A nurse is caring for a client who has a chronic illness. In which phase of the therapeutic relationship should the nurse help the client develop problem-solving skills?

Preinteraction phase

Working phase

Orientation phase

Termination phase

Answer and Explanation

The Correct Answer is B

A. Preinteraction phase: This phase occurs before the nurse meets the client and involves gathering information, reviewing the client’s history, and planning care. Problem-solving with the client is not addressed in this phase, as there is no direct interaction yet.

B. Working phase: The working phase is when the nurse and client actively collaborate to achieve identified goals. Helping the client develop problem-solving skills, coping strategies, and behavioral changes occurs during this phase, as it focuses on interventions and progress toward therapeutic outcomes.

C. Orientation phase: During the orientation phase, the nurse establishes trust, defines the nurse–client relationship, and sets initial goals. While assessment and goal setting occur, active problem-solving skill development has not yet begun.

D. Termination phase: The termination phase involves concluding the nurse–client relationship, reviewing achievements, and preparing the client for independence. Problem-solving has typically already been addressed in the working phase; this phase focuses on closure rather than skill development.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Cleanse the perineal area from back to front: Perineal hygiene after delivery should be performed from front to back to prevent transfer of gastrointestinal flora, such as Escherichia coli, to the episiotomy site or urinary tract. Cleansing from back to front increases the risk of wound contamination and postpartum infection.

B. Wash the perineal area with povidone-iodine twice daily: Routine use of antiseptic solutions such as povidone-iodine is not recommended for standard episiotomy care. These solutions can irritate healing tissue and disrupt normal skin flora. Gentle cleansing with warm water using a peri-bottle after voiding or defecation is typically advised.

C. Change the perineal pad with each void: Lochia provides a moist environment that can promote bacterial growth and increase infection risk at the episiotomy site. Changing the perineal pad frequently, especially after each void, helps maintain dryness, reduce bacterial proliferation, and support wound healing.

D. Wipe the perineal area with a soft towel: The perineal area should be gently patted dry rather than wiped to avoid mechanical trauma to the sutured episiotomy site. Wiping can place tension on the sutures and disrupt tissue approximation during the early stages of healing.

A. "The contraceptive effect will continue for 6 months following discontinuation of the medication." B. "Start the first patch on the seventh day of the menstrual cycle. C. "Apply the patch to the lower abdomen." D. "Expect to have a headache during the first month."

Correct Answer is C

Explanation

A. "The contraceptive effect will continue for 6 months following discontinuation of the medication.": The contraceptive effect of the transdermal patch does not persist after discontinuation. Fertility generally returns quickly, often within a few days to a month, so this statement is inaccurate and could lead to unintended pregnancy.

B. "Start the first patch on the seventh day of the menstrual cycle.": Standard instructions recommend applying the first patch on the first day of menstruation or on the first Sunday after menstruation begins. Starting on the seventh day could reduce contraceptive effectiveness and increase the risk of ovulation.

C. "Apply the patch to the lower abdomen.": The patch can be applied to the lower abdomen, buttocks, back, or upper arm, avoiding breasts. Correct placement ensures consistent absorption of hormones and optimal contraceptive effectiveness, making this an essential part of client teaching.

D. "Expect to have a headache during the first month.": While some clients may experience headaches as a side effect of estrogen-containing contraceptives, it is not a guaranteed or expected symptom. Teaching should focus on common, likely side effects rather than implying all clients will experience this.

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A nurse is caring for a client who has a chronic illness. In which phase of the therapeutic relationship should the nurse help the client develop problem-solving skills?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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