A nurse is Caring for a client who is extremely suspicious of the nursing staff and other clients. Which of the following nursing approaches is appropriate when establishing a therapeutic relationship with this client?

Disclose some personal information to the client to demonstrate approachability.

Approach the client frequently throughout the day for brief interactions.

Adopt a neutral attitude when providing care.

Wait for the client to initiate interaction.

Answer and Explanation

The Correct Answer is C

Sharing personal information can blur the professional boundaries and might not be effective in reducing the client's suspicion. It's important to maintain a professional demeanor while building trust.

B) Approach the client frequently throughout the day for brief interactions:

While it's important to establish a presence and provide support, approaching the client too frequently might increase their discomfort and reinforce their suspicion. It's better to allow the client some personal space while ensuring they know you are available when needed.

C) Adopt a neutral attitude when providing care.

Explanation:

When dealing with a client who is extremely suspicious, it's important for the nurse to approach the situation with a neutral attitude. A neutral attitude helps to build trust and minimize any potential triggers for the client's suspicion. This approach creates a non-threatening environment where the client may feel more comfortable and gradually begin to open up.

D) Wait for the client to initiate interaction:

While giving the client space is important, waiting for them to initiate interaction might prolong the development of a therapeutic relationship. Clients who are extremely suspicious might have difficulty initiating interactions due to their concerns.

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Correct Answer is ["A","B","C","D"]

Explanation

A. Lithium: Lithium is a mood stabilizer commonly used in the treatment of bipolar disorder. It helps to control mood swings and prevent the recurrence of manic and depressive episodes.

B. Carbamazepine: Carbamazepine is an anticonvulsant medication that has been found effective in managing mood swings in bipolar disorder. It can help stabilize mood and prevent manic episodes.

C. Valproate (Valproic acid or Divalproex sodium): Valproate is another anticonvulsant medication that is used as a mood stabilizer in bipolar disorder. It can help control manic and mixed episodes.

The following options are not used to treat bipolar disorder:

D. Paroxetine: SSRIs, including paroxetine, carry a risk of inducing mania or hypomania in individuals with bipolar disorder. This risk is why these medications are usually avoided or used cautiously, always in conjunction with a mood stabilizer like lithium, valproate, or atypical antipsychotics. Before initiating paroxetine, it’s crucial that the client is stabilized with a mood stabilizer to minimize the risk of mood switching (i.e., moving from depression to mania or hypomania).

E. Donepezil: Donepezil is a medication used to treat Alzheimer's disease and other forms of dementia. It is not used to treat bipolar disorder.

A. "I can see that you trust me, but you should share those feelings with your psychiatrist, not me." B. I will not violate our nurse-client relationship. The information we discuss will remain confidential between us." C. "Because you are a minor, I have to share any information that I feel is important with your parents." D. "I cannot promise that. I must share this information with other members of the team who are responsible for planning your care,"

Correct Answer is D

Explanation

A. "I can see that you trust me, but you should share those feelings with your psychiatrist, not me."

While encouraging the client to discuss their feelings with a mental health professional is important, this response does not address the immediate safety concern presented by the client's intent to harm others.

B. "I will not violate our nurse-client relationship. The information we discuss will remain confidential between us."

This response is inappropriate because it implies that the nurse will keep the information confidential, even though the client's statement raises concerns about the safety of others.

C. "Because you are a minor, I have to share any information that I feel is important with your parents."

While parents may have the right to be informed about their minor child's well-being, this situation goes beyond parental involvement. The nature of the threat requires immediate intervention from appropriate professionals and authorities.

"D. I cannot promise that. I must share this information with other members of the team who are responsible for planning your care."

Explanation: The client's statement about having a desire to harm others, especially classmates and a school teacher, raises significant concerns about the safety and well-being of not only the client but also the potential victims. In cases where the client poses a risk of harm to themselves or others, the nurse has a duty to breach confidentiality to ensure the safety of all involved parties. This response conveys the nurse's ethical obligation to involve other members of the treatment team and appropriate authorities to address the potential threat.

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A nurse is Caring for a client who is extremely suspicious of the nursing staff and other clients. Which of the following nursing approaches is appropriate when establishing a therapeutic relationship with this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","B","C","D"]

Explanation

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Correct Answer is D

Explanation

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