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Chapter 4: Problem 171

Which statement describes an event that would occur during the working phase of the nurse-client relationship? 1\. The nurse summarizes the objectives achieved in the relationship. 2\. The nurse assesses the client's level of psychological functioning, and mutual identification of problems and goals occurs. 3\. Some regression and mourning occur, although the client demonstrates satisfaction and competence. 4\. The client seeks connections among actions, thoughts, and feelings and engages in problem solving and testing of alternative behaviors.

Short Answer

Expert verified
Statement 4 describes the working phase, focusing on problem-solving and behavior testing.

Step by step solution

01

Understand the Phases of the Nurse-Client Relationship

The nurse-client relationship traditionally consists of three phases: the orientation phase, the working phase, and the termination phase. Each phase involves specific actions and goals. Knowing the characteristics of each phase is key to solving the problem.
02

Recognize Key Characteristics of Each Phase

In the orientation phase, initial assessments and mutual goal setting occur. During the working phase, active problem-solving and implementation of strategies are prominent. The termination phase includes summarizing achievements and addressing any feelings about the termination of the relationship.
03

Analyze Each Statement in the Context of the Working Phase

1. The nurse summarizes objectives - this is typically done in the termination phase. 2. The nurse assesses psychological functioning - assessments are more common in the orientation phase. 3. Regression and mourning - these are often associated with the termination phase. 4. The client seeks connections - this is characteristic of the working phase where problem-solving and behavior testing occur.
04

Identify the Statement That Matches the Working Phase

Based on the characteristics of the working phase, statement 4 describes activities typical of this phase, involving active engagement in problem solving and behavior testing by the client.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Working Phase
During the working phase of the nurse-client relationship, the focus shifts from initial assessments to active engagement. This period is crucial as it involves the implementation of strategies decided upon during the orientation phase.
Here is where the real change occurs in a client's behavior and mindset.
The nurse and client collaborate closely, working on previously set goals.
  • Clients test new behaviors and engage actively in problem-solving.
  • Nurses provide support and guide clients through challenges.
This dynamic interaction allows for the identification of connections between thoughts, feelings, and actions, which is essential for progress.
Open communication and trust are the backbones of this phase, allowing for honest discussion and effective problem-solving.
Orientation Phase
The orientation phase is the starting line of the nurse-client relationship. Both parties get to know each other and set the tone for future interactions.
Crucially, initial assessments are made during this phase, helping the nurse understand the client's psychological and physical needs.
  • Establishing trust and rapport is a primary goal.
  • Mutual goals are set collaboratively.
  • Clear communication is essential to outline expectations.
This phase lays a solid foundation for succeeding phases, as it equips both the nurse and the client with a roadmap for the rest of their journey together.
Termination Phase
As the journey in the nurse-client relationship progresses, it inevitably reaches the termination phase. This phase can be emotional for both parties as they bid farewell to the established relationship.
The nurse summarizes objectives achieved and reflects on the progress made, allowing clients to appreciate their growth.
  • Clients might experience feelings of loss or regression, which need to be addressed by the nurse.
  • Reviewing accomplishments helps reinforce new behaviors.
  • Nurses provide support to deal with feelings associated with the end of this professional relationship.
The termination phase is about closure and preparing clients to continue their progress independently.
Nursing Assessments
Nursing assessments are a crucial component of the orientation phase. They provide vital information about the client's physical and psychological state, informing the care plan.
Conducting thorough assessments ensures that client needs are accurately identified and addressed.
  • These assessments help in formulating a personalized care plan.
  • They involve gathering data from various sources including observations and client interviews.
  • Regular reassessments might be needed to update care plans as the client progresses.
Effective nursing assessments lay the foundation for successful interventions and are revisited as needed throughout other phases.
Problem-Solving in Nursing
Problem-solving in nursing is integral to the working phase. This process involves identifying issues, exploring options, and implementing solutions collaboratively with the client.
  • Nurses enable clients to connect actions with consequences, empowering decision-making.
  • Nurses facilitate the exploration of different strategies to tackle identified problems.
  • This process builds client confidence and self-efficacy.
Problem-solving is not just about resolving immediate issues, but also about equipping clients with skills for future self-management. Thus, it plays a critical role in both client autonomy and long-term well-being.

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Most popular questions from this chapter

A client is taking hydrocodone (Vicodin) for chronic back pain. The client has required an increase in the dose and asks whether this means he is addicted to Vicodin. The nurse would base the reply on the knowledge that: 1\. the client's body has developed efficient enzyme systems to metabolize the medicine, requiring more drug to produce the same effect. 2\. the client is preoccupied with getting the drug and has loss of control, indicating drug dependence. 3\. addiction is the term used to describe the physical dependence with withdrawal symptoms and tolerance. 4\. the client has a dual diagnosis of substance abuse and chronic back pain.

Antidepressants are considered the treatment of choice for major depression; however, they should be used with caution in clients with: 1\. respiratory disease. 2\. cardiac disease. 3\. renal disease. 4\. liver disease.

A client reports being hit in the stomach by her boyfriend, John Smith. The nurse would document this as: 1\. "Client reports being hit by boyfriend." 2\. "Client reports being hit in abdomen by boyfriend, John Smith. No bruising observed." 3\. "Client tearful, clutching abdomen. Says it is boyfriend's fault." 4\. "Client hysterical. Says boyfriend hit her two hours ago. There is no bruising, and it should be present."

A client has received counseling for a crisis situation following the death of a family member. Which statement indicates that no further teaching is required? 1\. "I know that I will never feel out of control again." 2\. "I have learned how to identify stress and how to deal with the feelings." 3\. "I will take my Valium whenever I begin to feel stressed." 4\. "I am embarrassed that I lost control. It will never happen again."

A client is being seen at a crisis center three months after a sexual assault. The client reports that "It feels like it happened yesterday." The nurse's best response would be: 1\. "It happened three months ago. Don't be irrational." 2\. 'What causes you to feel like it just happened?' 3\. "What are you doing to prevent being assaulted again?"' 4\. "What type of stress reduction activities are you practicing?"
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