Nokea
Which remark by a patient indicates passage from the orientation phase to the working phase of a nurse-patient relationship?
- A. I don't have any problems.'
- B. It is so difficult for me to talk about my problems.'
- C. I don't know how talking about things twice a week can help.'
- D. I want to find a way to deal with my anger without becoming violent.'
Correct Answer: D
Rationale: Expressing a desire to address specific behaviors indicates readiness for behavioral change, characteristic of the working phase.
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A patient says, 'I'm still on restriction, but I want to attend some off-unit activities. Would you ask the doctor to change my privileges?' What is the nurse's best response?
- A. Why are you asking me when you're able to speak for yourself?'
- B. I will be glad to address it when I see your doctor later today.'
- C. That's a good topic for you to take up with your doctor.'
- D. Do you think you can't speak to a doctor?'
Correct Answer: C
Rationale: Encouraging the patient to advocate for themselves promotes independence and optimal functioning.
Which statement shows a nurse has empathy for a patient who made a suicide attempt?
- A. You must have been very upset when you tried to hurt yourself.'
- B. It makes me sad to see you going through such a difficult experience.'
- C. If you tell me what is troubling you, I can help you solve your problems.'
- D. Suicide is a drastic solution to a problem that may not be such a serious matter.'
Correct Answer: A
Rationale: Empathy permits the nurse to see an event from the patient's perspective, understand the patient's feelings, and communicate this to the patient. The incorrect responses are nurse-centered, belittling, or sympathetic.
As a patient diagnosed with mental illness is being discharged from a facility, a nurse invites the patient to the annual staff picnic. What is the best analysis of this scenario?
- A. The invitation facilitates dependency on the nurse.
- B. The nurse's action blurs the boundaries of the therapeutic relationship.
- C. The invitation is therapeutic for the patient's diversional activity deficit.
- D. The nurse's action assists the patient's integration into community living.
Correct Answer: B
Rationale: The invitation creates a social rather than therapeutic relationship, blurring professional boundaries.
What patient behavior is the desirable outcome for the orientation stage of a nurse-patient relationship?
- A. Gaining a sense of independence
- B. Building rapport and trust with the nurse
- C. Assuming self-responsibility and autonomy
- D. Effective resolution of feelings of transference
Correct Answer: B
Rationale: Rapport and trust are necessary for the relationship to progress to the working phase. Other behaviors occur later.
A patient says, 'Please don't share information about me with the other people.' How should the nurse respond?
- A. I won't share information with others without your permission, but I will share information about you with other staff members.'
- B. A therapeutic relationship is just between the nurse and the patient. It's up to you to tell others what you want them to know.'
- C. It really depends on what you choose to tell me. I will be glad to disclose at the end of each session what I will report to others.'
- D. I cannot tell anyone about you. It will be as though I am talking about my own problems, and we can help each other by keeping it between us.'
Correct Answer: A
Rationale: A patient has the right to know with whom the nurse will share information and that confidentiality will be protected. Other staff members need pertinent data, making this response appropriate.