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A female psychiatric patient is talking to the nurse about her reasons for being hospitalized. She begins to discuss her relationship with her female significant other. The patient is describing the things in her relationship that are making her uncomfortable, and she asks, 'Should I break up with my partner?' Which response by the nurse would be most effective in building rapport between the patient and nurse?
- A. Of course you should; being a lesbian is just not natural.
- B. Yes, I think you should pursue building a relationship with a man.
- C. It sounds like you?re beginning to be uncomfortable in this relationship.
- D. You need to focus on yourself rather than the relationship right now.
Correct Answer: C
Rationale: Building rapport requires a nonjudgmental, empathetic response that acknowledges the patient?s feelings. 'It sounds like you?re beginning to be uncomfortable in this relationship' reflects the patient?s emotions, fostering trust. Options A and B are judgmental and biased, and option D shifts focus prematurely, potentially dismissing the patient?s concerns.
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A nurse is engaged in active listening. Which of the following would the nurse use? Select all that apply.
- A. Changing the subject to gather more information
- B. Responding indirectly to statements
- C. Using open-ended statements
- D. Concentrating on what patient says
- E. Allowing the patient to talk as he wishes
Correct Answer: C,D,E
Rationale: Active listening involves concentrating on the patient?s words, using open-ended statements to encourage elaboration, and allowing the patient to express themselves freely. Changing the subject or responding indirectly disrupts the flow and is nontherapeutic.
A group of students are reviewing the process of verbal communication. The students demonstrate understanding of the information when they identify which of the following as the first component of the process?
- A. Formulation of an idea
- B. Message encoding
- C. Transmission of message
- D. Message reception
Correct Answer: A
Rationale: Verbal communication begins with formulating an idea, which is then encoded, transmitted, and received. Formulation is the initial step where the speaker conceptualizes the message.
The nurse is engaged in a therapeutic nurse-patient relationship. The relationship is in the working phase. With which of the following would the patient be involved? Select all that apply.
- A. Beginning to identify a need
- B. Testing new ways for problem solving
- C. Testing the relationship
- D. Discussing problems related to needs
- E. Examining personal issues
Correct Answer: B,D,E
Rationale: In the working phase of the nurse-patient relationship (per Peplau), the patient actively engages in problem-solving, discussing needs, and examining personal issues to achieve therapeutic goals. Identifying needs and testing the relationship occur in the orientation phase.
While providing care to a patient with a mental disorder, the patient asks the nurse, 'Does mental illness run in your family?' Which response by the nurse would be most inappropriate?
- A. Mental illnesses do run in families, and I?ve had a lot of experience caring for people with mental illness.
- B. It sounds like you are concerned that there may be a family connection to your current problem?
- C. Yes, it does. I have a sister who was diagnosed several years ago with severe major depression.
- D. Mental illness can be family related. Let?s focus the discussion on you and how you?re doing today.
Correct Answer: C
Rationale: Self-disclosure, especially personal details like a family member?s mental illness, is inappropriate in therapeutic communication unless it directly benefits the patient. Option C risks shifting focus to the nurse. Other responses redirect to the patient?s concerns or provide general information, maintaining therapeutic focus.
A hospitalized patient diagnosed with depression asks the nurse, 'Should I go home this weekend?' Which response by the nurse uses the technique of reflection?
- A. Should you go home for the weekend?
- B. Home means what to you?
- C. It sounds as if you don?t want to go home this weekend.
- D. I doubt that you really should go home this weekend.
Correct Answer: A
Rationale: Reflection involves restating the patient?s words to encourage further exploration of their thoughts. Repeating 'Should you go home for the weekend?' mirrors the patient?s question, promoting self-reflection. Other options involve clarification, interpretation, or judgment, which are not reflective techniques.