RUHS, Jaipur, PB B.Sc Nursing Entrance-2019
Fundamental of Nursing
Easy
During which phase of therapeutic communication, should the nurse expect that the patient may test the competency and commitment of a nurse?
Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2019
Explanation
- The orientation phase is the initial period where the nurse and patient meet, and the primary goal is to build trust and establish rapport.
- During this phase, it is a common and expected behavior for patients to 'test' the nurse's sincerity, competence, and commitment to see if the nurse is a reliable and trustworthy figure.
- This testing can manifest as questioning the nurse's knowledge, challenging boundaries, being late for appointments, or being superficial to gauge the nurse's reaction and consistency.
- The nurse's role is to pass these tests by being consistent, reliable, and maintaining professional boundaries, which solidifies the foundation of the therapeutic relationship.
Why Other Options Were Wrong
- Option A: This phase occurs before the nurse ever meets the patient. It involves preparation, such as reviewing the patient's chart and self-assessment by the nurse. Since there is no patient interaction, the patient cannot test the nurse.
- Option C: In the working phase, trust has already been established. The focus shifts to active problem-solving, promoting patient insight, and facilitating behavioral change. Testing the relationship's foundation is characteristic of the earlier orientation phase.
- Option D: This is the final phase, focused on concluding the relationship, evaluating outcomes, and managing feelings about separation. The therapeutic work is ending, not beginning, so testing for commitment is not a characteristic feature.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Phases of the therapeutic nurse-patient relationship to guide bedside assessment, documentation, and the next nursing action.
- Recognizing testing behavior as a normal part of the orientation phase allows the nurse to respond therapeutically (with consistency and empathy) rather than defensively, which is crucial for building a strong therapeutic alliance.
- A nurse's ability to 'pass' these tests by being reliable, consistent, and maintaining professional boundaries directly impacts the success of the entire therapeutic relationship and subsequent patient outcomes.
- What if? If a patient continues significant testing behavior well into the working phase, it may indicate unresolved trust issues or a deeper underlying problem. This would require the nurse to reassess the care plan and perhaps revisit the tasks of the orientation phase, such as re-establishing boundaries and rapport.
How to Approach the Question
- First, identify the core of the question: it asks about a specific patient behavior ('testing the nurse') and wants to know in which phase of the therapeutic relationship this occurs.
- Recall the four phases of the therapeutic relationship, often based on Peplau's model: Pre-interaction, Orientation, Working, and Termination.
- Mentally associate the primary task with each phase. Pre-interaction is for preparation. Orientation is for building trust. Working is for problem-solving. Termination is for ending the relationship.
- Logically connect the 'testing' behavior to the phase where trust is being established. A patient tests a nurse to see if they are worthy of trust. This fits perfectly with the Orientation phase.
- Eliminate the other options based on their primary tasks. Testing is not possible before meeting (Pre-interaction), is less common after trust is built (Working), and is irrelevant when the relationship is ending (Termination).
Concept Tested & Keywords
- Concept Tested: Phases of the therapeutic nurse-patient relationship
- Stem keywords: therapeutic communication, phase, test the competency, commitment of a nurse
- Lead-in keywords: During which phase
- Negative lead-in flag: false
Question ID
QIZSB0Xyze711bzZ7gMrsC
Reference Book
E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 115-117
E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 110-112
E6 Nursing Fundamentals Taylor p. 87-89
Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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