Which remark by a patient indicates passage from the orientation phase to the working phase of a nurse-patient relationship?

Choice A reason: Flooding involves intense, immediate exposure to the feared stimulus, like elevators, overwhelming amygdala-driven fear responses. This contrasts with gradual exposure, which calms norepinephrine surges incrementally. Flooding is less controlled and riskier, making it incorrect for the described gradual relaxation technique.

Choice B reason: Systematic desensitization pairs gradual exposure to a fear, like elevators, with relaxation to reduce amygdala hyperactivity and norepinephrine-driven panic. This counterconditions fear responses, promoting calm neural pathways, aligning with the described technique and making it the correct choice for this therapeutic approach.

Choice C reason: Combination therapy involves multiple modalities, like medication and psychotherapy, not specifically gradual exposure with relaxation. The described technique targets phobia-specific amygdala responses, not a broad approach, making combination therapy too vague and incorrect for this targeted intervention.

Choice D reason: Cognitive restructuring modifies thought patterns, not exposure-based fear responses. While it addresses distorted beliefs, the described technique uses relaxation with gradual exposure to reduce norepinephrine-driven panic, not cognitive reframing, making this incorrect for the specific therapeutic method described.

Choice A reason: Interventions, like offering snacks, address identified problems (e.g., forgetting to eat) to meet nutritional needs. This action targets physiological deficits, potentially linked to cognitive impairments from low acetylcholine in dementia, ensuring adequate caloric intake to support brain function and overall health in the care plan.

Choice B reason: Planning/goals outline desired outcomes, not specific actions. Forgetting to eat, possibly due to frontal lobe dysfunction, requires goals like “maintain adequate nutrition.” Interventions, not goals, specify actions like offering snacks, making this section incorrect for the statement’s placement in the care plan.

Choice C reason: Assessment involves data collection, like observing eating patterns, not actions like offering snacks. Forgetting to eat may reflect cognitive deficits, but assessment identifies the problem, not solutions. This section precedes interventions, making it an incorrect location for the described statement.

Choice D reason: Diagnosis identifies problems, like “impaired nutrition” due to cognitive deficits, not specific actions. Offering snacks is an intervention to address the diagnosis, not the diagnosis itself. This section is incorrect for the statement, which belongs in the intervention phase of the care plan.