A nurse practicing Peplau’s Relations Theory is working with a newly admitted client who is withdrawn and reluctant to engage. According to Peplau’s working model, which nurse action best explains the orientation phase of the nurse-client relationship?
Focusing solely on medication administration to stabilize symptoms before building rapport.
Encouraging the client to express feelings freely without providing guidance.
Maintaining professional distance to avoid fostering dependency.
Establishing trust through consistent, honest communication and clarifying the client’s expectations.
The Correct Answer is D
Choice A reason: Focusing only on medications neglects the interpersonal development central to Peplau’s model. The orientation phase emphasizes relationship building, not task-centered care.
Choice B reason: Allowing expression without structure or guidance does not fulfill the orientation phase, which requires the nurse to actively build trust and clarify roles.
Choice C reason: Excessive distance prevents rapport, which is essential in the orientation phase where the foundation for a therapeutic relationship must be established.
Choice D reason: Establishing trust, being consistent, and clarifying client expectations define the orientation phase of Peplau’s theory. This phase sets the groundwork for collaboration and progress in treatment.
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Correct Answer is D
Explanation
Choice A reason: This response is factual but does not promote engagement or address the client’s passive stance. It emphasizes the nurse’s role without encouraging participation or collaboration from the older adult.
Choice B reason: This statement makes an assumption about the client’s feelings, labeling them as “angry,” which may not be accurate. It risks creating defensiveness and does not foster open communication or trust within the group.
Choice C reason: This response inappropriately offers group leadership to a member without assessing readiness or interest. It minimizes the therapeutic structure of the group and could confuse roles, making the group less effective.
Choice D reason: This option balances the acknowledgment of the nurse’s leadership role with an invitation for the client to share personal goals. It encourages involvement, respects autonomy, and helps build a therapeutic alliance by showing interest in what the older adult wants to accomplish.
Correct Answer is C
Explanation
Choice A reason: SSRIs are antidepressants used to treat depression and anxiety disorders. They do not address extrapyramidal side effects like acute dystonia, so they would not be useful in this case.
Choice B reason: Beta-blockers are primarily used for cardiovascular conditions and akathisia (a sense of restlessness), but they are not the treatment of choice for acute dystonia.
Choice C reason: Diphenhydramine, an antihistamine with strong anticholinergic properties, is effective in treating acute dystonia by restoring the balance between dopamine and acetylcholine in the basal ganglia. This makes it the correct choice for managing the client’s symptoms.
Choice D reason: Benzodiazepines may help with agitation or anxiety, but they are not first-line treatment for acute dystonic reactions caused by antipsychotic medications.
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