The nurse is meeting a family for the first time for family therapy. The husband/father is an accountant and is skeptical of the idea that talking can be helpful. The wife/mother is a teacher who states she is not skillful in conflict resolution. The daughter, age 15, is rebellious and in academic trouble. The son, age 17, is conflicted about where to attend college. According to family systems therapy who would be most likely to be listed as the 'identified patient"?

Wife/mother

Daughter

son

Husband/father

Answer and Explanation

The Correct Answer is B

Choice A Reason:

Wife/mother is incorrect. The wife/mother expresses that she is not skillful in conflict resolution, but her concerns are related to her own abilities rather than exhibiting specific problematic behaviors that are disruptive or distressing to the family system.

Choice B Reason:

Daughter is correct. The daughter, who is rebellious and in academic trouble, is most likely to be listed as the "identified patient" because her behavior is presenting visible challenges and concerns. In family systems therapy, addressing and understanding the dynamics surrounding the identified patient can provide insights into the broader family issues and interactions.

Choice C Reason:

Son is incorrect. The son is conflicted about where to attend college, which is a common developmental decision. While it may cause some family stress, it doesn't necessarily indicate the presence of disruptive or problematic behavior warranting the label of "identified patient."

Choice D Reason:

Husband/father is incorrect. The husband/father is skeptical of the idea that talking can be helpful, but skepticism or reluctance to engage in therapy does not necessarily make him the identified patient. His behavior doesn't present as a disruptive symptom within the family.

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Correct Answer is B

Explanation

Choice A Reason:

"If it weren't for you and the hours we've spent talking, I don't think I would be on my way to getting my anxiety under control." While this statement acknowledges the importance of the nurse-patient relationship in helping with anxiety, it might imply a somewhat dependent stance. The ideal therapeutic relationship encourages patients to gain skills and tools to manage their issues independently.

Choice B Reason:

"I appreciate the time you spent with me. I have a better understanding of what I can do to manage my problem." This statement reflects the patient's acknowledgment of the nurse's support and guidance, resulting in a positive impact on the patient's understanding and ability to manage their concerns. It emphasizes the constructive nature of the nurse-patient relationship and the effectiveness of the interactions in addressing the patient's needs.

Choice C Reason:

"I really need to talk with you. You always give me good advice about how to address my anger issues." While seeking support and advice from the nurse is positive, the emphasis on always receiving good advice might suggest a more directive approach rather than collaborative exploration and problem-solving, which is often a goal in therapeutic relationships.

Choice D Reason:

"You've been kind to me when I was at a low point. Knowing you've had low points too was such a help. “While mutual understanding and empathy are crucial in the nurse-patient relationship, the statement may focus more on the nurse's experiences rather than the patient's progress or understanding. The primary focus should be on the patient's needs and growth.

A. in the orientation phase B. On the working phase C. when the patient brings up the topic D. in the termination phase

Correct Answer is D

Explanation

Choice A Reason:

In the orientation phase is false. The orientation phase is focused on establishing rapport, building trust, and identifying the patient's needs and goals. It is too early to discuss termination during this phase.

Choice B Reason:

On the working phase is false. The working phase involves active problem-solving, goal attainment, and skill development. While progress is being made, it is not the appropriate time to introduce the topic of termination.

Choice C Reason:

When the patient brings up the topic is false. While it's important to be responsive to the patient's concerns, addressing the issue of termination solely based on the patient's initiation may not provide a comprehensive and planned discussion. The nurse should guide the conversation about termination at the appropriate time, considering the progress made in therapy.

Choice D Reason:

The termination phase is the final phase of the therapeutic relationship, and it involves discussing and planning for the conclusion of the therapeutic alliance. It provides an opportunity for the nurse and patient to reflect on the progress made, revisit goals, and discuss strategies for maintaining gains after the conclusion of the formal therapeutic relationship.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which patient statement best captures the helpfulness of the nurse-patient relationship? Select one:

Correct Answer is B

Explanation

During a therapeutic nurse-patient relationship, when would the nurse plan to first address the issue of termination?

Correct Answer is D

Explanation

A nurse is caring for a client who has cancer and is scheduled for immediate chemotherapy. The client tells the nurse that she wants to try nontraditional treatments first. Which of the following responses should the nurse make?

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?

A nurse is caring for a client who has dementia. When performing a Mental Status Examination (MSE) the nurse should include which of the following data? (Select all that apply)

Which cause is responsible for a patient reacting to the nurse by saying, "You are indifferent and cold, just like my mother"?

A nurse observes a client's spouse sitting alone in the waiting room crying. When approached, the spouse says. "I am really concerned about my husband. Which of the following is a therapeutic nursing response?

Which activity would a nurse perform in an inpatient psychiatric unit? Select all that apply. (Select All that Apply.)

Which stage of Maslow's hierarchy of needs is most threatened when a patient faces a possible layoff from work and witnesses intimate partner violence at home?

A nurse is performing a mental status examination (MSE) on a client who has a new diagnosis of dementia. Which of the following components should the nurse include? (Select all that apply.)