The nurse has been working with a depressed client for several ...

[codyclark]

The nurse has been working with a depressed client for several months. Which of the following signs would indicate that an ineffective working relationship has evolved between the client and the nurse?
 
  1. The client's sense of relaxation and confidence with the nurse
  2. The nurse's and client's sense of commitment to addressing the client's problems
  3. The nurse's sense of the client's severe dysfunction that cannot result in client growth
  4. The nurse's sense of making contact with the client

Question 2

During an admission assessment of an adolescent client, the nurse inquires about friends or peer groups. The adolescent smiles and jokingly tells the nurse that I consider myself a loner and I don't need any friends.
 
  The nurse's next action is to:
  1. Ask the client how he/she gets along in school.
  2. Ask the client to explain why he/she feels this way.
  3. Document this in the admission assessment.
  4. Encourage exploration of feelings.

[Kedrick2014]

Answer to Question 1

3
Rationale: A sense that the nurse cannot facilitate client growth due to severe client dysfunction indicates that a working relationship has not evolved effectively. The sense that the nurse has made contact with the client and is committed to addressing the client's problem is a sign of an effective working relationship. The sense that the client is relaxed and confident with the nurse's abilities also indicates an effective working relationship.

Answer to Question 2

4
Rationale: To avoid the possibility that this statement is a symptom characteristic of a further problem, the nurse utilizes therapeutic communication to explore the adolescent's perception of self, as adolescents' have a need for peer acceptance. Isolation could be symptomatic of an underlying problem. The findings should be documented and shared with the treatment team, but this is not the priority action at this time. Asking the client about getting along in school is not therapeutic and is an example of changing the subject. Asking the client to explain feelings is not therapeutic.

[codyclark]

Excellent

[aruss1303]

TYSM