A nurse is caring for a patient with bipolar disorder who is in a manic phase and refuses to attend a scheduled group therapy session. Which response by the nurse best promotes therapeutic engagement?
“You have to attend the session, or you won’t make progress.”
“I’ll let your doctor know you’re refusing to participate.”
“Can you share what’s making you hesitant about group therapy today?”
“If you don’t go, you’ll miss out on important treatment.”
The Correct Answer is C
Choice A reason: Using coercive language, like stating attendance is mandatory for progress, undermines patient autonomy and may increase resistance, especially in a manic phase where defiance is common. This non-therapeutic approach hinders trust, making it incorrect for promoting engagement.
Choice B reason: Reporting refusal to the doctor without exploring the patient’s reasons dismisses their feelings and escalates authority rather than fostering collaboration. Therapeutic engagement requires understanding the patient’s perspective, making this response non-therapeutic and incorrect.
Choice C reason: Asking about the patient’s hesitation uses open-ended questioning, a therapeutic communication technique that encourages expression of feelings and builds trust. This aligns with psychiatric nursing principles to engage patients respectfully, especially during mania, making this the correct choice.
Choice D reason: Warning about missing treatment is mildly coercive and does not explore the patient’s reasons for refusal. It fails to address underlying concerns, such as anxiety or grandiosity, which are critical in mania, making this less therapeutic than exploring hesitancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Administering medications addresses symptoms pharmacologically but is not a core cognitive behavioral therapy (CBT) intervention. CBT focuses on modifying thoughts and behaviors, not drug therapy, making this choice incorrect for the specified theoretical approach.
Choice B reason: CBT targets negative thought patterns to modify maladaptive behaviors and emotions, central to treating anxiety. Challenging distorted cognitions helps the patient reframe perceptions, reducing withdrawal, aligning with CBT principles, making this the correct choice.
Choice C reason: Group therapy encourages social interaction but is not a primary CBT intervention. CBT focuses on individual cognitive restructuring, not group dynamics, making this choice less relevant for the specified theoretical approach to anxiety treatment.
Choice D reason: Relaxation techniques are adjunctive in CBT but not the primary focus. Challenging negative thoughts is the core intervention, directly addressing cognitive distortions driving anxiety, making relaxation a secondary approach and this choice incorrect.
Correct Answer is B
Explanation
Choice A reason: Electroconvulsive therapy (ECT) is reserved for severe, treatment-resistant depression or acute suicidal ideation, not general hopelessness. It involves significant risks and requires specialist oversight, making it inappropriate as a first-line intervention for this symptom, which can be addressed with less invasive methods.
Choice B reason: Cognitive behavioral therapy (CBT) targets negative thought patterns, such as hopelessness, by restructuring cognitions, a core feature of depression. Evidence-based for mood disorders, CBT reduces symptoms through structured interventions, making it the most appropriate choice for addressing hopelessness in a mental health assessment.
Choice C reason: High-dose benzodiazepines treat acute anxiety or agitation, not hopelessness, which is a depressive symptom. They risk sedation and dependence without addressing cognitive distortions, making them inappropriate for this symptom and contrary to evidence-based psychiatric nursing practice.
Choice D reason: Avoiding social interactions may worsen hopelessness by increasing isolation, a risk factor for depression. Evidence-based practice encourages social engagement to improve mood and support networks, making this intervention counterproductive and incorrect for addressing the patient’s reported symptom.
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