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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.
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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.
A patient who is hospitalized with depression tells the nurse, 'I don?t want to take the medication because I?m afraid I?ll become suicidal.' Which response by the nurse would be most appropriate?
- A. Have you ever thought about hurting yourself?
- B. It?s important that you take this medication.
- C. I agree with you. I wouldn?t want to take this medication either.
- D. Another patient took that medication, and he really felt better.
Correct Answer: A
Rationale: The patient?s fear of becoming suicidal warrants immediate assessment for suicidal ideation. Asking 'Have you ever thought about hurting yourself?' directly addresses this concern and ensures patient safety. Other responses dismiss the fear, agree inappropriately, or provide irrelevant anecdotes, none of which address the patient?s concern effectively.
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.
The nurse is in the orientation phase of the nurse-patient relationship with a patient diagnosed with a mental disorder. When interviewing the patient during this first encounter, which information would be most important for the nurse to obtain about the patient?
- A. Known allergies
- B. Recent hospitalizations
- C. Perception of the problem
- D. Family history
Correct Answer: C
Rationale: In the orientation phase, establishing trust and understanding the patient?s perspective is critical. The patient?s perception of the problem provides insight into their mental health needs and guides the therapeutic relationship. Allergies, hospitalizations, and family history are important but secondary in this initial phase.
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.