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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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The nurse is in the orientation phase of the nurse-patient relationship with a patient diagnosed with a mental disorder. When interviewing the patient during this first encounter, which information would be most important for the nurse to obtain about the patient?
- A. Known allergies
- B. Recent hospitalizations
- C. Perception of the problem
- D. Family history
Correct Answer: C
Rationale: In the orientation phase, establishing trust and understanding the patient?s perspective is critical. The patient?s perception of the problem provides insight into their mental health needs and guides the therapeutic relationship. Allergies, hospitalizations, and family history are important but secondary in this initial phase.
During an interview, a patient tells the nurse that he was recently let go from his job. As the interaction continues, the patient states, 'I was really overqualified for that position anyway. It was definitely below my area of expertise.' The nurse interprets this information as reflecting which of the following?
- A. Denial
- B. Intellectualization
- C. Projection
- D. Passive aggression
Correct Answer: B
Rationale: Intellectualization involves using rational explanations to avoid emotional distress. The patient?s statement minimizes the job loss by focusing on being overqualified, distancing from the emotional impact. Denial avoids the reality, projection attributes feelings to others, and passive aggression expresses hostility indirectly.
A nursing instructor is describing the nurse-patient relationship to a group of nursing students. Which of the following would the instructor emphasize as crucial for establishing and maintaining the relationship?
- A. Rapport
- B. Empathy
- C. Self-awareness
- D. Values
Correct Answer: A
Rationale: Rapport, a trusting and harmonious connection, is crucial for establishing and maintaining the nurse-patient relationship, fostering open communication. Empathy and self-awareness support rapport, but rapport is the foundation. Values guide practice but are less directly tied to the relationship.
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.
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.