A nurse is caring for a patient diagnosed with bipolar disorder who is in the manic phase. The patient states, 'I don't need any help. I can do everything myself!' Which response is the most therapeutic?

Correct Answer: C

Rationale: The most therapeutic response in this scenario is option C: "I understand you feel capable, but it's important to stay safe." This response acknowledges the patient's feelings of capability while also emphasizing the importance of safety, which is crucial when caring for a patient in the manic phase of bipolar disorder. Option A may come across as directive and could potentially trigger defensiveness in the patient, as it tells the patient what they "need" to do. Option B, while promoting the idea of accepting help, does not address the immediate safety concern. Option D, by allowing the patient to believe they can do anything without any boundaries, could potentially enable risky behavior during the manic phase. In an educational context, it is essential for nurses to learn therapeutic communication techniques that validate the patient's feelings while also guiding them towards safe and healthy behaviors. Understanding the nuances of communication in mental health settings is crucial for providing effective care and support to patients with bipolar disorder and other mental health conditions.

Correct Answer: D

Rationale: In the context of the nursing process, the implementation phase involves putting the care plan into action through carrying out interventions and coordinating care (option D). This is the correct answer because it is during this phase that nurses directly provide the planned interventions to help the patient achieve the desired outcomes. By implementing the planned interventions effectively, nurses contribute to promoting patient health and well-being. Option A, participating in mutual identification of patient outcomes, is associated with the planning phase where goals are set in collaboration with the patient and the healthcare team. Option B, gathering accurate and sufficient patient-centered data, pertains to the assessment phase where data is collected to inform the care plan. Option C, comparing patient responses and expected outcomes, is part of the evaluation phase where the effectiveness of interventions is assessed. Understanding the distinct roles of each phase of the nursing process is crucial for nurses to provide comprehensive and effective care. By correctly identifying the activities associated with each phase, nurses can ensure a systematic and holistic approach to patient care, leading to improved patient outcomes and quality of care delivery.

Correct Answer: B

Rationale: The most appropriate response by the nurse in this scenario is option B: "It sounds like you're feeling very concerned about your body image." This response demonstrates empathy and active listening, acknowledging the patient's feelings without judgment. It opens up the opportunity for the patient to express their emotions and concerns further, fostering a therapeutic nurse-patient relationship. Option A is incorrect because it dismisses the patient's feelings and can be perceived as invalidating. It does not address the underlying issue of body image distortion in anorexia nervosa. Option C is inappropriate as it is directive and does not consider the complexity of the patient's psychological condition. Option D is also not the best response as it focuses solely on the physical aspect of weight gain without addressing the patient's emotional distress. In an educational context, it is essential for nurses to develop strong communication skills to effectively support patients with mental health disorders like anorexia nervosa. By responding empathetically and non-judgmentally, nurses can create a safe space for patients to express their thoughts and feelings, which is crucial for building trust and promoting positive health outcomes.

Correct Answer: B

Rationale: In this scenario, option B is the most appropriate intervention for the nurse to implement. This option focuses on offering nonjudgmental support and exploring the patient's feelings about their eating behaviors. This approach is crucial in building trust and establishing a therapeutic relationship with the patient. By actively listening and empathizing with the patient, the nurse can help the patient feel understood and supported, which is essential in addressing the underlying issues contributing to their bulimia nervosa. Options A, C, and D are incorrect for several reasons. Option A, encouraging the patient to restrict their food intake, can exacerbate the patient's feelings of lack of control and may reinforce disordered eating behaviors. Option C, telling the patient to stop purging and eating excessively, is too directive and ignores the complex psychological factors contributing to the patient's condition. Option D, focusing on improving body image, may not address the root causes of the patient's bulimia nervosa. Educationally, it is important for nurses to understand the principles of therapeutic communication and person-centered care when working with patients with eating disorders. Building a supportive and nonjudgmental environment is key to fostering trust and promoting open communication, which are essential for effective assessment and intervention in these cases. By prioritizing empathy and active listening, nurses can better support patients in their recovery journey.

Correct Answer: C

Rationale: The best response for the nurse in this scenario is option C: "I'm glad I could help you, but I can't accept the gift. My reward is seeing you with a renewed sense of hope." This response is appropriate because it acknowledges the patient's gratitude while also maintaining professional boundaries. Accepting gifts can create ethical dilemmas, blur boundaries, and potentially influence care decisions. By politely declining the gift and emphasizing the nurse's satisfaction in seeing the patient's progress, it reinforces the therapeutic nurse-patient relationship. Option A is incorrect as it comes off as rigid and dismissive of the patient's gesture, failing to acknowledge the emotional significance of the gift-giving. Option B, though appreciative, doesn't address the issue of accepting gifts in a healthcare setting. Option D, while highlighting the rewarding aspects of nursing, fails to address the potential ethical implications of accepting a gift from a patient. In an educational context, this scenario teaches students the importance of maintaining professional boundaries, ethical considerations in healthcare, and the significance of therapeutic communication in nursing practice. It underscores the need for nurses to navigate situations involving patient gratitude while upholding professional standards.