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A school-age child tells the school nurse, 'Other kids call me mean names and will not sit with me at lunch. Nobody likes me.' Select the nurse's most therapeutic response.
- A. Just ignore them and they will leave you alone.
- B. You should make friends with other children.
- C. Call them names if they do that to you.
- D. Tell me more about how you feel.
Correct Answer: D
Rationale: The correct response uses exploring, a therapeutic technique. The distracters give advice, a nontherapeutic technique.
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A patient tells the nurse, 'I don't think I will ever get out of here.' Select the nurse's most therapeutic response.
- A. Don't talk that way. Of course, you will leave here.
- B. Keep up the good work and you certainly will.
- C. You don't think you're making progress?
- D. Everyone feels that way sometimes.
Correct Answer: C
Rationale: By asking if the patient does not believe that progress has been made, the nurse is reflecting by putting into words what the patient is hinting. By making communication more explicit, issues are easier to identify and resolve. The remaining options are nontherapeutic techniques. Telling the patient not to 'talk that way' is disapproving. Saying that everyone feels that way at times minimizes feelings. Telling the patient that good work will always result in success is falsely reassuring.
A patient with severe depression states, 'God is punishing me for my past sins.' What is the nurse's best response?
- A. Why do you think that?'
- B. You sound very upset about this.'
- C. You believe God is punishing you for your sins?'
- D. If you feel this way, you should talk to a member of your clergy.'
Correct Answer: B
Rationale: The nurse reflects on the patient's comment, a therapeutic technique to encourage sharing for perceptions and feelings. The incorrect responses reflect probing, closed-ended comments, and giving advice, all of which are nontherapeutic.
The relationship between a nurse and patient as it relates to status and power is best described by which term?
- A. Symmetric
- B. Complementary
- C. Incongruent
- D. Paralinguistic
Correct Answer: B
Rationale: When a difference in power exists, as between student and teacher or nurse and patient, the relationship is said to be complementary. Symmetrical relationships exist between individuals of like or equal status. Incongruent and paralinguistic are not terms used to describe relationships.
A patient diagnosed with schizophrenia tells the nurse, 'The CIA is monitoring us through the fluorescent lights in this room. Be careful what you say.' Which response by the nurse would be most therapeutic?
- A. Let's talk about something other than the CIA.
- B. It sounds like you're concerned about your privacy.
- C. The CIA is prohibited from operating in health care facilities.
- D. You have lost touch with reality, which is a symptom of your illness.
Correct Answer: B
Rationale: It is important not to challenge the patient's beliefs, even if they are unrealistic. Challenging undermines the patient's trust in the nurse. The nurse should try to understand the underlying feelings or thoughts the patient's message conveys. The correct response uses the therapeutic technique of reflection. The other comments are nontherapeutic. Asking to talk about something other than the concern at hand is changing the subject. Saying that the CIA is prohibited from operating in health care facilities gives false reassurance. Stating that the patient has lost touch with reality is truthful but uncompassionate.
A patient is having difficulty making a decision. The nurse has mixed feelings about whether to provide advice. Which principle usually applies about giving advice?
- A. It is rarely helpful.
- B. It fosters independence.
- C. It lifts the burden of personal decision making.
- D. It helps the patient develop feelings of personal adequacy.
Correct Answer: A
Rationale: Giving advice fosters dependence on the nurse and interferes with the patient's right to make personal decisions. Giving advice also robs patients of the opportunity to weigh alternatives and to develop problem-solving skills. Furthermore, it contributes to patient feelings of personal inadequacy. It also keeps the nurse in control and feeling powerful.