Nokea
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.
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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 client who had been in a substance abuse treatment program asks the nurse to attend a picnic with his family after the client is discharged. The nurse should explain the importance of which of the following?
- A. Maintaining professional boundaries
- B. Attending family events to support recovery
- C. Ensuring family involvement in treatment
- D. Encouraging social interactions post-discharge
Correct Answer: A
Rationale: A therapeutic relationship is professional, focused on meeting the client's needs, and is terminated when the client no longer needs services. The nurse must maintain professional boundaries.
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.
The nurse is mindful of maintaining relationships with patients that are therapeutic. Certain characteristics of the relationships the nurse will foster include: Select all that apply.
- A. offering sound advice to the patient.
- B. establishing boundaries for both the nurse and patient.
- C. maintaining a patient-focus at all times
- D. sharing personal feelings openly with the patient.
- E. avoiding concern with whether the patient likes the nurse
Correct Answer: B,C,E
Rationale: The therapeutic relationship focuses on the needs, experiences, feelings, and ideas of the client only, with clear boundaries and no concern for whether the client likes the nurse.
A nurse is working with a patient whose background is very different from hers. A good question to ask herself to assure she can be effective working with this patient would be,
- A. Can this person understand me?
- B. Do I understand this patient's expectations of me?
- C. What experiences do I have with people with similar backgrounds?
- D. Is this person going to be able to relate to me?
Correct Answer: C
Rationale: To best assess self-awareness, the nurse should ask 'What experiences have I had with people from ethnic groups, socioeconomic classes, religions, age groups, or communities different from my own?'