A nurse works with an adolescent who is moody and withdrawn because the teen's parents are divorcing. Establishing a therapeutic alliance is a priority because:
a. focusing on the strengths of an individual increases the individual's self-esteem.
b. the adolescent should express feelings and not keep them internalized.
c. acceptance and trust convey feelings of security to the adolescent.
d. therapeutic activities provide an outlet for tension.
C
Trust is frequently an issue because the child or adolescent may never have had a trusting relationship with an adult. In this patient's situation, the trust she once had in her parents has been shattered, robbing her of feelings of security. Only the key relates to the therapeutic alliance.
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Which action will the nurse take to reduce the risk of excoriation to the mucosal lining of the patient's nose from a nasogastric tube?
a. Instill Xylocaine into the nares once a shift. b. Tape tube securely with light pressure on nare. c. Lubricate the nares with water-soluble lubricant. d. Apply a small ice bag to the nose for 5 minutes every 4 hours.
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Indicate whether the statement is true or false
As a nurse escorts a patient being discharged after treatment for major depressive disorder, the patient gives the nurse a gold necklace with a heart pendant and says, “Thank you for helping mend my broken heart.” Which is the nurse’s best response?
a. "Accepting gifts violates the policies and procedures of the facility." b. "I'm glad you feel so much better now. Thank you for the beautiful necklace." c. "I'm glad I could help you, but I can't accept the gift. My reward is seeing you with a renewed sense of hope." d. "Helping people is what nursing is all about. It's rewarding to me when patients recognize how hard we work."