Exam 1 - Psychiatric/Mental Health Nursing practice
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The nurse is working with a patient who is struggling to
over- come a serious mental illness. The patient begins
crying after learning that her family will no longer be
visiting. Which response by the nurse demonstrates
empathy?
A. "I am not sure what I would do if I were in your shoes."
B. "You must be wondering why they are acting this way."
C. "My sense is that this experience has been very painful
for you."
D. "I understand because I went through something similar
one time." - Answer-C. "My sense is that this experience
has been very painful for you."
Rationale: The nurse using empathy separates the nurse's
own feelings, experiences, and reactions and fully
engages with the patient an attempt to get a sense of how
the patient is feeling at that moment in time. In this
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instance, the nurse must be present to what the patient is
conveying and act to validate the observation of distress,
without conditions or judgment. Options a and d shift focus
back to the nurse and fail to recognize the patient's
experience as unique. Option b does not validate the
patient's verbal or nonverbal messages, but instead
makes an assumption that is likely to be based on the own
nurse's perspectives.
The nurse is acting as a preceptor to a recent nurse
graduate who wants to obtain a job on the mental health
unit. The new nurse has been struggling to differentiate
between social and therapeutic interactions because so
many of the patients are around his own age. Which
evaluation finding indicates that nurse is acting in
accordance with appropriate professional boundaries?
Select all that apply.
A. The nurse sets limits on inappropriate behaviors.
B. The nurse uses colloquial language to foster trust.
C. The nurse brings in clothing for a homeless patient.
D. The nurse offers a video collection for a group movie
night.
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E. The nurse lets a patient know when their time together
will end. - Answer-A, D, E
A. The nurse sets limits on inappropriate behaviors.
D. The nurse offers a video collection for a group movie
night.
E. The nurse lets a patient know when their time together
will end.
New nurses frequently fall back on relationship skills that
have been learned in the context of families and or
friendships. When nurses set limits on behaviors they are
acting in the role of a counselor, educator and caretaker.
Nurses act to meet the needs of all patients, and bringing
in movies is an example of sharing a resource that all
patients can use. When the nurse maintains the time
frames associated with professional and not personal
relationships the nurse is upholding boundaries
appropriate to nursing role and acting in a manner that is
consistent with professional and ethical standards. The
use of colloquial language conveys a sense of familiarity
that is not consistent with a professional relationship.
Bringing in clothing for an individual patient may be
construed as "special treatment," and demonstrates an
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inability to differentiate between professional and personal
relationships.
The nurse is working with a patient who presents in the
outpa- tient setting for the treatment of situational
depression. The patient has begun to try out new coping
strategies and has taken advantage of a support group the
nurse recommended. The nurse recognizes that the
patient has entered which phase of therapeutic nurse-
patient relationship?
A. Orientation
B. Working
C. Exploitation
D. Resolution - Answer-C. Exploitation
During the exploitation phase, the patient begins to make
use of the resources and tools that have been offered. The
orientation phase consists gaining an understanding of the
goals and needs for care. The working phase consists of
initial engagement in treatment. The resolution phase
consists of reviewing progress and terminating the
relationship.