During a family therapy session led by a nurse, which of the following statements should be recognized as an example of effective communication among a mother, father, and two adolescent siblings?

"She is always bossing me around. Should she do that?"

"Please do not raise your voice at the children. I am the one who left dishes in the sink."

"If you keep saying that, I will tell everyone what you did last night."

"Can you tell me the reason you get upset each time you go to the mall?".

Answer and Explanation

The Correct Answer is D

Choice A rationale:

This statement is accusatory and blaming, rather than promoting understanding and problem-solving. It focuses on the negative behavior of the sibling and seeks external validation for the speaker's feelings, rather than attempting to address the underlying issue directly with the sibling.

It uses "should" language, which can come across as judgmental and critical, potentially escalating conflict.

It does not express the speaker's own feelings or needs, making it difficult for the other person to understand and respond effectively.

Choice B rationale:

While this statement demonstrates a willingness to take responsibility for actions, it does not directly address the communication between the family members. It focuses on redirecting the father's anger rather than exploring the underlying reasons for the conflict.

It could be interpreted as silencing the children's voices and potentially reinforcing a hierarchical dynamic within the family, where one parent holds authority over the others.

Choice C rationale:

This statement is manipulative and threatening, using a fear of exposure to control the other person's behavior. It undermines trust and safety within the family, making it difficult to have open and honest communication.

It does not address the core issue at hand and instead escalates conflict by using a "tit-for-tat" approach.

Choice D rationale:

This statement effectively demonstrates several key principles of effective communication: It expresses curiosity and a genuine desire to understand the other person's perspective.

It avoids accusations or assumptions, instead inviting open dialogue.

It focuses on specific behaviors and events ("each time you go to the mall") rather than making sweeping generalizations about the person's character.

It uses "I" language to express the speaker's own feelings and concerns, inviting empathy and understanding.

It creates an opportunity for the other person to share their perspective and work towards a resolution together.

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

Explanation

Choice A rationale: Anorexia nervosa is an eating disorder characterized by relentless drive for thinness with a fear of gaining body weight associated with self-induced behaviors towards thinness. Symptoms include extreme weight loss, thin appearance, intense fear of gaining weight, bingeing and purging, abnormal blood counts, fatigue, insomnia, dizziness or fainting, bluish discoloration of the fingers, hair that thins, breaks or falls out, soft, downy hair covering the body, amenorrhea (absence of menstruation), constipation, dry or yellowish skin, intolerance of cold, irregular heart rhythms, low blood pressure, dehydration, osteoporosis, swelling of arms or legs. However, the client’s symptoms do not align with those of anorexia nervosa.

Choice B rationale: Bulimia nervosa is an eating disorder characterized by binge eating, followed by methods to avoid weight gain. Symptoms include binge eating, forceful vomiting, long-term fear of gaining weight, preoccupation with weight and body, a strong negative self-image, overuse of laxatives or diuretics, use of supplements or herbs for weight loss, excessive exercises, stained teeth (from stomach acid), calluses on the back of the hands, withdrawal from normal social activities. The client’s symptoms of using laxatives frequently and running for 1 hr after eating a very large meal, which happens at least 9 times a week, align with those of bulimia nervosa.

Choice C rationale: Histrionic personality disorder (HPD) is a mental health condition characterized by unstable emotions, a distorted self-image and a desire to be noticed. Symptoms include persistent attention seeking, dramatic behavior, rapidly shifting and shallow emotions, sexually provocative behavior, undetailed style of speech, and a tendency to consider relationships more intimate than they actually are. The client’s symptoms of feelings of anxiety and depression, starting smoking marijuana as that is what their “new friends do all the time”, and being recently arrested for stealing make-up from a local department store and acknowledging that this “is the first time I was caught” align with those of HPD.

A. Supporting the client's wish to refuse prescribed medications. B. Explaining unit rules and policies regarding unacceptable behaviors. C. Making sure the client understands expectations for client participation. D. Encouraging client feedback about satisfaction with the facility experience.

Correct Answer is A

Explanation

Choice A rationale:

Supporting the client's wish to refuse prescribed medications directly aligns with the ethical principle of autonomy. Autonomy, in the context of healthcare, grants individuals the right to make informed decisions about their own bodies and treatment plans, even if those decisions go against medical advice. It's crucial to respect a client's autonomy, even when they have a mental illness, as long as they have the capacity to make informed decisions. Key points to elaborate on:

Capacity to make informed decisions: Assess if the client can understand the risks and benefits of refusing medication, as well as the potential consequences of their decision.

Informed consent: Ensure the client has received comprehensive information about their diagnosis, treatment options, and potential risks and benefits, enabling them to make an informed choice.

Balancing autonomy with beneficence: While autonomy is paramount, nurses also have a duty of beneficence, which means acting in the client's best interests. Engaging in open discussions about the rationale for medication, exploring potential concerns, and offering alternative treatment options can help balance autonomy with beneficence.

Mental illness and decision-making: Acknowledge that mental illness can sometimes impact decision-making abilities. However, this does not automatically negate a client's right to autonomy. Careful assessment and ongoing communication are essential.

Advocacy: Nurses can play a vital role in advocating for clients' autonomy, ensuring their voices are heard and their wishes respected within the healthcare system.

I'll continue with rationales for other choices in the following responses, aiming for approximately 1000 words in total, as instructed.

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During a family therapy session led by a nurse, which of the following statements should be recognized as an example of effective communication among a mother, father, and two adolescent siblings?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Explanation

A nurse is caring for a client who has a mental illness.Which of the following actions by the nurse demonstrates the ethical concept of autonomy?

Correct Answer is A

Explanation

A nurse is making a home visit for a 16-year-old adolescent who attempted suicide. Which of the following behaviors should alert the nurse that the adolescent still has suicidal intent?

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A nurse is admitting a client who is about to undergo surgery for benign prostatic hypertrophy.The client states, "I don't know what I will do if they find I have cancer." Which of the following responses should the nurse make?

Which nursing intervention has priority as a client diagnosed with anorexia nervosa begins to gain weight after initiated therapy?

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A nurse is caring for a client who is hospitalized and says to the nurse, "My partner called and told me my boss hired someone to take my place." Which of the following responses should the nurse make?

A nurse in an acute care mental health facility is preparing to administer morning medication to a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take?