Boundaries & Abuse In The Nurse-client Relationship

25 Questions  I  By Jvranckx
Boundaries & Abuse in the Nurse-Client Relationship
Review of material from class 4.

  
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1.  Which of the following activities are potential boundary crossings or violations? Check all that apply.
A.
B.
C.
D.
2.  “One is One Too Many” is the name of the abuse prevention program organized by which nursing organization?
A.
B.
C.
D.
3.  A nurse should never provide care to a client with which he had had a prior personal relationship.
A.
B.
4.  The nurse should always refuse gifts from patients.
A.
B.
5.  Jim is a nurse on a General Medicine unit in a busy hospital. One day while at work, he overhears strange noises coming from a patient’s room. Going to investigate, he finds another nurse, Nancy, standing by the patient’s bed with her back to the door. The patient seems to be reaching for a pitcher that Nancy has in her hand, but she keeps it just out of his reach. “I’m sorry Mr. Smith, you can’t have any water unless you agree to stop ringing your call bell so frequently.” Jim’s response is to:
  1. Enter the room, take the pitcher from Nancy and give the patient a drink.
  2. Report Nancy to their manager.
  3. Speak with Nancy privately about her behaviour.
  4. Carry on with his day; Nancy’s behaviour is appropriate.
A.
B.
C.
D.
E.
6.  Within the nurse-client covenant, personal social relations provide significant healing benefits.
A.
B.
7.  When unsure if accepting of a gift is appropriate who/what should you consult?
A.
B.
C.
D.
8.  Susan, a colleague of yours has been working with a client named Greg for some time, and they have developed a close relationship.  On a number of occasions Susan stayed late after her shifts to talk to Greg, and on days that she was not assigned to care for Greg she made sure to go and see how he was doing.  One day you are assigned to care for Greg, and he shows you a stuffed bear that he plans to give Susan on Valentine’s Day.  What is the appropriate response or action in this circumstance?
9.  Statements that outline acceptable requirements for determining the quality of nursing care a client receives are:
A.
B.
C.
D.
10.  Suzanne is a nurse working in home care. Another nurse, Stephanie, works for the same agency. Stephanie knows that Suzanne and her husband are having serious financial difficulties and may lose their house. One day Suzanne calls in sick and Stephanie goes to visit one of Suzanne’s clients, a man who happens to live in a wealthy neighbourhood. At the end of the visit, the client gives Stephanie a cheque and asks her to make sure that it gets to Suzanne. When Stephanie asks what the cheque is for, the client tells her that he has been helping out with Suzanne’s mortgage payments in exchange for the wonderful care that she provides. True or false: Stephanie should take the cheque and give it to Suzanne.
A.
B.
11.  When, if ever, is it acceptable to accept gifts from clients? (select the best answer)
A.
B.
C.
D.
12.  Boundaries serve to protect the professional and therapeutic nature of the nurse-client relationship. Place the number of the term with the correct definition.
A. therapeutic relationship
A.
B. non-professional relationship
B.
C. professional boundaries
C.
D. nurse-client relationship
D.
E. non-therapeutic relationship
E.
13.  You have been providing home care for a resident for 2 years now.  Recently during one of your visits with the client you mentioned that you were having guests over on the weekend and needed to stop at the grocery store to get a few things.  The resident is home bound and asks if you mind picking up a few groceries for them.  What is the appropriate response or action in this circumstance? 
14.  Which of the following scenarios represent client abuse?
  1. Accepting power of attorney for a client who is currently under your care
  2. Withholding food and drink when a client is NPO before surgery
  3. Ignoring a client’s call bell because they are not being compliant with their medication
  4. Pulling a client’s hair to get them to stop thrashing while you are trying to get them dressed
A.
B.
C.
D.
15.  Excessive personal disclosure by the nurse is considered to be:
A.
B.
C.
D.
16.  Some boundary crossings are acceptable if in the nurse’s professional judgment, they help to meet the client’s therapeutic needs.
A.
B.
17.  Scenario: You overhear a colleague telling a patient she is upset that she doesn’t have a special someone to share Valentine’s Day with.  On Valentine’s Day the same patient presents the nurse with a box of chocolates.  The nurse happily accepts the gift and brings it to the staff room to share with her colleagues.  According to the CNO Practice Standard is this acceptable?
18.  What should nurse John do when a person in his care displays sexual interest and behaviour towards him?
A.
B.
C.
D.
19.  Read the descriptions of the following people carefully and give two reasons why they may be at risk for being either abuse victims or perpetrators.
  1. Jonathan is a 32-year-old man with Down Syndrome. He lives independently in the community, but has recently broken his leg and requires assistance getting out of the house. He has no relatives living close by.
  2. Carol, age 22, has just recently graduated from nursing school. She is working in home care and has been assigned an elderly client who is suffering from dementia. The woman reminds Carol of her grandmother, with whom she was very close. Her grandmother recently passed away.
  3. Olivia is 82 and recently widowed. Before her husband passed away, he handled all of their finances. Now her son, who has been unemployed for several months, has taken over this job. She is sometimes heard wondering how it is that she and her husband lived so comfortably before he died, and now she seems to be struggling to make ends meet.
  4. Mark is a 42-year-old nurse working in an acute care setting. He and his wife separated two weeks ago. He has been assigned to care for Nicole, a 23-year-old college student who is in hospital following a serious car accident. Nicole has suffered a head injury and is often uncooperative.
20.  It is the client that influences the level of intimacy or physical contact during the therapeutic and diagnostic process.
A.
B.
21.  Your best friend’s 19-year-old son, Jacob has been brought into the emergency department due to alcohol poisoning.  There is limited staff and you resultantly must help care for Jacob.  After the appropriate procedures are completed and Jacob is ready to be discharged, he asks you to please not tell his mother about this incident.   However, the next day when you meet Jacob’s mother for coffee she asks you to tell her what happened/ why her son was in the ER the night before.  What is the appropriate response in this situation?
22.  Janet was recently admitted to hospital for an elective surgical procedure. While her nurse, Dan, is completing a health history, he asks her if she is single, and peppers the interview with sexually explicit comments. True or false: Dan is abusing Janet sexually.
A.
B.
23.  The client and the nurse are responsible for ensuring that professional caring and social relationships are not confused with one another.
A.
B.
24.  Scenario:  A client on your ward is severely ill and has very few visitors as majority of his family lives overseas.  This client has been in your ward in a private room for several months and over the holidays the nursing staff decides to get him a small gift to brighten his spirits as they know his family is unable to visit.  According to the CNO Practice Standard is this acceptable?
25.  Please match the following forms of abuse with the correct example.
A. financial abuse
A.
B. verbal abuse
B.
C. neglect
C.
D. physical abuse
D.
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