When engaged in therapeutic communication with a client who has been diagnosed with a mental disorder, which is the most important principle for a nurse to keep in mind?
The nurse should have an empathetic relationship with the client.
The client is the primary focus of the interaction.
The nurse should self-disclose when indicated.
The client’s conversations should be recorded.
The Correct Answer is B
Choice A reason:
Having an empathetic relationship with the client is important, but it is not the most important principle. Empathy helps build trust and rapport, but the primary focus should always be on the client’s needs and experiences.
Choice B reason:
The client being the primary focus of the interaction is the most important principle in therapeutic communication. This ensures that the nurse’s attention and efforts are directed towards understanding and addressing the client’s concerns, promoting their well-being and recovery.
Choice C reason:
Self-disclosure by the nurse should be used sparingly and only when it benefits the client. While it can help build rapport, it is not the primary focus of therapeutic communication. The nurse’s primary role is to listen and support the client.
Choice D reason:
Recording the client’s conversations is not a standard practice in therapeutic communication and can breach confidentiality. The focus should be on creating a safe and trusting environment where the client feels comfortable sharing their thoughts and feelings.
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Correct Answer is B
Explanation
Choice A reason:
A predictable social environment is important for providing stability and security, which can contribute to a client’s overall well-being. However, according to Maslow’s hierarchy of needs, physiological needs such as food and water must be met before higher-level needs like social stability can be addressed. Therefore, while important, a predictable social environment is not the immediate priority.
Choice B reason:
Adequate food is a fundamental physiological need according to Maslow’s hierarchy of needs. Physiological needs are the most basic and must be satisfied before an individual can focus on higher-level needs such as safety, love, and self-esteem. Ensuring that the client has adequate food is essential for their survival and overall health, making it the top priority in the plan of care.
Choice C reason:
A positive self-image is associated with self-esteem needs, which are higher up in Maslow’s hierarchy. While fostering a positive self-image is important for a client’s mental health and well-being, it cannot be effectively addressed until basic physiological needs are met. Therefore, it is not the immediate priority in the plan of care.
Choice D reason:
Acceptance from family relates to the need for love and belonging, which is also higher up in Maslow’s hierarchy. While family acceptance is crucial for emotional support and social well-being, it is not as immediate a priority as ensuring that the client’s basic physiological needs, such as adequate food, are met first.
Correct Answer is C
Explanation
Choice A reason:
Bizarre behavior is considered a positive symptom of schizophrenia. Positive symptoms are those that add abnormal experiences, such as hallucinations, delusions, and disorganized behavior. Bizarre behavior falls into this category as it represents an addition to normal behavior patterns.
Choice B reason:
Somatic delusions are also positive symptoms of schizophrenia. These delusions involve false beliefs about the body, such as believing one has a serious illness despite medical evidence to the contrary. Positive symptoms are characterized by the presence of abnormal thoughts or behaviors.
Choice C reason:
Affective flattening is a negative symptom of schizophrenia. Negative symptoms are characterized by the absence or reduction of normal functions, such as emotional expression, motivation, and social interaction. Affective flattening refers to a lack of emotional expression, where the individual shows little to no facial expressions or emotional responses.
Choice D reason:
Illogicality, or disorganized thinking, is considered a positive symptom of schizophrenia. It involves incoherent or nonsensical speech and thought patterns. Positive symptoms are those that reflect an excess or distortion of normal functions.
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