A nurse is developing a plan of care integrating Maslow’s hierarchy of needs. Which area would the nurse identify as the priority?

PREDICTABLE SOCIAL ENVIRONMENT

ADEQUATE FOOD

POSITIVE SELF-IMAGE

ACCEPTANCE FROM FAMILY

Answer and Explanation

The Correct Answer is B

Choice A reason:
A predictable social environment is important for providing stability and security, which can contribute to a client’s overall well-being. However, according to Maslow’s hierarchy of needs, physiological needs such as food and water must be met before higher-level needs like social stability can be addressed. Therefore, while important, a predictable social environment is not the immediate priority.
Choice B reason:
Adequate food is a fundamental physiological need according to Maslow’s hierarchy of needs. Physiological needs are the most basic and must be satisfied before an individual can focus on higher-level needs such as safety, love, and self-esteem. Ensuring that the client has adequate food is essential for their survival and overall health, making it the top priority in the plan of care.
Choice C reason:
A positive self-image is associated with self-esteem needs, which are higher up in Maslow’s hierarchy. While fostering a positive self-image is important for a client’s mental health and well-being, it cannot be effectively addressed until basic physiological needs are met. Therefore, it is not the immediate priority in the plan of care.
Choice D reason:
Acceptance from family relates to the need for love and belonging, which is also higher up in Maslow’s hierarchy. While family acceptance is crucial for emotional support and social well-being, it is not as immediate a priority as ensuring that the client’s basic physiological needs, such as adequate food, are met first.

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Correct Answer is A

Explanation

Choice A reason:

“It is now time for you to bathe. Do you want to wear the red or green shirt?” This statement is therapeutic as it provides clear instructions and offers the client a choice, promoting autonomy and cooperation. It addresses the need for hygiene in a respectful and supportive manner.

Choice B reason:

“Do you really think it is okay not to bathe? What is going on with you?” This statement is confrontational and judgmental. It may make the client feel defensive or ashamed, which can hinder the therapeutic relationship and the client’s willingness to engage in self-care.

Choice C reason:

“This is it! You are getting a bath! There are three of us here to bathe you!” This statement is coercive and does not respect the client’s autonomy. Forcing the client to bathe without their consent can escalate the situation and damage trust between the client and the nurse.

Choice D reason:

“I’m going to ignore your lack of self-care because it is an aspect of the disorder.” Ignoring the client’s hygiene issues is not therapeutic. While it is important to understand that self-care deficits can be part of the disorder, the nurse should still address these issues in a supportive and respectful manner.

A. A lot of clients behave that way, but you cannot take it personally. B. Have you tried to establish a therapeutic relationship with the clients? C. Do you want me to assign another nurse? D. Clients often behave that way when they are in pain.

Correct Answer is B

Explanation

Choice A reason:
While this response acknowledges the nurse’s feelings, it does not provide a constructive solution or address the underlying issue. It may come across as dismissive rather than supportive.

Choice B reason:
Establishing a therapeutic relationship is fundamental to effective nursing care. This response encourages the nurse to build rapport and trust with the clients, which can improve their engagement and cooperation in their care. It is a proactive and supportive suggestion.

Choice C reason:
Offering to assign another nurse does not address the issue of building a therapeutic relationship and may not be feasible. It also does not help the nurse develop skills to improve client interactions.

Choice D reason:
While clients in pain may exhibit disinterest, this response does not address the broader issue of establishing a therapeutic relationship. It focuses on a specific cause rather than providing a general strategy for improving client engagement.

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A nurse is developing a plan of care integrating Maslow’s hierarchy of needs. Which area would the nurse identify as the priority?

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