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The nurse is in the orientation phase of the nurse-patient relationship with a patient diagnosed with a mental disorder. When interviewing the patient during this first encounter, which information would be most important for the nurse to obtain about the patient?
- A. Known allergies
- B. Recent hospitalizations
- C. Perception of the problem
- D. Family history
Correct Answer: C
Rationale: In the orientation phase, establishing trust and understanding the patient?s perspective is critical. The patient?s perception of the problem provides insight into their mental health needs and guides the therapeutic relationship. Allergies, hospitalizations, and family history are important but secondary in this initial 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 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.
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 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.
A group of students are reviewing the process of verbal communication. The students demonstrate understanding of the information when they identify which of the following as the first component of the process?
- A. Formulation of an idea
- B. Message encoding
- C. Transmission of message
- D. Message reception
Correct Answer: A
Rationale: Verbal communication begins with formulating an idea, which is then encoded, transmitted, and received. Formulation is the initial step where the speaker conceptualizes the message.