A nursing instructor is teaching about psychodrama, a specialized type of therapeutic group. Which student statement indicates that further teaching is necessary?

Correct Answer: C

Rationale: In psychodrama, the client is not simply an observer from the audience but actively participates as the protagonist. The protagonist takes on a role and interacts with other group members, often reenacting real-life situations to gain insight and work through emotions. This active involvement is a key aspect of psychodrama therapy, so the statement that the client observes actor interactions is incorrect and indicates a need for further teaching on how psychodrama therapy works.

Correct Answer: C

Rationale: A democratic form of self-government in the therapeutic milieu contributes to client therapy by setting community expectations wherein all clients are treated on an equal basis. This fosters a sense of respect, fairness, and inclusivity within the therapeutic environment, enhancing the overall therapeutic experience for each individual. By promoting equal treatment and shared responsibilities, clients in such a democratic setting can feel empowered, respected, and valued, leading to better engagement in therapy and a more supportive community atmosphere. This sense of egalitarianism can also help to build trust among clients and between clients and therapy staff, ultimately facilitating positive therapeutic outcomes.

Correct Answer: C

Rationale: In this scenario, the mother's anxiety and refusal to leave the postpartum unit are most likely due to an acute response to the external situational stressor of becoming a new mother. Postpartum anxiety and difficulties adjusting to the new role are common experiences for many new mothers and can precipitate a crisis situation. This crisis is not caused by preexisting psychopathology or normal life-cycle transitions, but rather by the specific stressors associated with the new maternal role. Recognizing this as an acute response to an external situational stressor will guide the nurse in providing appropriate care and support for the mother during this sensitive time.

Correct Answer: D

Rationale: In this scenario, the most appropriate intervention would be to prioritize setting firm limits on the behavior with staff support. By establishing boundaries, the nurse can convey clear expectations to the client and promote a therapeutic environment. Setting limits also helps in managing challenging behaviors and maintaining a safe space for both the client and staff members. This approach can prevent potential escalation of the behavior and provide structure and consistency in the therapeutic relationship. It is essential to address the behavior promptly and assertively, emphasizing respect and safety for all individuals involved.

Correct Answer: A

Rationale: In mental health crisis situations, effective communication is crucial for assessing the individual's needs and providing appropriate support. Option A, "Tell me what happened," is the correct choice because it allows the individual to express their immediate concerns and helps the nurse understand the context of the crisis. This open-ended question encourages the individual to share their thoughts and emotions, facilitating a therapeutic dialogue. Option B, "What coping methods have you used, and did they work?" focuses more on past strategies rather than the current situation, which may not be as relevant in an acute crisis. Option C, "Describe to me what your life was like before this happened," although seeking background information, does not address the immediate crisis at hand. Option D, "Let's focus on the current problem," while seemingly reasonable, may come off as dismissive or directive, potentially hindering rapport-building in a crisis scenario. Educationally, it is essential for nurses to learn how to ask open-ended, empathetic questions that allow individuals to express themselves during crises. This approach fosters trust, validates feelings, and helps the nurse gather relevant information for effective intervention. Training in therapeutic communication skills is vital for mental health professionals to provide quality care in crisis situations.