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Which statement would the nurse use to describe the primary purpose of boundaries?
- A. Boundaries define responsibilities and duties to one’s self in relation to others.
- B. Boundaries determine objectives of the various working stage of the relationship.
- C. Boundaries differentiate the assumed roles of both the nurse and of the patient.
- D. Boundaries prevent undesired material from emerging during the interaction.
Correct Answer: A
Rationale: Boundaries define responsibilities and duties to one’s self in relation to others. Setting boundaries is essential in establishing a safe and professional therapeutic relationship between a nurse and a patient. These boundaries help to create a clear understanding of each person's roles and responsibilities within the relationship. Boundaries also help protect both the nurse and the patient from potential harm, maintain professionalism, and ensure effective communication and focus on the therapeutic goals. By defining these boundaries, the nurse can better maintain appropriate relationships with patients and avoid conflicts of interest or ethical dilemmas.
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What would be an appropriate short-term outcome for a patient diagnosed with residual schizophrenia who exhibits ambivalence?
- A. Decide their own daily schedule.
- B. Decide which unit groups they will attend.
- C. Choose between two outfits to wear each morning.
- D. Choose which clinic staff member to work with.
Correct Answer: C
Rationale: Residual schizophrenia can cause ambivalence or difficulty making decisions. Offering simple choices reduces decision-making stress and promotes autonomy.
An advanced practice nurse is qualified to perform which action for patients?
- A. Perform mental health assessment interviews.
- B. Prescribe psychotropic medication.
- C. Establish therapeutic relationships.
- D. Individualize nursing care plans.
Correct Answer: B
Rationale: Advanced practice nurses, such as psychiatric-mental health nurse practitioners, are qualified to prescribe medications, including psychotropics, as part of their expanded scope of practice. Other listed actions can also be performed by registered nurses.
A nurse wants to assess for suicidal ideation in an elderly patient. Select the best question to begin this assessment.
- A. What are your beliefs about a person’s right to take his or her own life?
- B. Are there any things going on in your life that would cause you to consider suicide?
- C. Do you think you are vulnerable to developing a depressed mood?
- D. If you felt suicidal, would you tell someone about your feelings?
Correct Answer: B
Rationale: his open-ended question directly addresses the patient’s thoughts about suicide in the context of their current life situation, giving them an opportunity to express any concerns or ideations.
When asked, “Why do you go to music therapy every morning at 10?” The nurse explains that the nurse’s role in music therapy as:
- A. Fostering and encouraging performance talent
- B. Teaching patients about various styles of music
- C. Noting patient verbal and nonverbal expression of feelings
- D. Selecting and playing numbers that will reduce anxiety and stress
Correct Answer: C
Rationale: The nurse's role in music therapy is to note patient verbal and nonverbal expression of feelings. In music therapy, the focus is on using music as a tool to help patients express themselves, connect with their emotions, and communicate their feelings in a non-verbal manner. The nurse's job is to observe and interpret how the patients are engaging with the music and using it as a medium to express their inner thoughts and emotions. This can help in promoting emotional well-being and providing a space for patients to process their feelings in a therapeutic way.
The patient and the nurse have agreed on problems to be addressed during a short course of outpatient therapy. At the beginning of the appointment, the patient states, “I’d like to work on the issue of relationships today.” Which assessment can be made?
- A. The nurse should suggest several alternative behaviors.
- B. The patient must be able to manage emotions before continuing.
- C. The relationship is moving from orientation to working phase.
Correct Answer: C
Rationale: The correct assessment to be made in this scenario is that the relationship is moving from the orientation phase to the working phase. In the orientation phase of the nurse-patient therapeutic relationship, the focus is on building rapport, establishing trust, and determining the patient's needs and goals. As the patient voluntarily expresses a desire to work on the issue of relationships, it indicates a transition to the working phase where the patient actively identifies problems to address and goals to achieve. This shift demonstrates progress in the therapeutic relationship as the patient is engaging in the therapeutic process and contributing to the agenda set for the appointment. It signifies a readiness for collaborative problem solving and intervention planning, emphasizing the importance of the patient's involvement in decision-making and goal-setting in the therapeutic process.