What should the nurse do to establish trust in a therapeutic relationship with the clients?

Control the pace of establishing the nurse-client relationships.

Focus on the words of the clients.

Provide sympathy during interactions.

Demonstrate genuineness when communicating.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Controlling the pace of establishing nurse-client relationships is important, but it does not directly contribute to building trust. Trust is built on consistency and predictability, which can be fostered by controlling the pace, but it is the authenticity and transparency in interactions that lay the foundation for trust.

Choice B reason:

Focusing on the words of the clients shows attentiveness and respect for what they are saying, which is a component of active listening. While this is an essential skill for nurses, it is the understanding and empathetic response to those words that will build trust, not just the focus on the words themselves.

Choice C reason:

Providing sympathy during interactions can be comforting to clients, but sympathy alone may not establish trust. Sympathy is feeling compassion for someone else's situation, whereas empathy involves understanding and sharing the feelings of another. Empathy leads to deeper connections and trust than sympathy alone.

Choice D reason:

Demonstrating genuineness when communicating is the most effective way to establish trust. Genuineness involves being open, honest, and authentic with clients. It means the nurse is true to themselves and to the clients, which helps to create a safe space where clients feel understood and valued, leading to trust.

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Correct Answer is ["B","C","D","F"]

Explanation

Choice A: Set up a dietary consult for a low-sodium diet.

Reason: While a low-sodium diet is generally recommended for clients with heart failure to manage fluid retention and blood pressure, it is not the immediate priority in this scenario. The client’s current symptoms and lab results indicate lithium toxicity, which requires more urgent interventions.

Choice B: Notify the provider of potential medication interactions.

Reason: The client is taking lithium and furosemide, which can interact and increase the risk of lithium toxicity. Furosemide, a diuretic, can cause dehydration and electrolyte imbalances, exacerbating lithium toxicity. Notifying the provider is crucial to address these interactions and adjust medications accordingly.

Choice C: Withhold next dose of lithium.

Reason: The client’s lithium level is 2.2 mEq/L, which is above the therapeutic range (0.8 to 1.2 mEq/L) and indicates toxicity. Symptoms such as vomiting, diarrhea, muscle twitching, slurred speech, and drowsiness further support this. Withholding the next dose of lithium is necessary to prevent worsening toxicity2.

Choice D: Educate the client about the need for hemodialysis.

Reason: In cases of severe lithium toxicity, hemodialysis may be required to rapidly remove lithium from the body. Given the client’s high lithium level and symptoms, educating them about this potential treatment is important.

Choice E: Discuss contraception.

Reason: While discussing contraception is important for clients on lithium due to potential teratogenic effects, it is not an immediate priority in this acute situation. The focus should be on addressing the lithium toxicity and stabilizing the client.

Choice F: Assess need for and administer prochlorperazine PRN.

Reason: The client has been experiencing nausea and vomiting, which are symptoms of lithium toxicity2. Administering prochlorperazine can help manage these symptoms and provide relief. However, it is essential to monitor the client closely due to potential interactions with other medications.

A. "Let's discuss what you mean when you say that you cannot ever return to work." B. "You need to work hard on resolving conflict with those closest to you." C. "Antidepressants are not your solution, but this therapy group is." D. "I notice you keep clenching your fists. Why are you doing this?"

Correct Answer is A

Explanation

Choice A Reason:

This open-ended question invites the client to elaborate on their concerns and feelings about returning to work, which can be a significant source of stress after a cancer diagnosis. It allows the nurse to explore the client's perspective and provide support in addressing their fears and challenges.

Choice B Reason:

While resolving conflicts is important, this directive statement may come across as insensitive and may not acknowledge the complex emotions the client is experiencing. It's essential for the nurse to offer a supportive environment where clients feel understood rather than judged.

Choice C Reason:

This statement dismisses the potential role of antidepressants, which may be a valid part of treatment for some individuals. It's important for healthcare professionals to recognize that therapy and medication can both be valuable components of a comprehensive treatment plan.

Choice D Reason:

Noticing physical behaviors like clenching fists can be important, but asking "Why are you doing this?" might put the client on the defensive. A more empathetic approach would be to express concern and ask how the nurse can help the client feel more comfortable.

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What should the nurse do to establish trust in a therapeutic relationship with the clients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a client to the mental health unit. Exhibits The nurse is developing a plan of care for the client. Which of the following interventions should the nurse include? (Select all that apply.)

Correct Answer is ["B","C","D","F"]

Explanation

Choice A: Set up a dietary consult for a low-sodium diet.

Choice B: Notify the provider of potential medication interactions.

Choice C: Withhold next dose of lithium.

Choice D: Educate the client about the need for hemodialysis.

Choice E: Discuss contraception.

Choice F: Assess need for and administer prochlorperazine PRN.

A nurse is leading a group therapy session for clients who are newly diagnosed with cancer. Which of the following statements should be an appropriate response by the nurse?

Correct Answer is A

Explanation

A school nurse is speaking to the mother of a 16-year-old male adolescent. The mother has concerns about her son. Which of the following statements by the mother should indicate to the nurse that the adolescent is at risk for suicide?

A nurse is taking care of a client who is cognitively impaired. The nurse recognizes that which of the following rooms will provide a therapeutic environment for this client?

A nurse in a mental health facility is interacting with a client who is angry and becoming increasingly aggressive. Which of the following actions should the nurse take?

A nurse is caring for a client who is refusing to attend group therapy. The client states, "I don't know why you think I need therapy. I am fine without it." Which of the following responses by the nurse indicates a therapeutic response?

A nurse is teaching a female client who has an anxiety disorder and is prescribed alprazolam (Xanax). Which of the following information should the nurse include in the teaching?

A nurse is admitting a client with a history of alcohol use disorder. The nurse is aware that which of the following are potential physical symptoms of alcohol withdrawal? (Select all that apply.)

A nurse in an acute mental health facility is creating a plan of care for a new client who has histrionic personality disorder. Which of the following is the highest priority for the nurse?

A nurse is caring for an adolescent client who has a new diagnosis of schizophrenia. The client's parents are tearful and express feelings of guilt. Which of the following is an appropriate statement by the nurse?