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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.
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While providing care to a patient with a mental disorder, the patient asks the nurse, 'Does mental illness run in your family?' Which response by the nurse would be most inappropriate?
- A. Mental illnesses do run in families, and I?ve had a lot of experience caring for people with mental illness.
- B. It sounds like you are concerned that there may be a family connection to your current problem?
- C. Yes, it does. I have a sister who was diagnosed several years ago with severe major depression.
- D. Mental illness can be family related. Let?s focus the discussion on you and how you?re doing today.
Correct Answer: C
Rationale: Self-disclosure, especially personal details like a family member?s mental illness, is inappropriate in therapeutic communication unless it directly benefits the patient. Option C risks shifting focus to the nurse. Other responses redirect to the patient?s concerns or provide general information, maintaining therapeutic focus.
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.
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 patient who is hospitalized with depression tells the nurse, 'I don?t want to take the medication because I?m afraid I?ll become suicidal.' Which response by the nurse would be most appropriate?
- A. Have you ever thought about hurting yourself?
- B. It?s important that you take this medication.
- C. I agree with you. I wouldn?t want to take this medication either.
- D. Another patient took that medication, and he really felt better.
Correct Answer: A
Rationale: The patient?s fear of becoming suicidal warrants immediate assessment for suicidal ideation. Asking 'Have you ever thought about hurting yourself?' directly addresses this concern and ensures patient safety. Other responses dismiss the fear, agree inappropriately, or provide irrelevant anecdotes, none of which address the patient?s concern effectively.