What principle about nurse-patient communication should guide a nurse's fear about 'saying the wrong thing' to a patient?

Correct Answer: A

Rationale: The correct answer is A because effective nurse-patient communication is guided by principles of empathy, respect, and genuine concern. Patients value feeling understood and supported, which can foster trust and rapport. This approach helps alleviate the nurse's fear of saying the wrong thing by emphasizing the importance of good intentions and empathy. Choice B is incorrect because it assumes the patient is solely focused on talking and not listening, which can undermine effective communication. Choice C is incorrect because a patient's history does not guarantee immunity to harm from insensitive comments. Choice D is incorrect as it incorrectly generalizes about individuals with mental illness and forgiveness tolerance.

Correct Answer: B

Rationale: The correct answer is B: Evaluation of the family's ability to effectively care for the older client. Rationale: 1. Evaluating the family's ability to care for the older client is crucial as it helps in assessing the overall support system available to the client. 2. Family members' involvement can provide insights into the client's daily care needs, potential challenges, and resources available for caregiving. 3. Understanding the family dynamics and capabilities helps the nurse in developing a comprehensive care plan that considers both the client's needs and the family's capacity to provide care. 4. This choice directly relates to the importance of involving family members in mental health assessment of older adults, highlighting the significance of assessing the caregiving abilities within the family unit. Summary: - A: While interviewing family members may provide information about social support resources, this is not the primary focus when evaluating the family's caregiving abilities. - C: Determining the extent of memory impairment is important but not the primary purpose of involving family

Correct Answer: C

Rationale: The correct answer is C because during the first interview with a patient with a psychiatric disorder, it is crucial for the nurse to address relationship parameters to establish a therapeutic alliance, discuss the contract to clarify roles and expectations, ensure confidentiality to build trust, and explain termination to manage expectations. These aspects lay the foundation for a successful therapeutic relationship. A: Trust, congruence, attitudes, and boundaries - While trust and boundaries are important, they are part of relationship parameters addressed in choice C. Congruence and attitudes are more about the nurse's behavior than issues to address with the patient initially. B: Goals, resistance, unconscious motivations, and diversion - These are important aspects, but they are more relevant in later stages of therapy after a strong therapeutic alliance has been established. D: Transference, countertransference, intimacy, and developing resources - These are advanced concepts that may be addressed later in therapy as trust and rapport are established.

Correct Answer: A

Rationale: The correct answer is A. Self-injurious behavior in individuals with borderline personality disorder is often a maladaptive coping mechanism used to relieve intense emotional distress or stress. This behavior is a way for the individual to externalize internal pain and gain a sense of control. It is important for the nurse to provide accurate information to the client's sister. Choice B is incorrect because self-injurious behavior in BPD is not typically used to calm or sedate individuals. Choice C is incorrect because self-injury is not usually a mechanism to avoid delusional thinking in BPD. Choice D is incorrect because while mood swings are common in BPD, self-mutilation is not typically used to slow them down.

Correct Answer: A

Rationale: Step 1: Acknowledge individuality - By reacting to each child as unique individuals with their own talents and interests, parents can promote a sense of identity and reduce competition. Step 2: Encouraging positive interactions - Fostering cooperation rather than simply demanding it can help improve sibling relationships. Step 3: Address underlying issues - By focusing on individual needs and interests, parents can address root causes of rivalry rather than just surface behaviors. Step 4: Promoting healthy relationships - Encouraging children to appreciate each other's strengths and differences can lead to a more harmonious sibling dynamic. Summary: Choice A is correct as it addresses the core issues of sibling rivalry by promoting individuality and positive interactions. Choices B, C, and D are incorrect as they do not address the underlying causes of rivalry, promote unhealthy dynamics, or offer effective solutions.

Correct Answer: B

Rationale: The correct answer is B: Staying close to a door. By staying close to a door, the nurse can have a quick exit strategy in case the situation escalates. This allows the nurse to maintain a safe distance from the potentially violent patient and increases the chances of a swift escape if needed. Using protective devices (A) can be helpful but may not always be accessible in a community clinic setting. Keeping the door closed for privacy (C) may limit escape routes and hinder quick exit. Wearing inexpensive jewelry to distract the patient (D) is not a safe or effective strategy in managing a potentially violent situation.

Correct Answer: C

Rationale: The correct answer is C because validation therapy involves acknowledging and validating the person's feelings and reality. By reiterating the patient's desire to go home and prepare dinner for her husband, the nurse validates the patient's emotions and reality, which can help reduce distress and agitation. Choice A is incorrect because it simply redirects the patient without acknowledging her feelings or reality. Choice B is incorrect because it focuses on the patient's widow status rather than validating her current feelings and beliefs. Choice D is incorrect because it introduces a potentially negative and untrue statement about the patient's husband, which could escalate the situation rather than providing validation.

Correct Answer: C

Rationale: The correct answer is C. As individuals age, changes in liver functioning can lead to slower metabolism and clearance of medications from the body. This can result in medication levels accumulating in the system, potentially leading to toxicity. This explanation is important for the patient to understand the risks associated with their medications. Choice A is incorrect because the speed of stomach emptying does not necessarily impact medication effects. Choice B is incorrect as the entire GI system speeding up is not a typical age-related change and does not necessarily affect medication digestion. Choice D is incorrect as age-related circulation changes do not necessarily mean medications are delivered more quickly to specific body sites.

Correct Answer: A

Rationale: The correct answer is A because effective nurse-patient communication is guided by principles of empathy, respect, and genuine concern. Patients value feeling understood and supported, which can foster trust and rapport. This approach helps alleviate the nurse's fear of saying the wrong thing by emphasizing the importance of good intentions and empathy. Choice B is incorrect because it assumes the patient is solely focused on talking and not listening, which can undermine effective communication. Choice C is incorrect because a patient's history does not guarantee immunity to harm from insensitive comments. Choice D is incorrect as it incorrectly generalizes about individuals with mental illness and forgiveness tolerance.