The PMHNP has been working with a 28-year-old unmarried male client who has been late for his last three appointments. At this appointment, the nurse practitioner tells him he will need to reschedule if he runs late again. The client becomes upset and says this is why he has a hard time trusting medical professionals. “It's all about money, you don't really care about your patients.” What is the most appropriate response?
“If everyone ran late, I would never get to go home and see my family.”
“I must maintain a set schedule so that I can care for all of my patients.”
“This all goes back to your issues with being abandoned as a child.”
“The next time you are late, I will have to cut your appointment short.”
The Correct Answer is B
Choice A reason: This response shifts the focus to the clinician’s personal life and may come across as dismissive or lacking empathy. It does not validate the client’s concerns or maintain therapeutic boundaries.
Choice B reason: This response is professional, empathetic, and maintains boundaries. It explains the rationale for scheduling without being defensive or judgmental. It also communicates fairness and respect for all clients, which helps preserve the therapeutic alliance.
Choice C reason: This response is overly interpretive and risks pathologizing the client’s behavior without adequate context. It may feel intrusive and could damage rapport.
Choice D reason: This response is punitive and lacks empathy. It may reinforce the client’s mistrust and escalate the situation rather than de-escalate it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Taking detailed notes may help with documentation but does not directly foster a therapeutic alliance. It does not address the interpersonal dynamics or belief differences between the clinician and client.
Choice B reason: Asking preset questions may help structure the interview but can feel impersonal or rigid. It does not ensure respect for the client’s worldview or promote emotional safety.
Choice C reason: Nonjudgment is essential in therapeutic relationships, especially when personal beliefs differ. It allows the clinician to accept the client’s values and experiences without imposing their own. This fosters trust, openness, and psychological safety.
Choice D reason: While explaining that personal views won’t interfere may seem reassuring, it can come across as defensive or dismissive. Actions demonstrating nonjudgment and respect are more effective than verbal assurances alone.
Correct Answer is C
Explanation
Choice A reason: While encouraging autonomy is important, this response overlooks the potential danger of combining serotonergic agents. It may inadvertently reinforce unsafe behavior.
Choice B reason: Although tryptophan has been studied for its role in mood regulation, combining it with SSRIs like escitalopram increases the risk of serotonin syndrome—a potentially life-threatening condition. This response fails to address the safety concern.
Choice C reason: This response acknowledges the client’s progress while appropriately warning about the risk of serotonin syndrome. It maintains therapeutic rapport and provides necessary education about drug interactions.
Choice D reason: This response is overly critical and may damage the therapeutic relationship. It does not validate the client’s intent or provide constructive guidance.
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