A nurse is caring for an older adult client who reports their caregiver has been writing checks in their name without their consent. Which of the following types of abuse is the client experiencing?

A. Identification phase. In this phase, the nurse and client begin to build a therapeutic relationship and establish trust. The focus is on identifying the client's needs and concerns rather than actively engaging in therapeutic interventions like guided therapy.
B. Exploitation phase. During the exploitation phase, the nurse encourages the client to utilize the resources and therapeutic interventions available to them. This is an appropriate time to suggest guided therapy sessions, as the client is actively engaged in exploring their issues and working toward improvement.
C. Resolution phase. The resolution phase involves evaluating the progress made and preparing for the termination of the nurse-client relationship. It is not the appropriate time to introduce new therapeutic modalities, as the focus shifts to consolidating gains and planning for future support.
D. Orientation phase. The orientation phase establishes the groundwork for the therapeutic relationship, including discussing goals and expectations. While important, it is not the phase where guided therapy sessions would typically be suggested, as the relationship is still in its initial stages.

A. Encourage the client to use relaxation techniques. While relaxation techniques can help manage symptoms in somatic symptom disorder, they should not be the first response to a new symptom like chest pain. The nurse must first rule out a medical cause before assuming the pain is psychological.
B. Reassure the client that pain is an expected part of their disorder. Assuming that the pain is purely psychosomatic without assessing for a potential medical emergency could lead to a delay in necessary treatment. Each new symptom should be evaluated independently.
C. Explain to the client that the pain is not real. The pain experienced by clients with somatic symptom disorder is real to them, even if a physical cause is not found. Dismissing their symptoms can damage trust and discourage them from reporting future concerns.
D. Assess the client's vital signs. Any new report of chest pain should be taken seriously, regardless of the client’s psychiatric history. Assessing vital signs ensures that a potential cardiac event or other medical issue is not overlooked before considering psychological factors.