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 D
Explanation
Choice A rationale
Countertransference is a psychoanalytic concept describing the unconscious feelings and attitudes that the nurse or therapist develops towards the patient, often stemming from the provider's own past experiences or unresolved conflicts, which are then inappropriately projected onto the patient, influencing the professional relationship and potentially impeding objectivity.
Choice B rationale
A boundary violation occurs when the nurse crosses the line of the professional therapeutic relationship, engaging in behaviors that meet the nurse's personal needs rather than the patient's, potentially exploiting the patient's vulnerability. Examples include social relationships outside the clinical setting, personal gift-giving, or sharing inappropriate personal information with the patient.
Choice C rationale
Intuition refers to the ability to understand something immediately, without the need for conscious reasoning or evidence, often described as a "gut feeling.”. While valuable in clinical assessment, it does not describe the specific phenomenon of the patient re-directing feelings from a past significant relationship onto the present caregiver.
Choice D rationale
Transference is the unconscious displacement of feelings, attitudes, and patterns of behavior from a significant relationship in the patient's past (e.g., a parent, sibling, or former authority figure) onto the current healthcare provider. The patient's emotional reaction to the nurse's simple question, equating her with the mother, exemplifies this redirection of past emotional responses.
Correct Answer is A
Explanation
Choice A rationale
The working phase is the central phase of the therapeutic relationship, dedicated to problem identification, exploration of stressors, and the development and testing of new coping mechanisms. It is during this phase that the patient's identified issues are intensely explored and resolved as the nurse and patient work collaboratively towards achieving established goals.
Choice B rationale
The preorientation phase occurs before the first face-to-face encounter. The nurse's activities involve data gathering and self-assessment, such as reviewing the patient's chart, understanding the clinical context, and examining their own feelings, to prepare for the interaction. No direct patient issues are explored or resolved here.
Choice C rationale
The orientation phase is the initial period focused on establishing rapport, clarifying roles, setting goals, and establishing a contract for the relationship. While issues are identified, the in-depth work of exploring and resolving those issues has not yet begun; the foundation is merely being laid.
Choice D rationale
The termination phase is the final stage, focusing on summarizing goals achieved, reviewing the experience, and preparing for separation. The primary goal is to conclude the relationship therapeutically and ensure the patient can maintain gains, not to introduce or resolve new major issues.
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