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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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 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 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.
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 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.