The nurse has established a therapeutic relationship with a client. Which behaviors identified will indicate that the client has entered into the identification phase of the nurse-client relationship?
The client is sharing feelings and emotions with the nurse.
The client is attending all therapy sessions and utilizing the services provided.
The client states that they feel the issues have been resolved and no longer need to come.
The client is answering questions related to the plan of care.
The Correct Answer is A
The identification phase of the nurse-client relationship is characterized by the client feeling comfortable and secure enough to open up and share their feelings, emotions, and personal experiences with the nurse. It involves establishing trust and rapport, which allows the client to feel supported and understood by the nurse. Sharing feelings and emotions indicates that the client has reached a level of comfort and trust in the therapeutic relationship, making it a key indicator of the identification phase.
The other behaviors mentioned in the options are not specifically related to the identification phase:
● The client attending therapy sessions and utilizing services provided is an important aspect of engagement and active participation in the therapeutic process. However, it does not specifically indicate the identification phase of the relationship.
● The client stating that they feel the issues have been resolved and no longer need to come suggests the termination phase of the nurse-client relationship rather than the identification phase. The termination phase occurs when the client feels they have achieved their goals and no longer require ongoing therapy.
● The client answering questions related to the plan of care is a general indicator of communication and collaboration in the therapeutic process. It does not specifically signify the identification phase but rather active involvement in the treatment plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
When discussing culturally competent care at a nursing staff inservice, the nurse should include information about the importance of focusing on clients’ cultures when providing care. Culture plays a significant role in determining when a client will seek medical care and how they will respond to treatment. Nonverbal communication is important in many cultures and can provide valuable information about a client’s needs and preferences. Nurses should strive to provide care that is respectful of and responsive to clients’ cultural beliefs and practices, rather than expecting clients to adapt to the care provided.
● “Culture plays no role in determining when a client will seek medical care.” This statement is incorrect because culture can play a significant role in determining when and how a client seeks medical care. Cultural beliefs and practices can influence a client’s understanding of health and illness, their attitudes towards healthcare providers, and their willingness to seek and adhere to treatment.
● “Nonverbal communication is important in few cultures.” This statement is incorrect because nonverbal communication is important in many cultures. Nonverbal cues such as body language, facial expressions, and gestures can convey important information about a client’s emotions, needs, and preferences. Understanding and responding to nonverbal communication can help nurses provide culturally competent care.
● “Nurses should expect clients to adapt to the care provided regardless of culture.” This statement is incorrect because it is not culturally competent to expect clients to adapt to the care provided without considering their cultural beliefs and practices. Nurses should strive to provide care that is respectful of and responsive to clients’ cultural beliefs and practices. This may involve adapting the care provided to meet the unique needs of each client.
Correct Answer is A
Explanation
When encountering a client who is sexually aggressive, it is important for the nurse to establish firm limits and boundaries to ensure the safety and well-being of both the client and the healthcare team. This response promotes the maintenance of a therapeutic environment and helps prevent potential harm to the client, staff, and other patients.
the other choices are incorrect:
1. "Tell the client that you are going to report to the director of the unit." While it is important to report any concerning behaviors or incidents to the appropriate personnel, simply informing the client about reporting to the director may not be the most effective initial response. Prioritizing immediate actions to ensure safety and setting boundaries is crucial before involving higher-level staff.
2. "Walk away and have someone else take care of the client." Leaving the situation and passing the responsibility to someone else without addressing the issue directly is not an appropriate response. It is the nurse's responsibility to provide care and manage challenging situations within their scope of practice and training. Collaboration and support from the healthcare team may be sought, but abandoning the client is not an acceptable approach.
3. "It happens frequently, so just ignore it; they will stop." Ignoring sexually aggressive behavior is not an appropriate response. Such behavior should be taken seriously and addressed promptly to ensure the safety and well-being of everyone involved. Ignoring the behavior may enable its continuation and potentially lead to further harm or escalation of the situation.
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