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A group of nursing students are preparing a class presentation on therapeutic and nontherapeutic techniques of communication. The students demonstrate understanding of the information when they select which techniques to demonstrate as therapeutic? Select all that apply.
- A. Confrontation
- B. Open-ended statements
- C. Reflection
- D. Reassurance
- E. Agreement
- F. Challenges
Correct Answer: B,C
Rationale: Open-ended statements and reflection are therapeutic techniques, encouraging patient exploration and self-expression. Confrontation and challenges can be therapeutic in specific contexts but are often nontherapeutic if poorly timed. Reassurance and agreement risk dismissing patient concerns or aligning too closely, reducing therapeutic value.
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A patient who is hospitalized with depression tells the nurse, 'I don?t want to take the medication because I?m afraid I?ll become suicidal.' Which response by the nurse would be most appropriate?
- A. Have you ever thought about hurting yourself?
- B. It?s important that you take this medication.
- C. I agree with you. I wouldn?t want to take this medication either.
- D. Another patient took that medication, and he really felt better.
Correct Answer: A
Rationale: The patient?s fear of becoming suicidal warrants immediate assessment for suicidal ideation. Asking 'Have you ever thought about hurting yourself?' directly addresses this concern and ensures patient safety. Other responses dismiss the fear, agree inappropriately, or provide irrelevant anecdotes, none of which address the patient?s concern effectively.
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.
A nurse engaged in an interaction with a patient recognizes body space zones. Which of the following would the nurse identify as the individual?s personal zone?
- A. Beginning at the boundary of the intimate zone and ending at the social zone
- B. Extending outward from the border to the public zone
- C. Surrounding and protecting an individual from others, especially outsiders
- D. The most distant boundary that can be used for recognizing intruders
Correct Answer: A
Rationale: The personal zone, per Hall?s proxemics theory, extends from 1.5 to 4 feet, beginning at the boundary of the intimate zone (0?1.5 feet) and ending at the social zone (4?12 feet). It?s used for comfortable interactions. Other options describe the social zone, a general concept, or the public zone, respectively.
Termination takes place during the resolution phase of a nurse-patient relationship. During the termination process, a patient brings up resolved problems and presents them as new issues to work toward. The nurse interprets the patient?s action as indicating which of the following?
- A. The patient is angry that the nurse is abandoning him.
- B. The patient requires additional therapy.
- C. The patient is unhappy that the therapy was ineffective
- D. The patient is attempting to prolong the nurse-patient relationship.
Correct Answer: D
Rationale: Bringing up resolved issues as new problems during termination suggests the patient is reluctant to end the therapeutic relationship, a common reaction to avoid closure. Anger, need for more therapy, or perceived ineffectiveness are less likely interpretations without additional evidence.
When engaged in a nontherapeutic relationship, which of the following would the nurse identify as occurring first?
- A. Failure to recognize the patient as a person with a need
- B. Patient avoiding the nurse
- C. The nurse being perceived as rude
- D. Patient feeling hopeless and frustrated
Correct Answer: A
Rationale: A nontherapeutic relationship begins with the nurse?s failure to recognize the patient?s individual needs, undermining trust and rapport. This precedes patient avoidance, perceptions of rudeness, or feelings of hopelessness, which are outcomes of the initial failure.