Test 1 Blueprint (4)

Question 1

What are the 4 stages of the relationship?

Answer 1

(POW-T)

1) Pre-interaction
2) Orientation (Introductory)
3) Working
4) Termination

Question 2

Which r’ship phase begins the initial assessment and allows nurse to become aware of personal responses to knowledge about the client?

Answer 2

Pre-interaction

Question 3

What is the goal of the pre-interaction phase?

Answer 3

Examine one’s feelings about encounter

Question 4

Building trust and rapport take place in the _____ phase.

Answer 4

orientation

Question 5

Which stage allows the identification of the client’s strengths and limitations and allows nurse/client to devise nursing diagnoses and set goals/plans of action?

Answer 5

Orientation

Question 6

What is the goal of the orientation phase?

Answer 6

Establish trust and contract development

Question 7

What is the goal of the working phase?

Answer 7

Promote client change

Question 8

The therapeutic work of the relationship is done in the _____ phase.

Answer 8

working

Question 9

The termination phase begins upon ____.

Answer 9

admission

Question 10

What are some reasons a relationship may be terminated?

Answer 10

• mutual goals are met
• client discharged
• end of rotation
• too difficult for client and/or nurse

Question 11

What is the goal of the termination phase?

Answer 11

Evaluate goal attainment and ensure therapeutic closure.

Question 12

What should we remember regarding termination?

Answer 12

• Set a plan for continuing care during stressful events (phone #)
• Explore client’s feelings about termination of relationship
• Instill confidence in client’s growth “I feel confident that you can be discharged…”

Question 13

Define transference:

Answer 13

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

Question 14

How should we address transference?

Answer 14

• Not always necessary to terminate relationship
• Help pt sort out these emotions
• Assign correct meaning to the r’ships based on present circumstances, not the past

Question 15

_____ refers to the nurse’s behavioral and emotional responses to the client.

Answer 15

Countertransference

Question 16

When does countertransference negatively effect the therapeutic relationship?

Answer 16

The nurse shows favoritism to the client or does anything that hinders the r/ship.

Question 17

What should the nurse do in situations where countertransference is observed?

Answer 17

• Terminate r/ship only if necessary
• Identify misplaced feelings and work through them
• Evaluate sessions with client

Question 18

What are 2 responses to stress?

Answer 18

Anxiety & Grief

Question 19

List Peplau’s 4 levels of anxiety.

Answer 19

1) Mild
2) Moderate
3) Severe
4) Panic

Question 20

What is positive about mild anxiety?

Answer 20

Heightened perception
Enhanced learning
Increased motivation

Question 21

T/F: Mild anxiety is seldom a problem.

Answer 21

True

Question 22

Which level of anxiety is characterized by:

• reduced alertness
• decreased attention span
• decreased concentration
• increased restlessness, HR, BP, etc
• feeling of discontent
• some impairment in r’ships

Answer 22

Moderate

Question 23

Which level of anxiety is characterized by:

• greatly diminished perceptual field
• extremely limited attention span
• inability to concentrate or problem solve
• physical symptoms (HA, trembling, pain, insomnia)
• feelings of dread/loathing
• total focus on self

Answer 23

Severe

Question 24

Which level of anxiety is characterized by:

• inability to focus on even one detail
• inability to concentrate
• inability to comprehend even simple directions
• immobility or purposeless hyperactivity
• inability to verbalize or incoherence
• terror
• may be a break with reality

Answer 24

Panic

Question 25

Everyone has a _____ _____.

Answer 25

breaking point

Question 26

Acute = \_\_\_\_ anxiety
Chronic = \_\_\_\_ anxiety

Answer 26

state

trait

Question 27

The greater the anxiety, the greater the risk for ____ and ____ and ____ in relating to others.

Answer 27

hallucinations
delusions
impairment

Question 28

What are the 5 stages of grief (Kuebler Ross)?

Answer 28

(DABDA)

1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance

Question 29

Do individuals always move through the stages of grief linearly?

Answer 29

No, they can move back and forth.

Question 30

What is grief that occurs while anticipating an expected event?

Answer 30

Anticipatory grief

Question 31

How is anticipatory grief helpful?

Answer 31

It allows the person to have time to prepare for the loss.

Question 32

What is it called when an individual is unable to progress through the stages of grieving to resolution?

Answer 32

Maladaptive or complicated grief

Question 33

What are 3 types of maladaptive grief?

Answer 33

1) prolonged
2) delayed
3) distorted

Question 34

Prolonged grief: an intense ____ with ____ of the lost entity for ____ after the loss has occurred.

Answer 34

preoccupation
memories
years

Question 35

Delayed grief: individual becomes ____ in the ____ stage of grieving.

Answer 35

fixed

denial

Question 36

Distorted grief: fixed in the ____ stage of grief.

Answer 36

anger

Question 37

What are 4 factors that contribute to prolonged grieving?

Answer 37

1) Ambivalence of r’ship; unfinished business
2) Guilt: feelings of anger toward self; feelings of contribution to death
3) The # of recent losses (especially for elderly)
4) Bereavement overload: accumulation of grief