Share This Link

"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.

"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.

"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.

"It might help you feel better if you talk about it." While encouraging communication is generally good, the client has clearly expressed a desire not to talk at the moment. Pressuring them to talk may not be beneficial.

"I understand; I've felt like that before, too." While expressing empathy can be helpful, it's important not to overshadow the client's experience by sharing personal feelings at this moment.

"Why are you feeling so down?" This question may feel intrusive and may not be well-received by the client, especially when they've indicated a preference not to talk. It's important to approach the conversation with sensitivity and respect for the client's boundaries.

To provide support for the patient is not appropriate. While providing support is important in therapeutic communication, the nurse's statement is more focused on bringing attention to an inconsistency rather than offering direct emotional support.

To redirect the patient to an important idea is not appropriate. The nurse's statement is not aimed at redirecting the patient to a specific idea. Instead, it's about highlighting a potential incongruence between the patient's verbal and nonverbal expressions.

To provide a suggestion for coping strategies is not appropriate. The nurse's statement is not directly offering suggestions for coping strategies. It is more focused on helping the patient recognize and explore the discrepancy in their expressed emotions.

“I live too far from art and history museums to visit them as often as I would like. “This pertains more to self-actualization and leisure activities, which are higher-level needs.

"I feel so alone. I wish I had someone special in my life." This addresses the need for belonging and social connection, which is a higher-level need compared to safety.

"I did not do a good job on the project my supervisor assigned." This relates to self-esteem and job performance, which are higher-level needs.

Encourages staff to provide frequent negative feedback to patient is incorrect. A therapeutic milieu typically focuses on positive reinforcement and constructive feedback to support patients' growth and development.

Enforces rules and behavioral limits flexibly is incorrect. While establishing rules and limits is important for maintaining safety, flexibility in enforcing them allows for individualized care and consideration of the patient's unique needs.

Permits additional privileges for voluntary admitted patients is incorrect. Additional privileges may be granted based on the patient's progress and participation in their treatment. However, it should be done thoughtfully and as part of a therapeutic plan rather than as a blanket permission for all voluntary admitted patients.

Differentiation is incorrect. Differentiation refers to the ability of family members to maintain their individuality while remaining emotionally connected. It is not directly related to involving a third person in conflicts.

Scapegoating is incorrect. Scapegoating involves blaming one family member for the family's problems. While this can be a dysfunctional family dynamic, it is not specifically about involving a third person in conflicts.

Double Binding is incorrect. Double binding involves conflicting messages that create a no-win situation for the recipient. It does not specifically involve the inclusion of a third person in conflicts as observed in the given scenario.

"Why do you think you might have cancer when your diagnosis is a benign condition?” This response may come across as dismissive and could make the client feel unheard. It does not acknowledge the client's concerns and may discourage open communication.

"I'm looking at your chart here and I don't see any reason for you to worry about that.” This response focuses on the medical chart and might minimize the client's emotional concerns. It does not address the client's feelings and may create a sense of invalidation.

"I think that's something you need to discuss with your provider.” While it directs the client to the provider, it doesn't acknowledge the client's emotions or provide immediate support. It may seem like a deflection rather than an empathetic response.

"Now that we've discussed your reasons for being here and how often we will meet, I'd like to talk about what we will do at the time of your discharge." This option seems to introduce the topic of termination prematurely, especially if the client's issues and goals haven't been adequately addressed yet.

"You are being discharged today, so I'd like to bring up the subject of termination, which includes discussing your time here and summarizing what coping skills you have attained."This option presents termination at the time of discharge without prior discussion or collaboration with the client.

"I haven't met my new patient yet, but am working through my feelings of anxiety in dealing with a parent who wanted to kill herself." This statement is not related to the discussion of termination in the ongoing nurse-patient relationship.

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.

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.

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.

Clear is incorrect. - In a clear or rigid boundary, there is a distinct separation between family members, and individual autonomy is highly emphasized. The described behavior does not align with a clear boundary.

Differentiation is incorrect. Differentiation refers to the ability of family members to maintain their individuality while remaining emotionally connected. The behavior described is more indicative of a diffuse boundary than a differentiation issue.

Rigid is incorrect. A rigid boundary is characterized by strict rules and limited flexibility. The described behavior does not align with a rigid boundary where decision-making might be more centralized and less consultative.

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.

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."

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.

Countertransference is incorrect. Countertransference involves the therapist's emotional reactions to the client based on the therapist's unresolved issues or feelings. It is not about viewing the client positively.

Genuineness is incorrect. Genuineness, also known as congruence, is the therapist's ability to be authentic and transparent in the therapeutic relationship. While it contributes to a positive therapeutic environment, it is not specifically about viewing the client's worth and strengths.

Empathy is incorrect. Empathy involves understanding and sharing the feelings of the client. While it contributes to a positive therapeutic relationship, it does not necessarily focus on viewing the client as having strengths and achievement potential.

Facing reality and developing standards for responsible behavior is inappropriate. This goal aligns more with reality therapy or choice theory, which focuses on helping individuals take responsibility for their behavior and make choices that lead to responsible actions.

Developing satisfactory relationships, maturity, and relative freedom from anxiety is inappropriate. This goal may align with psychodynamic or humanistic approaches that emphasize personal growth, self-awareness, and improvement in relationships.

Reducing body tension through biofeedback training is inappropriate. This goal is more aligned with behavioral approaches that use techniques like biofeedback to address physiological symptoms.

A nurse visits one to three times a week to assess for extreme agitation does not describe the focus of psychiatric emergency care. This describes a more routine or outpatient assessment schedule rather than the urgent and immediate focus of psychiatric emergency care.

Overnight short-term observations are 1 to 3 days in duration does not describe the focus of psychiatric emergency care. This refers to a short-term observation period, which might occur in various psychiatric settings, but it does not specifically address the urgency of psychiatric emergencies.

Antipsychotic medications are administered does not describe the focus of psychiatric emergency care. Administering antipsychotic medications is a treatment approach that may be part of the overall psychiatric care plan, but it does not specifically capture the immediate triage and stabilization focus of psychiatric emergency care.

"Your mother will be fine. You shouldn't work so much." This response dismisses the son's feelings and does not address his sense of responsibility.

"So, it seems that you feel responsible for what happened to your mother." This response is more direct in acknowledging the son's feelings but might be perceived as judgmental or clinical. It's important to convey understanding and empathy.

"Why do you blame yourself? You could not have prevented the stroke." While this response is accurate, it may come across as somewhat confrontational and might not be as empathetic as option D. It focuses on the rational aspect without acknowledging the emotional component of the son's feelings.

A patient who states "I have no one who cares about me. "This statement relates more to the need for belonging and love, which is a lower level on Maslow's hierarchy.

A patient who states "I have never met my career goals." This statement relates to self-esteem and self-actualization needs, which are higher-level needs in Maslow's hierarchy.

A patient upset that his family can only visit during visiting hours. This situation is related to social needs and may not be as immediate a concern as the hostile and angry behaviors described in option C.

Focusing on the words of the clients is incorrect. While it's important to listen actively to clients, effective communication goes beyond just focusing on words. Nonverbal cues, emotions, and the overall context of communication are also crucial.

Providing sympathy during interactions is incorrect. Sympathy involves feeling sorry for someone, which may not always be helpful in a therapeutic relationship. Empathy, where the nurse understands and shares the client's feelings, is generally more therapeutic.

Controlling the pace of establishing the nurse-client relationships is incorrect. The establishment of therapeutic relationships is a collaborative process, and attempting to control the pace might hinder the development of trust. It's important to be responsive to the client's needs and preferences.

"Your provider is very knowledgeable, if he prescribes chemotherapy, it's the best treatment for you.” This response may be perceived as dismissive of the client's concerns and preferences. It is important to acknowledge and explore the client's perspective rather than making assumptions.

"Using nontraditional treatments is not a good deal, rather you avoid that route.” This response is directive and may be seen as judgmental. It does not invite the client to share their concerns openly and may hinder effective communication.

"A lot of people think nontraditional treatments will work, they end up regretting that choice. “This response introduces a potentially guilt-inducing statement and may create a negative atmosphere. It does not encourage the client to express their thoughts and concerns openly.

Formulating a nursing diagnosis is incorrect. This occurs after a comprehensive assessment of the patient's needs, and it helps guide the planning and implementation of nursing care.

Planning for continued care is incorrect. Once the nursing diagnosis is formulated, the nurse can develop a plan of care, including interventions and goals for the patient.

Promoting patient's insight is incorrect. This is a part of the ongoing therapeutic process and involves helping the patient gain self-awareness and understanding of their thoughts, feelings, and behaviors. It typically occurs after the initial assessment and planning.

"I’m so sad and I feel I haven't accomplished much in my life." This statement may relate more to feelings of despair and a sense of unfulfilled purpose, which could be associated with Erikson's stage of Integrity vs. Despair (late adulthood).

"I’m so anxious, can't seem to trust anyone. “This statement may indicate difficulties with trust and may be more aligned with Erikson's stage of Trust vs. Mistrust (infancy).

"I'm so tired after work that I just want to watch TV and be alone. “This statement may reflect fatigue or a desire for solitude and may not directly represent the identity development struggles associated with Erikson's Identity vs. Role Confusion stage.

Resource is incorrect. Peplau identified the nurse as a resource, emphasizing the nurse's role in providing information, support, and guidance to the patient. This aligns with the concept of the nurse as a source of knowledge and assistance for the patient.

Surrogate is incorrect. The surrogate role in Peplau's theory reflects the nurse's ability to act on behalf of the patient, representing their best interests, especially in situations where the patient may be unable to advocate for themselves. The nurse serves as a substitute or stand-in for the patient in certain circumstances.

Guardian is incorrect. The guardian role in Peplau's theory emphasizes the nurse's responsibility to protect the patient's rights and advocate for their well-being. The nurse acts as a guardian of the patient's interests, ensuring they receive appropriate care and support.