A nurse is caring for a client with whom she has developed a therapeutic relationship.
The client, who will be discharged later in the day, thanks the nurse for her help during the hospitalization.
Which of the following responses should the nurse make?
“How do you feel about being discharged?”
“I will send you a note in a few weeks.”.
“I know you will do well living out in the community.”.
“Aren’t you excited about being discharged today?” . .
The Correct Answer is A
Choice A rationale
The nurse’s response of asking the client, “How do you feel about being discharged?” is the most therapeutic. This open-ended question encourages the client to express their feelings and concerns about being discharged. It allows the nurse to assess the client’s readiness for discharge and to provide appropriate education or referrals if needed. It also demonstrates empathy and respect for the client’s feelings, which are key components of a therapeutic relationship.
Choice B rationale
Telling the client, “I will send you a note in a few weeks,” is not the best response. While it may seem like a kind gesture, it could potentially blur the boundaries of the therapeutic relationship. Nurses must maintain professional boundaries with clients to ensure that the focus remains on the client’s needs and not the personal feelings or needs of the nurse.
Choice C rationale
Saying, “I know you will do well living out in the community,” is an assumption and does not invite the client to share their feelings or concerns. It’s important for the nurse to encourage the client to express their feelings about discharge and to provide support and education based on the client’s individual needs.
Choice D rationale
Asking the client, “Aren’t you excited about being discharged today?” is a closed-ended question that assumes the client is excited about discharge. This type of question does not encourage the client to share their feelings or concerns. It’s important for the nurse to use open-ended questions to encourage the client to express their feelings about discharge.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale
Actively seeking is a stage of chemical dependency where the individual actively seeks out the substance. In this scenario, the teenager is not just seeking heroin, but is using it to prevent withdrawal symptoms, which suggests a more advanced stage of dependency.
Choice B rationale
Experimentation is the initial stage of chemical dependency where the individual first tries the substance. However, the teenager in this scenario is past the experimentation stage as she is using heroin regularly to prevent withdrawal symptoms.
Choice C rationale
Burnout is a stage of chemical dependency characterized by physical and mental exhaustion due to prolonged substance use. While the teenager may be experiencing burnout, the scenario specifically mentions her use of heroin to prevent withdrawal symptoms, which is more indicative of the preoccupation stage.
Choice D rationale
Preoccupation is a stage of chemical dependency where the individual is consumed by thoughts of the substance and uses it to prevent withdrawal symptoms. The teenager’s belief that she cannot cope without heroin and her use of it to prevent withdrawal symptoms align with this stage.
Correct Answer is C
Explanation
Choice A rationale
The preparation phase is the initial stage of the therapeutic relationship where the groundwork for the rest of the relationship is laid. However, the establishment of a working caregiver-client agreement is not a step in this phase.
Choice B rationale
The assessment phase involves gathering information about the client, but it does not typically involve the establishment of a working caregiver-client agreement.
Choice C rationale
The working phase of the therapeutic relationship is where nursing interventions frequently take place. Problems and issues are identified and plans to address these are put into action. This phase includes the establishment of a working caregiver-client agreement.
Choice D rationale
The orientation phase defines the problem and identifies the type of service needed by the patient. However, the establishment of a working caregiver-client agreement is not a step in this phase.
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