Chapter 11, Therapeutic Relationships and Communication Video Solutions, Psychiatric-Mental Health Nursing: Evidence-Based Concepts, Skills, and Practices

Problem 1

The mother of a 17-year-old girl with a history of several hospitalizations for depression seems guarded and defensive during the interview. She states, "We really are a loving family." The nurse interprets this statement as indicative of the mother's defensiveness, which may be related to which of the following?
a, Perceived blame from others for her daughter's illness
b. The mother's own dysfunctional behavior
c. A feeling of mutual disrespect by the nurse and mother
d. The mother's desire to cover her own sense of failure

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Problem 2

A mental health nurse, on her weekend off, arranges to meet a client with depression. The nurse is worried that the client will be lonely over the weekend because her family is away on vacation. The nurse is demonstrating which of the following?
a. Conscientious caring
b. Continuation of a therapeutic relationship
c. Countertransference
d. Judgmental attitude

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Problem 3

A client has failed to show up for her second appointment with the nurse. She calls later, sounding intoxicated, claiming she forgot the appointment. The nurse understands that testing behavior is common in the introductory phase of relationship development. Which response would be most appropriate?
a. Rescheduling the appointment without discussing the behavior
b. Gently questioning the client about her acting-out behavior
c. Firmly establishing boundaries for acceptable and unacceptable behavior
d. Referring the client to another therapist

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Problem 4

A client in the open psychiatric unit tells the nurse he doesn't love his wife and has had many extramarital affairs. After this discussion, the client avoids further talks with the nurse by not meeting scheduled appointments. Which of the following approaches by the nurse would be most helpful to the therapeutic relationship?
a. "I understand that you think that you were possibly too open with me at the last session, but I feel like you're trying to avoid me now. I would like to schedule a meeting with you to discuss this matter."
b. "You missed our last two appointments. I thought maybe you were sorry you revealed your feelings about your wife or that possibly my response was not helpful. Can you tell me more about what you're feeling?"
c. "We haven't talked in a few days. That's a problem. Would you like to talk more about your feelings toward your wife?"
d. "When we spoke on Monday, you said that you didn't love your wife. Now it seems as though you are holding back. Is there more going on than what you have told me?"

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Problem 5

While interviewing a family for the first time, the nurse notes that the mother takes charge of introducing everyone, relating that they've come to therapy because of the older son's acting-out behavior. The father and the three children nod but do not say anything. Which response would be most appropriate by the nurse immediately?
a. Acknowledge the older son first, because his behavior has been mentioned as problematic.
b. Acknowledge the father first, because he is the other parent.
c. Acknowledge the children first, because they may feel left out of the situation.
d. Acknowledge the mother first, because she seems to take the lead.

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