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A nurse directs the client interaction and plans for interventions to achieve client goals. According to Peplaus framework for psychodynamic nursing, what therapeutic role is this nurse assuming?
- A. The role of technical expert
- B. The role of resource person
- C. The role of teacher
- D. The role of leader
Correct Answer: D
Rationale: The correct answer is D: The role of leader. In Peplau's framework, the nurse in this scenario is assuming the therapeutic role of a leader because they are directing client interactions and planning interventions to achieve client goals. This role involves guiding and facilitating the therapeutic process, fostering a collaborative relationship with the client, and empowering them to make decisions and progress towards their goals.
A: The role of technical expert is incorrect because it focuses more on providing specialized knowledge and skills rather than leading and directing client interactions.
B: The role of resource person is incorrect as it typically involves providing information and support, but not necessarily directing client interactions and planning interventions.
C: The role of teacher is incorrect because while education and guidance are important in nursing, it does not fully capture the leadership and direction involved in the scenario described.
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A client is trying to explore and solve a problem. Which nursing statement would be an example of verbalizing the implied?
- A. You seem to be motivated to change your behavior.
- B. How will these changes affect your family relationships?
- C. Why dont you make a list of the behaviors you need to change.
- D. The team recommends that you make only one behavioral change at a time.
Correct Answer: A
Rationale: Step 1: A is correct as it reflects active listening and shows empathy towards the client.
Step 2: By stating "You seem to be motivated to change your behavior," the nurse acknowledges the client's feelings and encourages further exploration.
Step 3: This statement helps the client feel understood and supported in their journey towards change.
Summary:
B: Focuses on family relationships, not the client's motivation.
C: Suggests a directive approach rather than exploring the client's feelings.
D: Imposes a specific recommendation without considering the client's readiness or motivation.
A client comes to a psychiatric clinic, experiencing sudden extreme fatigue and decreased sleep and appetite. The client works 12 hours a day and rates anxiety as 8/10 on a numeric scale. What correctly written long-term outcome is realistic in addressing this clients crisis?
- A. The client will change his or her type A personality traits to more adaptive ones by week
- B. The client will completely eliminate all anxiety within 2 weeks.
- C. The client will reduce work hours from 12 to 6 hours per day immediately.
- D. The client will develop and implement a self-care routine to improve sleep and appetite within 4 weeks.
Correct Answer: D
Rationale: The correct answer is D. Developing and implementing a self-care routine to improve sleep and appetite within 4 weeks is the most realistic long-term outcome in addressing the client's crisis.
Rationale:
1. Self-care routines can positively impact sleep and appetite.
2. Improvements in sleep and appetite can help alleviate fatigue and other symptoms.
3. Realistic timeline of 4 weeks allows for gradual changes and adjustments.
4. It focuses on tangible actions the client can take to improve their well-being.
Incorrect Choices:
A: Changing personality traits is a complex and long-term process, unlikely to occur within a week.
B: Completely eliminating anxiety within 2 weeks is unrealistic and may not address the underlying causes.
C: Immediate reduction of work hours may not be feasible or necessary for addressing the client's crisis.
Which client statement may indicate a transference reaction?
- A. I need a real nurse. You are young enough to be my daughter and I dont want to tell you about my personal life.
- B. I deserve more than I am getting here. Do you know who I am and what I do? Let me talk to your supervisor.
- C. I dont seem to be able to relate to people. I would rather stay in my room and be by myself.
- D. My mother is the source of my problems. She has always told me what to do and what to say.
Correct Answer: A
Rationale: Step 1: The client's statement "I need a real nurse" suggests a desire for a particular type of nurse, implying a transfer of feelings from a significant person onto the nurse.
Step 2: The client mentioning the nurse's age and relationship dynamics ("young enough to be my daughter") indicates projection of unresolved emotions onto the nurse.
Step 3: The client's reluctance to share personal information and discomfort with the nurse's perceived identity further supports the presence of transference reactions.
Summary: Option A is correct as it demonstrates transference by projecting emotions onto the nurse based on age and personal dynamics. Other choices lack clear indications of transference and focus on different issues like entitlement, social interaction difficulties, and blaming family members.
A psychiatric nurse uses Sullivans theories in group and individual therapy. According to Sullivan and other theorists like him, how are client symptoms viewed behaviors that are maintained because they are reinforced?
- A. Client symptoms are viewed as responses to anxiety arising from interpersonal relationships.
- B. Client symptoms are viewed as internal conflicts arising from early childhood trauma.
- C. Client symptoms are viewed as the misinterpretations of experiences.
- D. Client symptoms are viewed as learned
Correct Answer: B
Rationale: The correct answer is B because Sullivan and other theorists like him believe that client symptoms are viewed as internal conflicts arising from early childhood trauma. Sullivan emphasized the impact of early relationships on personality development, suggesting that unresolved conflicts from childhood can manifest as symptoms in adulthood. This perspective aligns with psychodynamic theories that emphasize the role of unconscious processes and early experiences in shaping behavior.
Choice A is incorrect because it focuses on anxiety arising from interpersonal relationships, which is more aligned with interpersonal theories rather than Sullivan's emphasis on childhood experiences. Choice C is incorrect as it suggests misinterpretations of experiences, which does not fully capture the depth of internal conflicts highlighted by Sullivan. Choice D is incorrect as it simplifies client symptoms as learned behaviors without considering the underlying emotional conflicts rooted in early childhood experiences, as emphasized by Sullivan.
From an interpersonal theory perspective, which intervention would a nurse use to assist a client diagnosed with major depressive disorder?
- A. Offer family therapy sessions
- B. Discuss childhood events
- C. Teach alternate coping skills
- D. Encourage discussion of feelings
Correct Answer: A
Rationale: The correct answer is A because family therapy sessions can help address underlying family dynamics contributing to the client's depression. This intervention aligns with interpersonal theory, which focuses on improving relationships and communication within the client's social network. Family therapy can enhance support systems and promote healthier interactions.
Option B is incorrect as discussing childhood events may not directly address current interpersonal difficulties. Option C, teaching coping skills, is helpful but may not target the interpersonal issues specific to major depressive disorder. Option D, encouraging discussion of feelings, is important but may not address the broader interpersonal dynamics impacting the client's condition.