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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.
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A nurse engaged in an interaction with a patient recognizes body space zones. Which of the following would the nurse identify as the individual?s personal zone?
- A. Beginning at the boundary of the intimate zone and ending at the social zone
- B. Extending outward from the border to the public zone
- C. Surrounding and protecting an individual from others, especially outsiders
- D. The most distant boundary that can be used for recognizing intruders
Correct Answer: A
Rationale: The personal zone, per Hall?s proxemics theory, extends from 1.5 to 4 feet, beginning at the boundary of the intimate zone (0?1.5 feet) and ending at the social zone (4?12 feet). It?s used for comfortable interactions. Other options describe the social zone, a general concept, or the public zone, respectively.
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 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 group of nursing students are preparing a class presentation on therapeutic and nontherapeutic techniques of communication. The students demonstrate understanding of the information when they select which techniques to demonstrate as therapeutic? Select all that apply.
- A. Confrontation
- B. Open-ended statements
- C. Reflection
- D. Reassurance
- E. Agreement
- F. Challenges
Correct Answer: B,C
Rationale: Open-ended statements and reflection are therapeutic techniques, encouraging patient exploration and self-expression. Confrontation and challenges can be therapeutic in specific contexts but are often nontherapeutic if poorly timed. Reassurance and agreement risk dismissing patient concerns or aligning too closely, reducing therapeutic value.
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.