A nurse is planning care for a client who has chronic substance use disorder. Which of the following is the most therapeutic response to help the client cease alcohol consumption?
"Let me tell you how I struggled to stop drinking whiskey over the years, but finally succeeded."
"You have stopped drinking, haven't you?"
"The physician has ordered you to stop drinking all alcoholic beverages. Are you going to make us happy?"
"Let's work together on a plan that includes medication, group support, and counseling."
The Correct Answer is D
Rationale:
A. Sharing personal experiences can be supportive, but it may not be the most therapeutic or professional approach in this situation.
B. This question is leading and doesn't encourage an open dialogue. It may also induce guilt or defensiveness in the client.
C. This statement is authoritative and may come across as coercive, which can be counterproductive in encouraging the client to take responsibility for their recovery.
D. Collaborating with the client on a comprehensive plan that includes medication, group support, and counseling is a therapeutic approach that empowers the client to actively participate in their recovery, offering them the best chance of success.
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Correct Answer is A
Explanation
Rationale:
A. Stopping the transfusion is the priority action as it is essential to prevent further potential adverse effects and initiate an investigation of a possible transfusion reaction.
B. Assessing the skin for a rash is important but secondary to stopping the transfusion.
C. Notifying the provider is necessary, but the immediate priority is to stop the transfusion.
D. Covering the client with a blanket does not address the potential severity of a transfusion reaction.
Correct Answer is B
Explanation
Rationale:
A. Boundaries refer to maintaining professional limits in the nurse-client relationship, which is not directly related to the cause of hallucination exacerbation.
B. Relapse is the return of symptoms after a period of improvement, which is a common explanation for the recurrence of hallucinations in a client with schizophrenia.
C. The SE model (Social Ecological Model) is a framework for understanding the various levels of influence on health behaviors and is not a direct cause of hallucinations.
D. Stigma refers to the negative attitudes and beliefs about mental illness, which can affect a client’s self-perception but is not a direct cause of symptom exacerbation.