When engaged in therapeutic communication with a client who has been diagnosed with a mental disorder, which is the most important principle for a nurse to keep in mind?

The nurse should have an empathetic relationship with the client.

The client is the primary focus of the interaction.

The nurse should self-disclose when indicated.

The client’s conversations should be recorded.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Having an empathetic relationship with the client is important, but it is not the most important principle. Empathy helps build trust and rapport, but the primary focus should always be on the client’s needs and experiences.

Choice B reason:

The client being the primary focus of the interaction is the most important principle in therapeutic communication. This ensures that the nurse’s attention and efforts are directed towards understanding and addressing the client’s concerns, promoting their well-being and recovery.

Choice C reason:

Self-disclosure by the nurse should be used sparingly and only when it benefits the client. While it can help build rapport, it is not the primary focus of therapeutic communication. The nurse’s primary role is to listen and support the client.

Choice D reason:

Recording the client’s conversations is not a standard practice in therapeutic communication and can breach confidentiality. The focus should be on creating a safe and trusting environment where the client feels comfortable sharing their thoughts and feelings.

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Correct Answer is A

Explanation

Choice A reason:
Asking “What are the voices telling you to do?” is an appropriate response because it allows the nurse to assess the content of the hallucinations and determine if the client is at risk of harming themselves or others. This approach shows empathy and concern while gathering important information for the client’s safety.
Choice B reason:
Telling the client “You need to understand that there are no voices” dismisses the client’s experience and can increase their distress. It is important to acknowledge the client’s feelings and perceptions, even if they are not based in reality.
Choice C reason:
Asking “Why do you think you are hearing the voices?” may not be helpful in the moment of distress. The client may not be able to provide a rational explanation for their hallucinations, and this question could increase their confusion and anxiety.
Choice D reason:
Telling the client “You need to tell the voices to leave you alone” may not be effective, as the client may not have the ability to control their hallucinations. It is more important to assess the content of the hallucinations and provide support.

A. Honk the car horn to get the client’s attention. B. Stop the car in the client’s driveway and call the authorities. C. Keep driving in a path that is going away from the client’s house. D. Calmly speak the client’s name out of the car window.

Correct Answer is C

Explanation

Choice A reason:
Honking the car horn to get the client’s attention could startle the client and potentially escalate the situation. It is important to avoid actions that could provoke a violent response or increase the client’s agitation. Safety is the primary concern, and honking the horn does not ensure the nurse’s or the client’s safety.

Choice B reason:
Stopping the car in the client’s driveway and calling the authorities is not the safest immediate action. While calling the authorities is necessary, stopping in the driveway could put the nurse in a vulnerable position. It is safer to move away from the immediate vicinity before making the call.

Choice C reason:
Keeping driving in a path that is going away from the client’s house is the safest immediate action. This ensures the nurse’s safety by creating distance from the potentially dangerous situation. Once at a safe distance, the nurse can then call the authorities to handle the situation appropriately.

Choice D reason:
Calmly speaking the client’s name out of the car window could also escalate the situation. The client may perceive this as a threat or intrusion, leading to unpredictable behavior. It is safer to avoid direct interaction and ensure personal safety first.

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When engaged in therapeutic communication with a client who has been diagnosed with a mental disorder, which is the most important principle for a nurse to keep in mind?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is talking with a client who has schizophrenia. Suddenly the client states, “I’m frightened. Do you hear that? The voices are telling me to do terrible things.” Which of the following responses by the nurse is appropriate?

Correct Answer is A

Explanation

A home health nurse drives up to the house of her client, who has schizophrenia with manic episodes. The client is sitting on his front porch with a shotgun in his arms. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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