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.
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A female psychiatric patient is talking to the nurse about her reasons for being hospitalized. She begins to discuss her relationship with her female significant other. The patient is describing the things in her relationship that are making her uncomfortable, and she asks, 'Should I break up with my partner?' Which response by the nurse would be most effective in building rapport between the patient and nurse?
- A. Of course you should; being a lesbian is just not natural.
- B. Yes, I think you should pursue building a relationship with a man.
- C. It sounds like you?re beginning to be uncomfortable in this relationship.
- D. You need to focus on yourself rather than the relationship right now.
Correct Answer: C
Rationale: Building rapport requires a nonjudgmental, empathetic response that acknowledges the patient?s feelings. 'It sounds like you?re beginning to be uncomfortable in this relationship' reflects the patient?s emotions, fostering trust. Options A and B are judgmental and biased, and option D shifts focus prematurely, potentially dismissing the patient?s concerns.
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.
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.
When engaged in a nontherapeutic relationship, which of the following would the nurse identify as occurring first?
- A. Failure to recognize the patient as a person with a need
- B. Patient avoiding the nurse
- C. The nurse being perceived as rude
- D. Patient feeling hopeless and frustrated
Correct Answer: A
Rationale: A nontherapeutic relationship begins with the nurse?s failure to recognize the patient?s individual needs, undermining trust and rapport. This precedes patient avoidance, perceptions of rudeness, or feelings of hopelessness, which are outcomes of the initial failure.
A patient is talking to the nurse about the recent death of her grandmother. She is obviously very sad, and a tear rolls down her cheek as she talks. The nurse remembers how she felt when her own grandmother died the previous summer. The nurse puts her hand on the patient?s shoulder and says, 'This must be very difficult for you.' The nurse is demonstrating empathy based on which of the following?
- A. The response comment reflects an attempt to communicate understanding of patient?s feelings.
- B. The nurse?s response and use of reassuring touch reinforce the nurse?s concern for the patient.
- C. The nurse demonstrates understanding of how the patient feels because of her own grandmother?s death.
- D. The nurse?s statement expresses compassion and kindness toward the patient.
Correct Answer: A
Rationale: Empathy involves understanding and communicating the patient?s feelings. The nurse?s statement and touch reflect an attempt to convey understanding of the patient?s grief, aligning with empathy. Option C describes countertransference, and options B and D describe compassion but not the specific mechanism of empathy.
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