The nurse helps a client practice various techniques of assertive communication by giving positive feedback for improvement of passive-aggressive interactions. This intervention would occur in which phase of the nurse-client relationship?

Correct Answer: C

Rationale: In the working phase of the nurse-client relationship, the focus is on implementing interventions to address the client's issues. In this scenario, the nurse is actively helping the client practice assertive communication techniques and providing positive feedback for improvement. This phase involves collaboration and active problem-solving to achieve therapeutic goals. A: Pre-interaction phase is about gathering information before meeting the client. B: Orientation phase is about establishing rapport and setting goals. D: Termination phase is about summarizing progress and preparing for closure. Therefore, the correct answer is C because it aligns with the active intervention and problem-solving nature of the working phase.

Correct Answer: B

Rationale: The correct initial nursing action for a client wanting to leave against medical advice from an inpatient locked psychiatric unit is to check the client's admission status and discuss the reasons for wanting to leave (Choice B). This approach allows the nurse to assess the client's mental status, risk factors, and reasons for wanting to leave, which are essential for providing appropriate care and interventions. By understanding the client's perspective and concerns, the nurse can work collaboratively with the client to address underlying issues and potentially prevent harm. Choices A, C, and D are incorrect because they do not prioritize understanding the client's reasons for wanting to leave or assessing the client's mental status and risk factors. Choice A dismisses the client's request without exploring the underlying issues. Choice C focuses on punitive measures rather than therapeutic communication. Choice D, placing the client on one-on-one observation, does not address the client's concerns or reasons for wanting to leave.

Correct Answer: A

Rationale: The correct answer is A because brief psychodynamic therapy is typically suitable for individuals with specific, time-limited issues like the aftermath of an extramarital affair. This type of therapy focuses on exploring unconscious conflicts and patterns related to the specific problem. Choices B, C, and D present more complex and severe issues that would likely require longer-term or more intensive therapies such as cognitive-behavioral therapy, dialectical behavior therapy, or medical interventions. It is important to match the therapy approach to the individual's needs and presenting concerns.

Correct Answer: C

Rationale: The correct answer is C: Refer the request for information to the patient's case manager. The case manager is responsible for coordinating the patient's care, including length of stay discussions with the health insurer. This ensures that the information is handled appropriately and in accordance with privacy regulations. Incorrect answers: A: Obtaining information from the medical record and relaying it to the caller may violate patient confidentiality and privacy laws. B: While patient information is confidential, it is important to address the health insurer's request through the appropriate channels. D: Referring the request to the health care provider may not be necessary as the case manager is typically the appropriate point of contact for length of stay discussions with the health insurer.

Correct Answer: C

Rationale: The correct answer is C because accepting gifts from patients can create a conflict of interest and compromise the nurse's professional boundaries. By politely declining the gift in response to the patient's gratitude, the nurse maintains professionalism and reinforces the therapeutic relationship. This response acknowledges the patient's gratitude while emphasizing the nurse's commitment to ethical practice. Choices A and B are incorrect because they either violate facility policies or fail to address the issue of accepting gifts. Choice D is incorrect as it does not address the ethical dilemma of accepting gifts from patients.