Select the best outcome for a client with the nursing diagnosis: Impaired social interaction related to sociocultural conflict as evidenced by stating, "Although I'd like to, I don't participate because I don't speak the language very well.”. Client will engage in what action?
Show improved use of language.
Become more independent in decision making.
Demonstrate improved social skills.
Select and participate in one group activity per day.
The Correct Answer is D
Choice A rationale
While improved language use (e.g., fluency, confidence) is a necessary component for resolving the underlying reason for the social withdrawal, an outcome should be a measurable behavioral change or demonstrable action. Improving language skills is an antecedent step or a parallel goal, not the direct, observable behavioral goal of "Impaired social interaction.”.
Choice B rationale
Increased independence in decision making is a worthy goal related to autonomy, but it does not directly address the social interaction component of the nursing diagnosis. The core problem identified is the lack of participation in group settings due to the stated sociocultural conflict, requiring an outcome focused on behavioral engagement.
Choice C rationale
Improved social skills is a broad concept; the client's stated issue is a specific linguistic barrier, not necessarily a deficit in general social etiquette or reciprocal conversation skills. A behavioral outcome must be highly specific and directly linked to the evidence (not participating due to language difficulty) provided in the nursing diagnosis.
Choice D rationale
This outcome is the most measurable and directly addresses the impaired social interaction evidenced by non-participation. Selecting and participating in one group activity per day is a clear, time-bound behavioral goal that requires the client to overcome the stated barrier and engage in the desired social action.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Although diagnostic tools (like rating scales or questionnaires) are often used to gather information from parents and teachers, the diagnosis of ADHD is fundamentally a clinical diagnosis. It is based on a structured clinical interview and the persistence and pervasiveness of symptoms, not merely confirmation by a specific psychological or diagnostic test.
Choice B rationale
While ADHD symptoms can indeed be exacerbated by severe stress, the diagnostic criteria from the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) mandate that the symptoms must be present for at least 6 months and be inconsistent with the developmental level. They must be present before age 12 and cause clinically significant impairment in functioning, not just worsen under stress.
Choice C rationale
The DSM-5 criteria for ADHD require that the symptoms of inattention, hyperactivity, and impulsivity must be present in two or more settings (e.g., home, school, work, or with friends/relatives). This cross-situational requirement is crucial because it helps to rule out a disorder whose symptoms are simply a reaction to a specific situational stressor or environmental trigger.
Choice D rationale
While clinical observations are a part of the diagnostic process, the diagnosis relies significantly on historical data and reports from parents, teachers, and the individual, using established criteria. Requiring symptoms to be confirmed only by supervised clinical observations would be impractical and insufficient, as symptoms may fluctuate and may not be consistently present during a brief observation.
Correct Answer is A
Explanation
Choice A rationale
A therapeutic nurse-patient relationship is fundamentally patient-centered and goal-oriented, with a focus exclusively on the patient's needs and growth. The nurse assists in identifying and discussing problems, exploring alternatives, and providing support, but the responsibility for implementing solutions and behavioral change ultimately lies with the patient, fostering autonomy and self-efficacy within the relationship's defined boundaries.
Choice B rationale
This describes characteristics of a personal or social relationship, which is mutually satisfying and involves the reciprocal sharing of feelings and meeting of both individuals' needs. A therapeutic relationship, by contrast, maintains strict professional boundaries, is not mutual in meeting needs, and is focused solely on the patient's therapeutic outcomes and mental health goals.
Choice C rationale
This explanation, while reflecting partnership in goals, is too broad and leans toward the mutuality and reciprocal satisfaction found in a personal relationship. The professional nature of the therapeutic relationship dictates that the nurse's concern is specifically for the patient's growth, not a mutual concern for the nurse's growth and satisfaction, maintaining a clear professional boundary.
Choice D rationale
In a therapeutic relationship, the focus always remains on the patient; it does not shift to the nurse. Furthermore, the nurse does not offer personal advice, but rather helps the patient explore their own solutions. Mutual implementation of solutions also breaches professional boundaries and diminishes the patient's responsibility for their own self-directed change and recovery.
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