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When communicating with a patient, which of the following would the nurse use to convey positive body language?
- A. Sitting erect with back against the chair
- B. Crossing the arms over the chest
- C. Sitting at the patient?s eye level
- D. Keeping the feet flat on the floor with the legs crossed
Correct Answer: C
Rationale: Sitting at the patient?s eye level conveys openness, respect, and engagement, fostering positive communication. Crossing arms or legs can appear defensive, and sitting erect with back against the chair may seem rigid, less conducive to rapport.
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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 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.
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.
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.
A patient is a successful insurance salesman; however, because of market changes, his level of sales has dropped. His boss tells him he will consequently be receiving a $2,000 per year cut in his salary. When the patient arrives home from work, the family dog runs to greet him as he always does, barking and jumping up and down and begging for attention. The patient yells at the dog, 'Get away from me; I can?t take your barking right now.' The patient?s response reflects a defense mechanism because it was which of the following?
- A. An intentional behavior performed to let the dog know his behavior was inappropriate
- B. Automatic, protecting the patient from the anxiety related to his upcoming pay cut
- C. Implemented to keep the patient from having to cope with his upcoming pay cut
- D. Implemented so the patient could rationalize his upcoming pay cut
Correct Answer: B
Rationale: The patient?s response reflects displacement, a defense mechanism where emotions (anxiety about the pay cut) are redirected to a less threatening target (the dog). This is automatic and protects the patient from directly confronting anxiety. The response is not intentional training, avoidance of coping, or rationalization.