A nurse is analyzing data collected during the assessment phase for a patient at risk for suicide. What is the primary goal of the diagnosis phase in the nursing process?
Building rapport and trust with the patient.
Identifying the nursing diagnoses related to suicide risk.
Developing a plan of care for the patient's needs.
Evaluating the effectiveness of interventions.
The Correct Answer is B
Choice A rationale:
Building rapport and trust with the patient. Building rapport and trust is a crucial aspect of the assessment phase, not the diagnosis phase, of the nursing process. While it's important to establish a strong nurse-patient relationship, the primary goal of the diagnosis phase is to identify and define the patient's health problems and needs.
Choice B rationale:
Identifying the nursing diagnoses related to suicide risk. The diagnosis phase involves analyzing the assessment data to identify and define the patient's health issues and needs. In the case of a patient at risk for suicide, it's essential to accurately identify the specific nursing diagnoses related to the suicide risk. This lays the foundation for developing an appropriate plan of care.
Choice C rationale:
Developing a plan of care for the patient's needs. While developing a plan of care is a critical step in the nursing process, it comes after the diagnosis phase. Once nursing diagnoses are identified, the nurse can then proceed to plan interventions and strategies to address the patient's needs.
Choice D rationale:
Evaluating the effectiveness of interventions. Evaluation is the final phase of the nursing process and occurs after interventions have been implemented. It involves determining whether the interventions have been successful in achieving the desired outcomes. The primary goal of the diagnosis phase is to identify the patient's health problems, not to evaluate interventions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Telling the client that they shouldn't feel a certain way and suggesting that others care about them minimizes their emotions and can be invalidating. It's essential to acknowledge the client's feelings without dismissing them.
Choice B rationale:
Expressing understanding and acknowledging the overwhelming nature of grief is appropriate and empathetic. This response validates the client's emotions and creates a safe space for them to express their feelings.
Choice C rationale:
While the intention behind encouraging the client to stay strong for their children might be positive, it oversimplifies the complexity of grief and emotional responses. Grief is a personal experience, and implying that they should suppress their emotions for the sake of others is not ideal.
Choice D rationale:
Suggesting that the client avoid thinking about their loss or that time will heal their wounds can invalidate their current emotional state. Grief doesn't always follow a linear path, and minimizing the impact of the loss can hinder the client's healing process.
Correct Answer is C
Explanation
Choice C rationale:
Collaborating with the client to develop a comprehensive aftercare plan is a priority nursing goal for a client who has recently attempted suicide and is now stabilized. Aftercare planning involves creating a structured plan that addresses the client's ongoing psychological, emotional, and social needs. This includes arranging follow-up therapy sessions, connecting with appropriate community resources, and involving the client in decisions regarding their care. Developing an aftercare plan aims to prevent further episodes of suicidal ideation and support the client's overall well-being. Isolating the client from friends and family, as mentioned in choice A, would be counterproductive. Isolation can exacerbate feelings of loneliness and hopelessness, potentially increasing the risk of further emotional distress. Encouraging the client to keep their feelings and experiences private, as suggested in choice B, is not in line with therapeutic practice. Open communication and sharing emotions with appropriate support systems are crucial for the client's healing process. Discharging the client home as soon as possible, as mentioned in choice D, without addressing the underlying issues and providing a comprehensive aftercare plan, could lead to a recurrence of suicidal thoughts and behaviors. It is essential to ensure the client's safety and well-being before considering discharge.
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