What is the best explanation a nurse can give to the family of a mentally ill patient regarding how a therapeutic nurse-patient relationship differs from personal relationships?
The focus is on the patient, and problems are discussed by the nurse and patient, but solutions are implemented by the patient.
The focus of the relationship is socialization, mutual needs are met, and feelings are shared openly.
The focus is creation of a partnership in which each member is concerned with the growth and satisfaction of the other.
The focus shifts from nurse to patient as the relationship develops, and advice is given by both, with solutions implemented mutually.
The Correct Answer is A
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.
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 B
Explanation
Choice A rationale
A person with alcoholism who relapses is exhibiting self-destructive behavior, but generally, involuntary commitment requires the person to pose an imminent, immediate danger to themselves or others. While a relapse is concerning, it does not automatically meet the legal criteria for necessary emergency detention unless coupled with acute, life-threatening behavior.
Choice B rationale
An individual with bipolar disorder in a manic phase who has not eaten for four days is exhibiting behavior that leads to severe physical deterioration and poses an imminent, life-threatening danger to self due to malnutrition and dehydration. This meets the legal criterion for involuntary hospitalization (commitment) necessary to protect the client's life.
Choice C rationale
Repeatedly phoning a national TV service is behavior that indicates poor judgment or delusion and may be intrusive or disruptive, but it does not constitute a clear and present danger to the person or others. This is insufficient grounds for legally mandated involuntary confinement, as freedom of speech remains protected.
Choice D rationale
Stopping prescribed antipsychotic medication is considered non-adherence and is likely to lead to a psychotic relapse, which is a significant health concern. However, medication non-adherence alone, without the presence of an immediate danger to self or others, does not satisfy the legal requirements for involuntary commitment.
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