During which phase of the nurse-patient relationship can the nurse anticipate that the patient's identified issues will be explored and resolved?

Choice A rationale

Inadequacy pertains to a lack of sufficiency or quality regarding a statement's content or detail to convey a full idea. While the statement "My marriage is just great. My spouse and I always agree" might lack depth, the primary concern is the disparity between the verbal and non-verbal communication, suggesting internal conflict, rather than mere insufficiency of descriptive detail. The non-verbal cues overshadow content.

Choice B rationale

Inconsistency describes a conflict between different elements of communication, specifically here the spoken word and the observed body language. The client's verbal declaration of perfect agreement contrasts sharply with the continuous, agitated non-verbal behaviors (foot movement, button twirling), indicating underlying anxiety, psychological distress, or internal tension that contradicts the seemingly idyllic verbal message. This non-verbal leakage suggests the statement is not truthful.

Choice C rationale

Clarity refers to the ease of understanding the manifest content of the verbal message. The client's statement about the marriage being "just great" and always agreeing is grammatically clear and easily understood at a literal level. However, the nurse's observation of the non-verbal behavior suggests that the meaning or truthfulness of the statement is compromised by internal conflict.

Choice D rationale

Distortion implies a misrepresentation or alteration of reality, potentially stemming from a cognitive process or defense mechanism. While the client might be distorting the truth of their marriage, the nurse's direct observation reveals an immediate, simultaneous inconsistency between the two forms of communication, making inconsistency the more direct and observable conclusion regarding the communication dynamic itself.

Choice A rationale

Anticholinergic medications primarily block acetylcholine receptors, commonly leading to side effects like dry mouth, blurred vision, constipation, and urinary retention. They do not typically cause hyperprolactinemia-related effects such as gynecomastia (male breast enlargement), amenorrhea (absence of menstruation), or galactorrhea (milky discharge).

Choice B rationale

First-generation (conventional) antipsychotics, like haloperidol, exert a potent Dopamine-2 receptor antagonism in the tuberoinfundibular pathway. This blockade lifts the dopaminergic inhibition on prolactin release from the anterior pituitary, resulting in hyperprolactinemia, which is the direct cause of gynecomastia, amenorrhea, and galactorrhea.

Choice C rationale

Second-generation (atypical) antipsychotics also block D2 receptors but often have a broader receptor profile. While some (like risperidone) can cause hyperprolactinemia, others are prolactin-sparing or cause it less frequently or severely than the first-generation agents.

Choice D rationale

Third-generation antipsychotics, such as aripiprazole, are often dopamine system stabilizers (partial agonists). They are less likely to cause significant D2 blockade and often have a lower risk of inducing hyperprolactinemia and the associated endocrine side effects compared to both first- and some second-generation agents.