A confused older adult patient in a skilled nursing facility was asleep when unlicensed assistive personnel (UAP) entered the room quietly and touched the bed to see if it was wet.

The patient awakened and hit the UAP in the face.

Which statement best explains the patient’s action?

Choice A rationale
The nurse’s response, “Tell me how you felt when your fiancé broke up with you,” is the most therapeutic because it encourages the client to express feelings. This is a crucial step in the healing process. The nurse is using active listening skills and showing empathy, which can help build a therapeutic relationship with the client. It’s important for the nurse to provide a safe and nonjudgmental environment for the client to express feelings of sadness, anger, or guilt related to the breakup.
Choice B rationale
The response, “Maybe the breakup was for the best,” is not therapeutic because it minimizes the client’s feelings and experiences. It’s not the nurse’s place to make judgments or assumptions about the situation. The nurse should focus on the client’s feelings and provide support.
Choice C rationale
The response, “Do you think you are better off without your fiancé?” could be seen as leading or suggestive. It’s important for the nurse to remain neutral and not impose personal beliefs or opinions on the client.
Choice D rationale
The response, “How could your fiancé be wonderful after saying those things to you?” could be seen as confrontational and judgmental. It’s not the nurse’s role to judge the client’s relationships or experiences. The nurse should provide a supportive and understanding environment for the client to express feelings.

Choice A rationale
While it’s true that both therapy and medication are often recommended for treating conditions like depression, this doesn’t explain why a patient needs to attend therapy in addition to taking their prescribed antidepressant medication.
Choice B rationale
The statement that the effects of medications will not last forever is somewhat misleading. While it’s true that medications aren’t a cure-all, they can provide long-term management of symptoms for many individuals.
Choice C rationale
This choice doesn’t provide an explanation for why therapy is necessary in addition to medication. It merely acknowledges that the patient has reservations about going to therapy.
Choice D rationale
This is the best explanation. Medications can help improve brain function by balancing neurotransmitters, which can alleviate symptoms of mental health conditions. Therapy, on the other hand, can help patients develop coping strategies, understand and change thought patterns, and implement behavioral changes, which can lead to more enduring improvements over time.