A nurse explains to a nursing student how the therapeutic relationship differs from a social relationship. What is the best explanation for the therapeutic relationship between the nurse and patient?
“The focus of the relationship is socialization. Mutual needs are met, and feelings are openly shared.”
“The focus is the creation of a partnership in which each member is concerned with the growth and satisfaction of the other.”
“The focus is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient.”
“The focus shifts from nurse to patient as the relationship develops. Advice is given by both, and solutions are implemented.”
The Correct Answer is C
Choice A reason: Socialization and mutual needs define social relationships, not therapeutic ones. Therapeutic relationships focus on patient needs, like addressing serotonin-driven depression, not reciprocal sharing. This approach risks blurring professional boundaries, making it incorrect for psychiatric nursing’s patient-centered focus.
Choice B reason: Mutual growth and satisfaction characterize social partnerships, not therapeutic relationships. In psychiatric care, the focus is on patient recovery, addressing issues like dopamine imbalances, not nurse satisfaction. This option misaligns with the professional, patient-centered nature of therapeutic relationships.
Choice C reason: The therapeutic relationship centers on the patient, addressing issues like amygdala-driven anxiety through collaborative discussion. Solutions, like medication adherence, are patient-driven to promote autonomy, aligning with neurobiological and psychological recovery principles, making this the correct description of the therapeutic dynamic.
Choice D reason: Shifting focus and mutual advice blur professional boundaries, resembling social relationships. Therapeutic relationships prioritize patient needs, like serotonin stabilization, with nurse guidance, not reciprocal advice. This option misrepresents the patient-centered, evidence-based nature of psychiatric therapeutic relationships.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Arising slowly addresses orthostatic hypotension, a side effect of alpha-1 receptor blockade, not dopamine effects. First-generation antipsychotics primarily block D2 receptors, affecting motor and cognitive pathways, not vascular tone. Hypotension is unrelated to dopaminergic effects, making this teaching point scientifically inaccurate.
Choice B reason: Dopamine D2 receptor blockade in the nigrostriatal pathway causes extrapyramidal symptoms, like muscle stiffness, in first-generation antipsychotics. This mimics Parkinson’s disease due to reduced dopamine signaling, impairing motor control. Teaching patients to report stiffness ensures early detection and management, aligning with the neuropharmacological impact of these drugs.
Choice C reason: Chewing sugarless gum addresses dry mouth, an anticholinergic side effect, not dopaminergic. First-generation antipsychotics block muscarinic receptors, not dopamine, causing reduced salivation. While common, this is unrelated to dopaminergic effects, making this teaching point irrelevant for the specified drug mechanism.
Choice D reason: Increasing dietary fiber addresses constipation, another anticholinergic effect, not dopaminergic. Dopamine blockade affects motor and reward systems, not gastrointestinal motility, which is regulated by muscarinic receptors. This teaching point does not correspond to the dopaminergic effects of first-generation antipsychotics, rendering it incorrect.
Correct Answer is A
Explanation
Choice A reason: Paroxetine, an SSRI, is first-line for GAD, enhancing serotonin in the amygdala and prefrontal cortex, reducing excessive worry. Its efficacy and tolerability, with minimal dependence risk, align with evidence-based guidelines for long-term anxiety management, making it the preferred choice.
Choice B reason: Imipramine, a tricyclic antidepressant, affects serotonin and norepinephrine but has significant anticholinergic side effects, reducing tolerability. It is not first-line for GAD due to slower onset and side effect profile compared to SSRIs, which better target anxiety’s neurobiological basis.
Choice C reason: Hydroxyzine, an antihistamine, reduces anxiety via histamine receptor blockade, causing sedation. It is used as needed, not for chronic GAD management. SSRIs, like paroxetine, offer sustained serotonin modulation, making hydroxyzine a less effective, non-first-line option for long-term treatment.
Choice D reason: Alprazolam, a benzodiazepine, enhances GABA activity, providing rapid anxiety relief but carries high dependence risk. It is not first-line for GAD, as SSRIs offer safer, long-term serotonin-based treatment, making alprazolam unsuitable for chronic management due to addiction potential.
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