Nokea
A nurse has engaged in self-awareness and has come to understand his own personal beliefs and attitudes and has recognized some prejudicial ideas. Based on this understanding, which of the following would the nurse now be able to accomplish?
- A. Have a therapeutic relationship with a patient.
- B. Influence patients with certain biases.
- C. Change learned behaviors.
- D. Formulate values and morals.
Correct Answer: A
Rationale: Self-awareness, including recognizing personal biases, allows the nurse to set aside prejudices and engage objectively with patients, fostering a therapeutic relationship. Influencing patients with biases is unethical, changing behaviors requires more than self-awareness, and formulating values and morals is a broader personal process not directly tied to patient care.
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A patient is a successful insurance salesman; however, because of market changes, his level of sales has dropped. His boss tells him he will consequently be receiving a $2,000 per year cut in his salary. When the patient arrives home from work, the family dog runs to greet him as he always does, barking and jumping up and down and begging for attention. The patient yells at the dog, 'Get away from me; I can?t take your barking right now.' The patient?s response reflects a defense mechanism because it was which of the following?
- A. An intentional behavior performed to let the dog know his behavior was inappropriate
- B. Automatic, protecting the patient from the anxiety related to his upcoming pay cut
- C. Implemented to keep the patient from having to cope with his upcoming pay cut
- D. Implemented so the patient could rationalize his upcoming pay cut
Correct Answer: B
Rationale: The patient?s response reflects displacement, a defense mechanism where emotions (anxiety about the pay cut) are redirected to a less threatening target (the dog). This is automatic and protects the patient from directly confronting anxiety. The response is not intentional training, avoidance of coping, or rationalization.
A hospitalized patient diagnosed with depression asks the nurse, 'Should I go home this weekend?' Which response by the nurse uses the technique of reflection?
- A. Should you go home for the weekend?
- B. Home means what to you?
- C. It sounds as if you don?t want to go home this weekend.
- D. I doubt that you really should go home this weekend.
Correct Answer: A
Rationale: Reflection involves restating the patient?s words to encourage further exploration of their thoughts. Repeating 'Should you go home for the weekend?' mirrors the patient?s question, promoting self-reflection. Other options involve clarification, interpretation, or judgment, which are not reflective techniques.
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.
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.
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.