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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.
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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.
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.
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.
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.
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.