Nokea
The nurse is engaged in a therapeutic nurse-patient relationship. The relationship is in the working phase. With which of the following would the patient be involved? Select all that apply.
- A. Beginning to identify a need
- B. Testing new ways for problem solving
- C. Testing the relationship
- D. Discussing problems related to needs
- E. Examining personal issues
Correct Answer: B,D,E
Rationale: In the working phase of the nurse-patient relationship (per Peplau), the patient actively engages in problem-solving, discussing needs, and examining personal issues to achieve therapeutic goals. Identifying needs and testing the relationship occur in the orientation phase.
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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 responds to a patient?s statement with silence based on the rationale that this technique is used primarily to do which of the following?
- A. Allow the nurse to determine an appropriate response
- B. Permit the patient to gather his or her thoughts
- C. Encourage self-reflection by the nurse
- D. Demonstrate passive listening
Correct Answer: B
Rationale: Silence in therapeutic communication allows the patient to gather thoughts, process emotions, or continue speaking, promoting deeper exploration. It?s not primarily for the nurse?s response planning, self-reflection, or passive listening, which is nontherapeutic.
A nurse has engaged in self-awareness and has come to understand his own personal beliefs and attitudes and has recognized some prejudicial ideas. Based on this understanding, which of the following would the nurse now be able to accomplish?
- A. Have a therapeutic relationship with a patient.
- B. Influence patients with certain biases.
- C. Change learned behaviors.
- D. Formulate values and morals.
Correct Answer: A
Rationale: Self-awareness, including recognizing personal biases, allows the nurse to set aside prejudices and engage objectively with patients, fostering a therapeutic relationship. Influencing patients with biases is unethical, changing behaviors requires more than self-awareness, and formulating values and morals is a broader personal process not directly tied to patient care.
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.
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.