Psychiatric Medications Q 5
One morning a female client on the inpatient psychiatric service complains to nurse Hazel that she has been waiting for over an hour for someone to accompany her to activities. Nurse Hazel replies to the client “We’re doing the best we can. There are a lot of other people in the unit who need attention too.” This statement shows that the nurse’s use of:
A. Defensive behavior
B. Reality reinforcement
C. Limit-setting behavior
D. Impulse control
Correct Answer: A. Defensive behavior
The nurse’s response is not therapeutic because it does not recognize the client’s needs but tries to make the client feel guilty for being demanding. Another non-therapeutic communication technique is defending or trying to protect a person, place, or idea from a verbal attack. An example of this may be a client saying something negative about a doctor and the nurse saying, ‘The doctor is only looking out for you.’ This basically tells the patient that their critique is unfounded and that the patient shouldn’t express their feelings or opinions. Defending only serves to reinforce the patient’s opinion and shut down further communication.
Option B: One of the many different ways in which people can learn is through a process known as operant conditioning (also known as instrumental conditioning). This involves learning through reinforcement or punishment. The type of reinforcement used can play an important role in how quickly a behavior is learned and the overall strength of the resulting response.
Option C: Limit setting allows the boundaries of the therapeutic relationship to be established and provides the consumer with a clear understanding of what is and isn’t acceptable behavior and what the consequences of their actions will be. It also allows for consistency across staff interactions with the consumer aiding in reducing agitation and confusion. Clear, effective limit setting is a part of the therapeutic relationship that all staff should develop with consumers in their care.
Option D: The ability to control impulses, or more specifically control the desire to act on them, is an important factor in personality and socialization. Deferred gratification, also known as impulse control is an example of this, concerning impulses primarily relating to things that a person wants or desires.