A client who was admitted 5 days ago for medication non-adherence is ready for discharge. The client's thoughts are now more organized.
What is covered during the termination phase?
Ask the client about their problems to gather data.
Review events during the nurse-patient relationship.
Ask the case manager to arrange a transfer to a long-term care facility.
Have a discussion about relationship parameters.
The Correct Answer is B
Choice A rationale
The initial phase of the nurse-patient relationship, known as the orientation phase, is where data collection and problem identification occur. During this phase, the nurse and client establish a rapport and define the purpose and goals of their interaction. This is a foundational step, distinct from termination, which focuses on the conclusion of the relationship. The termination phase involves summarizing and evaluating progress made.
Choice B rationale
The termination phase of the therapeutic relationship involves a systematic review of the entire nurse-patient interaction. This includes summarizing the progress made, identifying the client's new coping skills, and discussing the client's feelings about the end of the relationship. This process helps solidify the client's gains and prepares them for continued self-management after discharge, promoting independence.
Choice C rationale
Arranging for a transfer to a long-term care facility is a component of discharge planning, but it is not the primary focus of the termination phase itself. Discharge planning involves interdisciplinary collaboration to ensure a safe transition for the client. The termination phase is a distinct psychological and therapeutic process that concludes the one-on-one relationship between the nurse and the client.
Choice D rationale
Relationship parameters, such as the purpose, rules, and boundaries of the interaction, are established during the orientation phase. This phase sets the stage for a therapeutic alliance, differentiating it from a social relationship. The termination phase, in contrast, focuses on the conclusion of the established relationship and the planning for the client’s future beyond the nurse's care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Leaving the picture of the Virgin Mary where the client placed it shows cultural respect and acknowledges the client's spiritual beliefs. This action promotes a trusting therapeutic relationship by validating the client's values and practices. Culturally competent care involves honoring an individual's unique background, and this simple act demonstrates that the nurse respects the client as a whole person, which is essential for holistic care and patient satisfaction.
Choice B rationale
Sending the picture home with the client’s family would be culturally insensitive and could be perceived as disrespecting the client's spiritual beliefs. This action may cause the client to feel their values are not important or are being disregarded, which can damage the nurse-client relationship. Furthermore, it could lead to increased anxiety and mistrust, negatively impacting the client's overall well-being and willingness to cooperate with the treatment plan.
Choice C rationale
Sending a personal, religious item to the business office safe is unnecessary and disrespectful. This action implies the item is of no importance to the client's care, which can be spiritually and emotionally distressing. It separates the client from a source of comfort and spiritual strength, which is a vital part of a holistic approach to healing. It also fails to recognize the significance of such items in many cultures.
Choice D rationale
Moving the picture to a different location, even to a window, can be seen as dismissive of the client's wishes and spiritual needs. The client placed the picture in a specific spot for a reason, likely for comfort and proximity. Relocating it without permission disregards their autonomy and could be perceived as a subtle form of disrespect, potentially causing a client to feel powerless and unimportant in their own care.
Correct Answer is A
Explanation
Choice A rationale
The sympathetic nervous system is a branch of the autonomic nervous system responsible for the "fight-or-flight" response. When the client experiences severe anxiety, the sympathetic nervous system is stimulated. This activation leads to a cascade of physiological changes including an increased heart rate, elevated blood pressure, and pupil dilation, preparing the body to respond to a perceived threat or stressor.
Choice B rationale
The parasympathetic nervous system is responsible for the "rest-and-digest" response. It works antagonistically to the sympathetic nervous system, promoting relaxation and conserving energy. Its activation would lead to a decrease in heart rate and blood pressure, and would not be stimulated in a state of severe anxiety.
Choice C rationale
The vagus nerve is the tenth cranial nerve and is a major component of the parasympathetic nervous system. While it plays a crucial role in regulating heart rate and digestion, its primary function is to promote rest and relaxation. Therefore, it would not be stimulated during a state of severe anxiety.
Choice D rationale
The limbic system is a complex set of structures in the brain that plays a major role in emotion, motivation, and memory. While it is involved in the experience of anxiety, it is not part of the autonomic nervous system. The limbic system is the central processing unit for emotional responses, which then trigger the autonomic nervous system.
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