A client diagnosed with schizophrenia, on an inpatient unit, approaches a nurse, stating, "Someone took my dinner! People need to respect others, and you need to do something about this now!" Which response by the nurse is guided by the basic assumption of the therapeutic milieu?
"I can see that you are upset. Let's talk about ways to resolve this."
I'll fix this right away. You need to calm down."
"Let's find a way to avoid this conflict in the future."
"You should bring this up during group therapy later this week."
The Correct Answer is A
a. "I can see that you are upset. Let's talk about ways to resolve this." This is correct because it validates the client's feelings, encourages problem-solving, and maintains the therapeutic milieu's principles of respect and support.
b. "I'll fix this right away. You need to calm down." This response does not encourage the client’s participation in resolving the issue and does not foster the therapeutic milieu's goal of client empowerment.
c. "Let's find a way to avoid this conflict in the future." While this promotes future problem-solving, it does not address the immediate concern or validate the client's current feelings.
d. "You should bring this up during group therapy later this week." This delays addressing the client's immediate concerns and might make the client feel unheard.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
a. "I can make that promise to you based on nurse-client privilege." Nurse-client confidentiality is important, but it doesn't apply to threats of violence. The nurse has a duty to protect the client and others.
b. "Those kinds of thoughts will make your hospitalization longer." While true, this response doesn't directly address the safety concern and might be perceived as judgmental.
c. "I cannot promise that. Confidentiality does not include plans to hurt others." This is a clear and honest statement. It explains the limitations of confidentiality and prioritizes safety.
d. "You should share this thought with your psychiatrist." While encouraging the client to talk to a psychiatrist is a good suggestion, it doesn't directly address the confidentiality issue or the immediate threat.
Correct Answer is B
Explanation
a. "I may consider dating you once you have fully recovered." This response, while seemingly kind, is unprofessional. It creates a false sense of hope for the client and blurs the professional line.
b. "This is a professional relationship, and we need to be clear on that." This is a direct and professional way to set boundaries. It reminds the client of the nature of the relationship and avoids any misunderstanding.
c. "It's against hospital policy for me to date clients." While some hospitals might have such policies, this isn't always the case. A broader and more direct response like option b is preferable.
d. "I'm sorry, but I'm married and not interested in dating." This response might be true, but it focuses on the nurse's personal life and deflects from the professional aspect. Option b is more appropriate.
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