A client diagnosed with schizophrenia, on an inpatient unit, approaches a nurse, stating, "Someone took my dinner! People need to respect others, and you need to do something about this now!" Which response by the nurse is guided by the basic assumption of the therapeutic milieu?
"I can see that you are upset. Let's talk about ways to resolve this."
I'll fix this right away. You need to calm down."
"Let's find a way to avoid this conflict in the future."
"You should bring this up during group therapy later this week."
The Correct Answer is A
a. "I can see that you are upset. Let's talk about ways to resolve this." This is correct because it validates the client's feelings, encourages problem-solving, and maintains the therapeutic milieu's principles of respect and support.
b. "I'll fix this right away. You need to calm down." This response does not encourage the client’s participation in resolving the issue and does not foster the therapeutic milieu's goal of client empowerment.
c. "Let's find a way to avoid this conflict in the future." While this promotes future problem-solving, it does not address the immediate concern or validate the client's current feelings.
d. "You should bring this up during group therapy later this week." This delays addressing the client's immediate concerns and might make the client feel unheard.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
a. Remain with the client: This is correct because staying with the client provides reassurance and safety, which is crucial during a panic attack.
b. Ask the client to describe what was happening before the anxiety began: While understanding triggers is important, this is not the immediate action during a panic attack when the client needs reassurance.
c. Instruct the client to remain alone until the symptoms subside: This is incorrect as being alone can increase the client’s anxiety and panic.
d. Teach the client to recognize signs of a panic attack: Education is important but should be done after the acute symptoms have subsided. The immediate priority is to provide comfort and safety.
Correct Answer is C
Explanation
a. "I can make that promise to you based on nurse-client privilege." Nurse-client confidentiality is important, but it doesn't apply to threats of violence. The nurse has a duty to protect the client and others.
b. "Those kinds of thoughts will make your hospitalization longer." While true, this response doesn't directly address the safety concern and might be perceived as judgmental.
c. "I cannot promise that. Confidentiality does not include plans to hurt others." This is a clear and honest statement. It explains the limitations of confidentiality and prioritizes safety.
d. "You should share this thought with your psychiatrist." While encouraging the client to talk to a psychiatrist is a good suggestion, it doesn't directly address the confidentiality issue or the immediate threat.
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