinds of questions will a nurse use to utilize therapeutic communication with their patients

Answer 28

Open-ended - not a yes or no answer Closed-ended - yes or no answer Projective - "what if" questions Miracle question - "If a miracle happened and the problem was gone, what would your life look like?" - goal setting question

Question 29

How do you engage in active listening

Answer 29

S - sit facing the client O - open posture L - learn forward towards client E - eye contact R - relax

Question 30

What are some examples of non-therapeutic techniques

Answer 30

- asking too many questions - giving approval or disapproval - giving advice - asking "why"

Question 31

What is kinesic communication

Answer 31

A type of nonverbal communication made by body movement - facial expressions - body posture - gestures

Question 32

What is proxemics

Answer 32

The study of personal space

Question 33

What is considered an intimate distance in the united states

Answer 33

0-18 inches

Question 34

What is considered a personal distance

Answer 34

18 inches-4 feet

Question 35

What is considered a social distance

Answer 35

4-12 feet

Question 36

What is considered a public distance

Answer 36

12+ feet

Question 37

What are some advantages of group therapy

Answer 37

- treat multiple people at the same time - members benefit from other clients viewpoints - safe place tp practice new skills - can make them feel like they belong

Question 38

What are some disadvantages of group therapy

Answer 38

- privacy concerns - disruptions - discouraging group norms may hinder self expression

Question 39

What are the phases of group therapy development

Answer 39

Planning phase Orientation phase Working phase Termination phase Evaluation phase

Question 40

What happens during the planning phase of group therapy development

Answer 40

- name of group - objectives of group - who is going to be in the group - group schedule - location - seating configuration - leader and member responsibilities - methods of evaluating outcomes

Question 41

What happens during the orientation phase of group therapy development

Answer 41

- formation of the group and getting members together - establish purpose of group

Question 42

What happens during the working phase of group therapy development

Answer 42

leader facilitates communication, the flow of group processes, and group conduct

Question 43

What happens during the termination phase of group therapy development

Answer 43

members express the effectiveness of the group

Question 44

What happens during the evaluation phase of group therapy development

Answer 44

Objective measures of feedback from group members

Question 45

What does group therapy from a humanistic approach look like

Answer 45

- focuses on self-actualization - leader practices nondirective, active listening, and Socratic dialogue (determining the accuracy and helpfulness of thoughts)

Question 46

What does group therapy from a cognitive behavioral approach look like

Answer 46

- focuses on specific maladaptive behaviors and thought patterns - leader practices goal setting, planning, and reinforcing good behaviors/thought patterns

Question 47

What does group therapy from a psychodynamic approach look like

Answer 47

- focuses on resolving inner conflicts of patients - leader practices listening, interpreting, confronting, and working through these thoughts

Question 48

What does group therapy from an educational approach look like

Answer 48

- focuses on coping, emotional and practical support - leader practices teaching, organizing, and leading discussions

Question 49

What does group therapy from a systems approach look like

Answer 49

- focuses on positive interactions with social and political environment and social equality - leader practices strategizing, activism, and lifestyle investigation

Question 50

What are the different styles of leadership

Answer 50

Autocratic Democratic Laissez-faire

Question 51

What are the characteristics of an autocratic leader

Answer 51

- exerts control over the group - does not encourage much interaction - leader has all the power - rewards and punishment

Question 52

What are the characteristics of a democratic leader

Answer 52

- promotes extensive group interaction - delegates authority - encourages participation - feedback

Question 53

What are the characteristics of a laissez-faire leader

Answer 53

- hands off - very little leading - little to no direction - allows freedom as much as possible

Question 54

How do you deal with a monopolizing member of your group therapy session

Answer 54

- remind entire group to let everyone talk - talk to them privately if needed

Question 55

How do you deal with a disruptive member of your group therapy session

Answer 55

- listen objectively - ask in private about cause of anger - empathize

Question 56

How do you deal with a silent member of your group therapy session

Answer 56

- determine cause - require a response to ease group discomfort - come back to them to allow them to think of an answer