A patient says, 'Please don't share information about me with the other people.' How should the nurse respond?

Correct Answer: A

Rationale: A patient has the right to know with whom the nurse will share information and that confidentiality will be protected. Although the relationship is primarily between the nurse and patient, other staff needs to know pertinent data. The other incorrect responses promote incomplete disclosure on the part of the patient, require daily renegotiation of an issue that should be resolved as the nurse-patient contract is established, and suggest mutual problem solving. The relationship must be patient centered. See relationship to audience response question.

Correct Answer: C

Rationale: Asking, 'Am I correct in understanding that "¦' permits clarification to ensure that both the nurse and patient share mutual understanding of the communication. Asking about common elements encourages comparison rather than clarification. The remaining responses are implied questions that suggest the nurse was not listening.

Correct Answer: C

Rationale: Silence can be helpful to both participants by giving each an opportunity to contemplate what has transpired, weigh alternatives, and formulate ideas. A nurse breaking silences is not a principle related to silences. It is inaccurate to say that patients withdraw during long silences or that silence helps patients know that they are understood. Feedback helps patients know they have been understood.

Correct Answer: B

Rationale: The correct answer is B) The patient's speech is fragmented and difficult to understand. Disorganized thinking is a hallmark symptom of schizophrenia, characterized by incoherent and fragmented speech patterns that make it challenging to follow the patient's thoughts. This can include rapid shifts in topics, tangential responses, or even word salad where words are strung together without logical connection. Option A is incorrect because speaking in a logical, coherent manner with clear thoughts does not demonstrate disorganized thinking, which is a specific symptom of schizophrenia. Option C describes delusional thinking, which is a different symptom associated with schizophrenia but not synonymous with disorganized thinking. Option D mentions well-organized thoughts with concentration difficulties, which is more indicative of attention deficits rather than disorganized thinking. In an educational context, understanding the nuances of symptoms like disorganized thinking in schizophrenia is crucial for nurses to provide appropriate care and support for patients. Recognizing these symptoms helps in developing effective nursing care plans tailored to the individual's needs, promoting better outcomes and quality of life for patients with schizophrenia.

Correct Answer: B

Rationale: In this scenario, the priority nursing intervention is option B) Assess the patient for suicidal thoughts and intentions. This is the correct choice because the patient's statement about having no hope for the future and not seeing a way out indicates a high level of hopelessness, which is a significant risk factor for suicide in individuals with major depressive disorder. Option A) Encouraging the patient to set realistic goals for the future may be important for the patient's overall mental health, but in this situation, assessing for immediate safety concerns takes precedence. Option C) Offering positive affirmations may provide some comfort to the patient, but it does not address the serious risk of suicide that the patient's statement implies. Option D) Suggesting engagement in physical activities is a helpful intervention for managing depression symptoms, but it does not directly address the patient's expression of hopelessness and potential suicidal ideation. Educationally, it is crucial for nurses to recognize and prioritize interventions based on the level of risk to the patient. Assessment of suicidal ideation is a fundamental aspect of caring for individuals with mental health disorders, and immediate action is required to ensure patient safety. This case underscores the importance of thorough assessment and timely intervention in addressing mental health crises.