A new nurse tells a mentor, 'I want to convey to my patients that I am interested in them and that I want to listen to what they have to say.' Which behaviors are helpful in meeting the nurse's goal? (Select all that apply.)
- A. Sitting behind a desk, facing the patient
- B. Introducing self to a patient and identifying own role
- C. Using facial expressions that convey interest and encouragement
- D. Assuming an open body posture and sometimes mirror imaging
- E. Maintaining control of the topic under discussion by asking direct questions
Correct Answer: B,C,D
Rationale: Introducing oneself, using encouraging facial expressions, and open body posture foster trust and convey interest.
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A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent for most of the session. Another patient comes to the door of the room, interrupts, and says to the nurse, 'I really need to talk to you right now.' What action is most appropriate?
- A. Saying to the interrupting patient, 'I am not available to talk with you at the present time.'
- B. Ending the unproductive session with the current patient and spend time with the patient who has just interrupted.
- C. Inviting the interrupting patient to join in the session with the current patient.
- D. Telling the patient who interrupted, 'This session will end in 5 minutes; then, I will talk with you.'
Correct Answer: D
Rationale: Adhering to the session schedule demonstrates trust and prioritizes the current patient. This response respects the contract while addressing the interrupting patient's needs.
Why should the nurse introduce the matter of a contract during the first session with a new patient?
- A. To specify what the nurse will do for the patient
- B. To explain the participation and responsibilities of each party
- C. To indicate the feeling tone established between the participants
- D. To prevent either party from prematurely ending the relationship
Correct Answer: B
Rationale: A contract outlines mutual participation and responsibilities, emphasizing collaboration rather than unilateral action.
A nurse says, 'I am the only one who truly understands this patient. Other staff members are too critical.' What does the nurse's statement indicate?
- A. Boundary blurring
- B. Sexual harassment
- C. Positive regard
- D. Advocacy
Correct Answer: A
Rationale: Overinvolvement suggests boundary blurring, likely due to countertransference, requiring supervision.
Which behavior shows that a nurse values autonomy?
- A. Setting limits on a patient's romantic overtures toward the nurse
- B. Suggesting one-on-one supervision for a patient who is suicidal
- C. Informing a patient that the spouse will not be in during visiting hours
- D. Helping the patient weigh the consequences of their behaviors and decisions
Correct Answer: D
Rationale: Supporting autonomy involves helping the patient make informed decisions by weighing alternatives.
Which remark by a patient indicates passage from the orientation phase to the working phase of a nurse-patient relationship?
- A. I don't have any problems.'
- B. It is so difficult for me to talk about my problems.'
- C. I don't know how talking about things twice a week can help.'
- D. I want to find a way to deal with my anger without becoming violent.'
Correct Answer: D
Rationale: Expressing a desire to address specific behaviors indicates readiness for behavioral change, characteristic of the working phase.
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