Psychiatric Medications Q 65
When establishing an initial nurse-client relationship, Nurse Hazel should explore with the client the:
A. Client’s perception of the presenting problem.
B. Occurrence of fantasies the client may experience.
C. Details of any ritualistic acts carried out by the client.
D. Client’s feelings when external; controls are instituted.
Correct Answer: A. Client’s perception of the presenting problem.
The nurse can be most therapeutic by starting where the client is, because it is the client’s concept of the problem that serves as the starting point of the relationship. The client’s goals for therapy might be very different from what you assume they are or think they should be. Talk to the client about what they hope to get from therapy. Then use these goals as guideposts. When the client clams up, explain to them how discussing a particular topic can help them achieve their goals.
Option B: It’s nearly impossible to go through life without judging people. Judgment, however, is therapy’s death knell. While all nurses strive to be nonjudgmental, clients can pick up on the slightest hint of judgment. Avoid giving advice that might feel like a condemnation or giving insight that is outside your scope of practice. For example, nurses should not generally give religious or medical advice. If you feel yourself judging the client, the client may feel it, too. So work to keep your own feelings in check.
Option C: Nurses are human beings with their own emotional baggage, just like their clients. It’s easy to feel rejected or judged by a client who does not talk. Remember therapy is for the client, and the only needs that matter are the client’s needs. Don’t make the client feel like they’re hurting you. Talking with another therapist or a supervisor can help you sort through your own emotions about a client who doesn’t want to open up.
Option D: Asking a single question or two may not be enough to get a client to open up. Sometimes you may need to ask more questions, different questions, or present the same question in a different way. Ideally, your questions should feel like an interview by an interested person, not an interrogation. Respond warmly and empathically, and follow the client’s lead. Stoic silence when the client laughs or a light-hearted approach to something the client takes seriously can make them clam up.