NUR 422 Worchester Fall at Massachusetts College of Pharmacy and Health Sciences Fall 2025
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Free NUR 422 Worchester Fall at Massachusetts College of Pharmacy and Health Sciences Fall 2025 Questions
1. A nurse's statement, "You remind me a lot of my grandmother, so I am sure we will get along very well," is an example of what?
- Sympathy
- Countertransference
- The working phase
- Transference
Explanation
Countertransference occurs when the nurse unconsciously transfers feelings or attitudes from past relationships onto the client. In this case, the nurse is associating the client with their grandmother and assuming the relationship will be positive based on that personal emotional connection. This can interfere with objective care and appropriate therapeutic boundaries, making it countertransference.
2. Which of the following is the priority nursing action during the orientation (introductory) phase of the nurse-client relationship?
- Explore how thoughts and feelings may adversely impact nursing care.
- Establish rapport and develop mutually agreeable treatment goals
- Attempt to find alternative placement for the client.
- Acknowledge the client's action and generate alternative behaviors.
Explanation
During the orientation (introductory) phase, the nurse’s priority is to build trust, establish rapport, and collaboratively create treatment goals with the client. This phase sets the foundation for the therapeutic relationship by clarifying roles, expectations, and the plan of care. Establishing a safe, trusting environment encourages open communication and supports successful treatment throughout the relationship.
3. Which outcome does the nurse expect during the working phase of the nurse-client relationship?
- The client explores personal strengths and weaknesses that impact behaviors.
- The client and nurse establish rapport and mutually develop treatment goals.
- The client explores feelings related to reentering the community.
- The client gains insight and incorporates alternative behaviors.
Explanation
The working phase focuses on implementing the treatment plan and facilitating change. During this phase, the client confronts ineffective coping patterns, gains insight into problem behaviors and emotions, and practices healthier alternatives. This is the core therapeutic phase where real behavioral and emotional growth occurs through active participation and therapeutic interaction.
4. Which therapeutic communication technique is being used in this nurse-client interaction?
Client: "When I get angry, I get into a fistfight with my partner or I take it out on the kids."
Nurse: "I notice that you are smiling as you talk about this physical violence."
Client: "When I get angry, I get into a fistfight with my partner or I take it out on the kids."
Nurse: "I notice that you are smiling as you talk about this physical violence."
- Making observations
- Exploring
- Formulating a plan of action
- Encouraging comparison
Explanation
"Making observations" is a therapeutic technique where the nurse states what they see or notice about the client’s behavior or affect. In this case, the nurse points out the incongruent affect (smiling while describing violence). This helps the client gain insight into emotional disconnect or denial and encourages self-awareness without judgment or confrontation.
5. During the planning of care for a suicidal client, which correctly written outcome should be the nurse's priority?
- The client will remain safe during the hospital stay.
- The client will express hope for the future by day 3.
- The client will establish a trusting relationship.
- The client will not physically harm self.
Explanation
For a suicidal client, the highest-priority outcome is the direct prevention of self-harm. The statement “The client will not physically harm self” clearly addresses the primary and immediate safety need for suicide risk. It focuses specifically on preventing self-injury, which is the core safety priority in suicide precautions.
6. An angry patient states to the nurse, "You redheaded skinny witch. You can't tell me what to do." Which appropriate interventions would the nurse implement during this outburst?
- Ignore initial derogatory remarks.
- Respond to angry expressions with matching verbalizations.
- Offer support using empathy and therapeutic touch.
- Reprimand the patient for poor judgment and derogatory remarks.
Explanation
During an anger outburst, the nurse should not personalize insults or escalate the situation. Ignoring the initial name-calling focuses on de-escalation, maintaining safety, and remaining therapeutic. Addressing the underlying emotion rather than reacting to hostility helps prevent power struggles and keeps the environment calm. Once the patient is calmer, boundaries about respectful communication can be reinforced.
7. A client diagnosed with a neurocognitive disorder (NCD) is exhibiting behavioral problems every day. At the change of shift, the client's behavior escalates from pacing to screaming and flailing. Which action would the nurse implement first?
- Anticipating the behavior and restraining when pacing begins
- Medicating the client with prn antianxiety medication
- Assessing environmental triggers and potential unmet needs
- Consulting the psychologist regarding behavior modification techniques
Explanation
When a client with a neurocognitive disorder shows escalating behaviors, the priority is to assess for possible environmental stressors and unmet needs such as pain, hunger, fatigue, overstimulation, or confusion. Change of shift can be overstimulating. Identifying and removing triggers, and addressing needs early, often prevents further escalation. Assessment and non-pharmacologic interventions are first-line before restraints or medications.
8. The family of a suicidal client is supportive and requests more facts related to caring for their family member after discharge. Which information should the nurse provide?
- Address only serious suicide threats to avoid the possibility of secondary gain.
- Be available to actively listen, support, and accept the client's feelings.
- Offer a private environment to provide needed time alone at least once a day.
- Promote trust by not sharing suicide attempt information outside the family.
Explanation
Following discharge, individuals with suicidal ideation or attempts require a strong support system, emotional availability, and nonjudgmental listening. Encouraging family to actively listen and validate the client’s feelings helps reduce isolation, increases safety, and promotes open communication. Providing emotional presence and support is one of the most effective protective factors against suicide.
9. Which of the following is an example of crisis intervention?
- Exposure therapy
- Lengthy interpersonal therapy sessions
- Resolution of an immediate crisis
- A mass shooting in a public space
Explanation
Crisis intervention focuses on providing short-term, immediate support and stabilization to help individuals manage an acute crisis. The goal is rapid problem-solving and restoring functioning to pre-crisis levels, not long-term insight or deep psychotherapy. "Resolution of an immediate crisis" directly reflects the purpose and goal of crisis intervention—addressing urgent emotional distress and ensuring safety.
10. A nurse states to a client, "Things will look better tomorrow after a good night's sleep." This is an example of which communication technique?
- The nontherapeutic technique of giving false reassurance
- The therapeutic technique of formulating a plan of action
- The therapeutic technique of presenting reality
- The nontherapeutic technique of giving advice
Explanation
Telling a client that things will improve tomorrow offers unrealistic optimism without acknowledging the client's feelings or current distress. False reassurance minimizes emotional pain and may discourage further expression. Effective therapeutic communication validates the client’s concerns rather than offering simplistic comfort. This statement gives the illusion of improvement without evidence, making it a classic example of false reassurance.
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