Which remark by a patient indicates passage from orientation to the working phase of a nurse–patient relationship?

Correct Answer: D

Rationale: The correct answer is D because it shows the patient's willingness to address their issues and actively seek solutions. This indicates a transition to the working phase where the patient is ready to engage in problem-solving and therapeutic work. Choice A indicates denial or reluctance to open up about problems. Choice B suggests difficulty in expressing emotions. Choice C reflects skepticism about the therapeutic process.

Correct Answer: D

Rationale: The correct answer is D because the continuum of care refers to a seamless and integrated system that spans from illness to wellness states. This means that care is provided across different levels, from prevention to acute care to rehabilitation. This approach ensures that patients receive comprehensive care tailored to their needs at every stage of their health journey. Choice A, care provided in episodic intervals, is incorrect because the continuum of care is continuous and not fragmented into separate episodes. Choice B, a system of care that focuses primarily on wellness, is incorrect as it does not capture the comprehensive nature of the continuum of care, which includes all stages of health and illness. Choice C, a single organization as responsible for care delivery, is incorrect because the continuum of care involves coordination and collaboration among multiple healthcare providers and settings to ensure holistic care.

Correct Answer: B

Rationale: The correct answer is B: Catharsis. Catharsis refers to the process of emotional release and purification through expressing feelings and emotions. In this scenario, the patient is engaging in bibliotherapy and expressing his feelings, indicating a release of pent-up emotions. This is a therapeutic process that allows the patient to process and cope with their emotions in a healthy way. Choice A: Insight is incorrect as it refers to gaining a deeper understanding or awareness, which is not explicitly mentioned in the scenario. Choice C: Anxiety reduction is incorrect as the scenario does not specify that the patient's goal is to reduce anxiety, but rather to express feelings associated with the reading material. Choice D: Problem solving is incorrect as the scenario does not involve the patient actively working through a specific problem, but rather expressing emotions related to the reading material.

Correct Answer: C

Rationale: The correct answer is C because genograms typically use horizontal lines to show marriages. This allows for a clear visual representation of the relationships between family members. Using circles to represent male members (choice A) would be inaccurate as circles usually represent females. Horizontal lines connecting parents with children (choice B) are used to show parent-child relationships, not marriages. Using asterisks to denote ages listed at the bottom (choice D) is not a common practice in constructing genograms. Therefore, choice C is the most appropriate and accurate way to represent marriages in a genogram.

Correct Answer: D

Rationale: The correct answer is D: Exhaustion. In the general adaptation syndrome model, developed by Hans Selye, the final stage is exhaustion. This stage occurs when the body can no longer cope with the stressors and resources are depleted. This leads to a breakdown in physical and emotional functioning. The other choices are incorrect because: A: Perception of a threat is the first stage (alarm reaction); B: Use of coping mechanisms occurs in the second stage (resistance); C: Physiologic response is a general term encompassing all stages, not specific to the final stage.