A nurse is caring for a client who states, "I don’t belong here." Which response is most appropriate?
Were you feeling this way before this hospitalization?
You don’t think this is the right place for your care?
Suggest you discuss your concerns with the doctor in the morning
This is an inappropriate statement for you to make
The Correct Answer is B
Choice A reason: Asking if the client felt this way before hospitalization focuses on past feelings, which may not address the current emotional state or therapeutic needs. While it gathers history, it lacks empathy and does not encourage the client to elaborate on their current concerns, making it less therapeutic.
Choice B reason: Reflecting the client’s statement by asking if they feel the setting is wrong demonstrates active listening and empathy, key components of therapeutic communication. It encourages the client to express feelings, fostering trust and exploration of their concerns, aligning with psychiatric nursing principles, making this the correct choice.
Choice C reason: Suggesting the client discuss concerns later with a doctor dismisses their current emotional state, potentially undermining trust in the nurse-client relationship. It avoids immediate engagement and fails to address the client’s feelings, which is critical in psychiatric care, making this response non-therapeutic and incorrect.
Choice D reason: Labeling the client’s statement as inappropriate is judgmental and dismissive, hindering therapeutic communication. It may increase the client’s sense of alienation or shame, contrary to psychiatric nursing goals of building trust and validating feelings. This response is non-therapeutic and does not support the client’s emotional needs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: In Peplau’s orientation phase, the nurse establishes trust, fosters collaboration, and sets boundaries to build a therapeutic relationship. This foundation is critical for patients with psychiatric disorders, ensuring a safe space for engagement, making this the correct choice.
Choice B reason: Medication adherence is a clinical intervention addressed later, in the working phase, not orientation. The initial phase focuses on relationship-building, not specific treatments, making this choice incorrect for the orientation phase’s goals.
Choice C reason: Coping skill development occurs in the working phase, after trust is established. Orientation prioritizes relationship foundations like trust and boundaries, not skill-building, making this choice incorrect for the initial nurse-patient interaction phase.
Choice D reason: Long-term goals are addressed in the working or termination phases, not orientation, which focuses on establishing trust and rapport. Setting goals prematurely may hinder relationship-building, making this choice incorrect for the orientation phase.
Correct Answer is A
Explanation
Choice A reason: Basic-level nurses, such as LPNs or RNs, can teach coping skills, a standard intervention within their scope. This involves education on stress management, aligning with psychiatric nursing roles to support patient and family well-being, making this the correct choice.
Choice B reason: Treating major depressive disorder requires advanced skills, like prescribing or managing complex therapies, which is beyond a basic-level nurse’s scope. This is typically reserved for advanced practice nurses or physicians, making this choice incorrect.
Choice C reason: Prescribing antidepressants is restricted to advanced practice nurses or physicians, not basic-level nurses. This task involves medical decision-making outside the scope of RNs or LPNs, making it unsafe and inappropriate, thus incorrect.
Choice D reason: Assessing suicide risk requires advanced clinical judgment, often reserved for advanced practice nurses or psychiatrists. While basic-level nurses can observe and report, formal assessment exceeds their scope, making this choice incorrect for their role.
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