Nokea
A patient being discharged appears angry with the nurse when the nurse attempts to review discharge instructions with the patient. The nurse can best assist the patient in this stage of the relationship with which of the following responses?
- A. We have to go over these instructions before you can go. Please try to listen
- B. Would you rather not be discharged today?
- C. I can sense you are angry this morning. Tell me how you feel about being discharged today.
- D. You should be able to regulate your feelings better by now. Why are you angry?
Correct Answer: C
Rationale: Acknowledging the client's angry feelings and assuring the client that this response is normal helps address the sense of loss during termination.
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During the orientation phase of the nurse/patient relationship, the nurse directs the patient to do which of the following?
- A. Identify problems to examine
- B. Express needs and feelings
- C. Develop interpersonal skills
- D. Identify self-care strategies
Correct Answer: A
Rationale: The orientation phase focuses on identifying problems to examine.
When preparing for the first clinical experience with patients on a forensic unit at a psychiatric hospital, the nursing instructor discusses students' beliefs and fears surrounding forensic patients. The primary reason for discussing personal beliefs is to
- A. practice reflective communication skills in a role-play situation.
- B. assign the most compatible patients to the students
- C. assess the appropriateness of the setting for implementing nursing skills.
- D. become aware of possible barriers to developing therapeutic relationships.
Correct Answer: D
Rationale: Self-awareness allows the nurse to observe, pay attention to, and understand the subtle responses and reactions of clients when interacting with them.
A nurse is using the Johari window to identify the degree to which he feels comfortable communicating with others. After completing the exercise, the nurse discovers that quadrant 1 has the longest list of qualities. This indicates which of the following about the nurse?
- A. The nurse conceals personal information about himself.
- B. The nurse needs to increase insight into his own characteristics.
- C. The nurse is open to others.
- D. The patient is sharing more than the nurse in the therapeutic relationship.
Correct Answer: C
Rationale: When using the Johari window, if quadrant 1 is the largest, this indicates that the nurse is open to others.
A nurse is assigned to care for a client whose sexual orientation differs from the nurse's sexual orientation. When should the nurse seek clinical supervision?
- A. When the nurse tries to assist the client to change values
- B. To discuss the nurse's feelings about the client with a supervisor
- C. When the nurse begins to empathize with the client
- D. When the nurse identifies anxieties regarding the client's values and sexuality
Correct Answer: A
Rationale: It is not the nurse's role to change the values of the client.
If a client tells a student nurse that the client plans to kill a family member, the student nurse must
- A. respect the client's privacy and not tell anyone
- B. tell the client that the student nurse cannot keep that secret and then report it to the instructor and/or staff members.
- C. tell the client that the student nurse will keep the secret and then tell the instructor and/or staff members.
- D. tell the instructor and then ask the instructor to keep it secret.
Correct Answer: B
Rationale: The nurse is required to notify intended victims and police of a homicidal threat, releasing them from privileged communication.