A nurse is assessing a newly hospitalized patient. Select the best example of the communication technique of "offering self."

I’d like to sit with you for a while to help you get comfortable talking to me

I’ve also had traumatic life experiences; maybe it would help to share them

Why do you think you had so much difficulty adjusting to this change in your life?

Let’s discuss your treatment plan and how we can make it work for you

Answer and Explanation

The Correct Answer is A

Choice A reason: Offering self involves making oneself available to the patient, fostering trust through presence and empathy. Sitting with the patient to facilitate comfort aligns with therapeutic communication, creating a safe space for dialogue, critical in psychiatric nursing, making this the correct choice.

Choice B reason: Sharing the nurse’s personal experiences shifts focus from the patient, risking boundary violations. This is non-therapeutic, as it does not prioritize the patient’s needs or foster their openness, failing to demonstrate the "offering self" technique, making this choice incorrect.

Choice C reason: Asking why the patient struggled with adjustment is a probing question that may feel confrontational. It does not convey availability or empathy, key to "offering self," but instead seeks explanation, potentially hindering trust, making this choice non-therapeutic and incorrect.

Choice D reason: Discussing the treatment plan focuses on clinical tasks, not emotional availability. While collaborative, it does not specifically demonstrate "offering self," which emphasizes presence and support to build trust, making this choice less aligned with the therapeutic technique described.

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Correct Answer is B

Explanation

Choice A reason: Weight gain and metabolic changes are side effects of clozapine, primarily due to its antihistaminic and serotonergic effects, not its dopaminergic action. Dopamine blockade is more associated with movement disorders, making this choice incorrect for teaching related to dopaminergic effects.

Choice B reason: Clozapine’s strong dopaminergic effect, particularly D2 receptor blockade, can cause extrapyramidal symptoms like tardive dyskinesia, a movement disorder. Patient education must emphasize monitoring for abnormal movements, as these are significant risks in antipsychotic therapy, making this the correct choice.

Choice C reason: Infection risk, particularly agranulocytosis, is a serious clozapine side effect but is unrelated to its dopaminergic action. It stems from bone marrow suppression, requiring blood monitoring, not dopamine-related teaching, making this choice incorrect for the question’s focus.

Choice D reason: Improved mood is not a direct result of clozapine’s dopaminergic effect, which primarily addresses psychotic symptoms. Mood changes occur over weeks and involve multiple receptors, not just dopamine, making this choice incorrect for dopaminergic-focused teaching.

A. Encourage the patient to argue with the voices to challenge their validity B. Teach the patient distraction techniques, such as listening to music C. Administer an additional dose of antipsychotic medication without consulting the prescriber D. Advise the patient to ignore the hallucinations and focus on daily tasks

Correct Answer is B

Explanation

Choice A reason: Encouraging the patient to argue with auditory hallucinations can escalate distress and reinforce engagement with the voices, which is non-therapeutic in schizophrenia management. Evidence-based practice emphasizes reducing focus on hallucinations through coping strategies, not confrontation, making this choice incorrect.

Choice B reason: Teaching distraction techniques, like listening to music, is an evidence-based non-pharmacological intervention for managing auditory hallucinations. It helps shift attention away from the voices, reducing their intensity and promoting coping, aligning with psychiatric nursing principles, making this the correct choice.

Choice C reason: Administering an additional dose of antipsychotic medication without prescriber consultation violates nursing scope of practice and safety protocols. It risks toxicity and side effects, such as extrapyramidal symptoms, making this choice unsafe and incorrect for managing hallucinations.

Choice D reason: Advising the patient to ignore hallucinations is oversimplified and often ineffective, as it dismisses the distress caused by symptoms. This approach lacks therapeutic support and does not provide practical coping strategies, making it less appropriate than teaching distraction techniques.

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A nurse is assessing a newly hospitalized patient. Select the best example of the communication technique of "offering self."

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient begins therapy with clozapine medication. What teaching should the nurse provide related to the drug’s strong dopaminergic effect?

Correct Answer is B

Explanation

A nurse is working with a patient diagnosed with schizophrenia who is experiencing auditory hallucinations. Which intervention best supports the patient in managing these symptoms?

Correct Answer is B

Explanation

A patient has acute anxiety related to a car accident. The nurse knows the patient will need teaching about which medication category?

Which term best describes a nurse who can examine their own beliefs, values, and cultural practices?

Silence can be a helpful therapeutic tool for group participants by giving each an opportunity to contemplate what has transpired, weigh alternatives, and formulate ideas. Which statement best supports this?

A nurse is conducting a mental health assessment for a patient reporting persistent feelings of hopelessness. Which intervention best aligns with evidence-based practice for addressing this symptom?

In which phase of group therapy should the nurse plan to first address termination?

A nurse instructs a patient taking a monoamine oxidase inhibitor (MAOI) drug to avoid certain foods and drugs because of the risk of which condition?

An adolescent hospitalized after a physical outburst tells the nurse, "I’m going to kill my father, but you can’t tell anyone." Select the nurse’s best response.

Which scenario best depicts a behavioral crisis?