Nokea
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.
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When communicating with a patient, which of the following would the nurse use to convey positive body language?
- A. Sitting erect with back against the chair
- B. Crossing the arms over the chest
- C. Sitting at the patient?s eye level
- D. Keeping the feet flat on the floor with the legs crossed
Correct Answer: C
Rationale: Sitting at the patient?s eye level conveys openness, respect, and engagement, fostering positive communication. Crossing arms or legs can appear defensive, and sitting erect with back against the chair may seem rigid, less conducive to rapport.
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 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.
When engaged in therapeutic communication in a therapeutic relationship with a patient with a mental health problem, which of the following would be most important for the nurse to keep in mind?
- A. The nurse should self-disclose when indicated.
- B. The patient is the primary focus of the interaction.
- C. The nurse should have an empathetic relationship with the patient.
- D. The patient?s conversations should be recorded.
Correct Answer: B
Rationale: Therapeutic communication prioritizes the patient?s needs and perspective, making the patient the primary focus. Self-disclosure is used cautiously and only when beneficial, empathy is important but secondary to patient focus, and recording conversations is inappropriate without consent and not a primary concern.
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.