Which activity demonstrates that the client has met the working phase goal of the helping relationship?
A post-operative hip client is compliant with daily out of bed to chair orders.
The client states, "I am so happy that I was able to participate in physical therapy every day that I was here in the hospital.”.
The nurse informs the client that she will be the nurse on duty from 0700 to 1500.
The client will call the nurse by her name.
The Correct Answer is A
Choice A rationale
The working phase of the helping relationship is characterized by the nurse and client collaborating to meet specific health goals. When a client complies with orders to get out of bed and sit in a chair, they are actively participating in their recovery and performing the work necessary for rehabilitation. This phase involves problem-solving and the implementation of the care plan. Active participation in physical tasks demonstrates that the client is engaged in achieving the desired health outcomes.
Choice B rationale
This statement is more characteristic of the termination phase of a relationship. The client is reflecting on their progress and expressing satisfaction with the outcomes achieved during their stay. While it shows the goals were met, the act of reflecting on the past journey usually happens when the relationship is coming to a close. The working phase is about the ongoing effort and action rather than the final summary of success after the tasks are largely completed.
Choice C rationale
This action occurs during the orientation phase of the nurse-client relationship. The orientation phase is when the nurse introduces themselves, establishes the parameters of the relationship, and sets the schedule for care. It is the foundation where trust is built and roles are defined. Providing information about shift times is a clerical and introductory task that precedes the actual therapeutic work and goal setting that defines the subsequent working phase of the professional relationship.
Choice D rationale
Learning and using the nurse's name is part of the orientation phase. It signifies that a rapport is beginning to develop and that the client recognizes the nurse as an individual provider. While it is important for establishing a connection, it does not demonstrate the achievement of complex health-related goals or the collaborative work typical of the working phase. It is an early social and professional milestone rather than a sign of active participation in the clinical care plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The mode of transmission refers to how a pathogen travels from a reservoir to a new host, such as through droplets or airborne particles. Placing a surgical mask on a patient with an active respiratory infection physically contains the infectious agents at the source. This prevents the dispersal of pathogens into the environment during coughing or sneezing, thereby directly interrupting the pathway through which the microorganism moves from the client to others.
Choice B rationale
Hand hygiene is a critical component of infection control, but it primarily targets the portal of entry or the means of transfer via the hands of the healthcare worker. While it reduces the risk of cross-contamination, it does not stop the primary respiratory transmission from the patient’s lungs to the air. In the context of a respiratory infection, containing the source via masking is a more direct way to break the specific mode of transmission link.
Choice C rationale
Administering antibiotics focuses on treating the infectious agent within the reservoir or host. By reducing the microbial load, it eventually makes the person less infectious. However, this action does not immediately break the mode of transmission link itself. Instead, it works on the etiologic agent or reservoir link of the chain. It is a secondary measure compared to physical barriers that stop the active movement of pathogens during the infectious phase.
Choice D rationale
Providing a nutritious, high-protein diet is an intervention aimed at the susceptible host link of the chain of infection. Adequate nutrition, particularly protein intake, supports the immune system, promotes tissue repair, and enhances the body’s natural defense mechanisms against invading pathogens. While this makes the client more resilient, it does nothing to prevent the actual transmission of the respiratory pathogens from the current host to other individuals in the vicinity.
Correct Answer is B
Explanation
Choice A rationale
Implementing a change quickly without addressing staff concerns or seeking input often leads to significant resistance, decreased morale, and high turnover. Rapid implementation ignores the psychological transition required for staff to adapt to new schedules. In leadership theory, forcing change without transparency or engagement bypasses the vital stages of unfreezing and moving, which can compromise the stability of the operating room environment and lead to errors in patient care delivery.
Choice B rationale
Effective change management involves aligning the proposed modifications with the existing culture, values, and beliefs of the nursing staff. By relating the change to what the nurses already value, such as patient safety or work-life balance, the manager reduces perceived threats. This approach fosters collaboration and allows the staff to find common ground with the organizational goals. Addressing the human element of change ensures a more sustainable and smoother transition for the entire surgical team.
Choice C rationale
Discouraging discussion is a restrictive leadership style that stifles communication and breeds resentment among professional staff. When nurses feel their voices are silenced, trust in management diminishes, which can negatively impact teamwork in the high-stakes operating room setting. Open communication is essential for identifying potential flaws in the proposed schedule. Suppressing dialogue does not stop the underlying dissatisfaction but rather pushes it underground, where it can manifest as passive-aggressive behavior or burnout.
Choice D rationale
Discussing only the disadvantages to the hospital focuses on the organization's needs rather than the nurses' concerns. While institutional needs are relevant, this approach can seem dismissive of the personal impact the change has on the staff's lives. To gain buy-in, the manager should focus on a balanced perspective that includes how the change might benefit the staff or the quality of patient care, rather than using a guilt-based or purely administrative justification.
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