A client asks the evening shift nurse,"How do you feel about my refusing to attend group therapy this morning?" The nurse responds,"How did your refusing to attend group make you feel?" This nurse is using which communication technique?

Correct Answer: C

Rationale: The correct answer is C: Therapeutic use of "reflection." This communication technique involves mirroring the client's feelings or thoughts back to them, allowing them to explore their own emotions. In this scenario, the nurse is reflecting the client's feelings back to them by asking how their refusal to attend group therapy made them feel. This encourages self-exploration and insight. A: Therapeutic use of "restatement" involves repeating the client's words to show understanding, which is not demonstrated in the scenario. B: Nontherapeutic use of "probing" involves asking direct questions that may feel intrusive, which is not the case here. D: Nontherapeutic use of "interpreting" involves offering interpretations or judgments, which is not demonstrated in the scenario.

Correct Answer: A

Rationale: The correct answer is A: provide for the patient's safety. This is the highest priority because the patient is exhibiting behaviors that indicate distress and potential harm to themselves or others. Ensuring the patient's safety is the immediate concern to prevent any accidents or dangerous situations. Choice B is incorrect because encouraging clarification of feelings is not the priority when the patient is in a state of distress and potential danger. Choice C is incorrect as respecting personal space is important but not the most critical in this urgent situation. Choice D is also incorrect as offering an outlet for energy is not the immediate need when the patient is displaying alarming behaviors.

Correct Answer: C

Rationale: Rationale: The correct response is C. When someone is in emotional pain to the extent of contemplating suicide, their ability to think clearly and rationally is often compromised. This is especially true in the case of sudden or impulsive suicides. Therefore, the therapist's best response would be to explain that the husband's emotional turmoil likely clouded his judgment and prevented him from leaving a note. Incorrect Choices: A: This choice assumes impulsivity, but it doesn't address the husband's emotional state. B: While this choice considers the impact on Gladys, it doesn't directly address the husband's mental state. D: This choice focuses on Gladys' potential interpretation rather than the husband's state of mind.

Correct Answer: A

Rationale: The correct answer is A: Implement suicide precautions. This is the highest priority intervention because the patient has a plan for suicide, which poses an immediate risk to their safety. Implementing suicide precautions involves ensuring the patient's safety by removing any potential means of self-harm, closely monitoring their behavior, and providing constant supervision to prevent any suicide attempts. Choice B is incorrect because offering high-calorie snacks and fluids frequently does not address the immediate risk of suicide. Choice C is incorrect because assisting the patient to identify personal strengths is important for building self-esteem but is not the highest priority when the patient is at risk of suicide. Choice D is incorrect because observing the patient for therapeutic effects of antidepressant medication is important but ensuring the patient's safety takes precedence when there is a risk of suicide.

Correct Answer: D

Rationale: The correct answer is D: Alzheimer's disease. Alzheimer's disease is the most prevalent mental disorder in the United States, affecting millions of individuals. It is a neurodegenerative disorder characterized by memory loss and cognitive decline. Schizophrenia (A) is less common than Alzheimer's disease. Bipolar disorder (B) and Dissociative fugue (C) are also less prevalent compared to Alzheimer's disease. Alzheimer's disease is specifically known for its high prevalence and impact on the population.

Correct Answer: A

Rationale: The correct answer is A because cognitive behavioral therapy focuses on changing thoughts and behaviors, not necessarily on events as the underlying issue. The therapist would be least likely to include this as it does not align with the core principles of CBT. Choice B is correct as CBT acknowledges that beliefs can exist irrespective of their origin. Choice C is correct as CBT emphasizes the role of practice in changing beliefs. Choice D is correct as CBT involves challenging and replacing negative thoughts with more accurate ones.

Correct Answer: C

Rationale: The correct answer is C: Serotonin syndrome. This is because both fluoxetine and St. John's wort increase serotonin levels in the brain, leading to a risk of serotonin syndrome - a potentially life-threatening condition characterized by symptoms such as confusion, agitation, sweating, and muscle twitching. Water intoxication (A) is not typically associated with these medications. Increased depressive symptoms (B) may occur if the client stops taking fluoxetine abruptly, but not specifically due to the combination with St. John's wort. Hypertensive crisis (D) is not a common concern with these medications.

Correct Answer: C

Rationale: Step 1: Identify Peplau's contribution - Peplau is known for her Interpersonal Theory, which emphasizes the therapeutic nurse-patient relationship. Step 2: Compare with Freud - Just like Freud is associated with psychoanalytic theory, which focuses on the unconscious mind and childhood experiences, Peplau's Interpersonal Theory focuses on the interpersonal relationships in nursing. Step 3: Eliminate other choices - A (Psychosocial theory) is more closely associated with Erikson, B (Nursing theory) is too broad, and D (Object relations theory) is more aligned with Melanie Klein. Step 4: Conclusion - The correct answer is C (Interpersonal theory) because Peplau's work focuses on the interpersonal relationships within the nursing context, similar to how Freud focused on psychoanalytic theory.

Correct Answer: B

Rationale: The correct answer is B: the client's cultural background. Before touching the client to offer comfort, the nurse should consider the client's cultural background to ensure that the gesture is appropriate and respectful. Different cultures have varying attitudes towards touch, and what may be comforting in one culture could be inappropriate or invasive in another. Understanding the client's cultural background helps the nurse provide culturally sensitive care. Incorrect choices: A: the client's recent vital signs - Vital signs are important for assessing physical health, but they are not directly relevant to offering comfort through touch in this situation. C: if the doctor should be notified - Notifying the doctor is not necessary before offering comfort through touch. It is more important to consider the client's needs and preferences. D: if the client has been sad recently - While the client's emotional state is important, it is not the primary consideration before offering comfort through touch. Cultural background plays a more crucial role in determining the appropriateness of touch.