In an in-patient psychiatric unit, the nurse helps the patient practice various techniques of assertive communication and gives positive feedback for attempting to improve passive-aggressive interactions. This interaction would occur in which phase of the nurse-patient relationship?

1. A

   Pre-interaction phase

2. B

   Working phase

3. C

   Termination phase

4. D

   Introductory phase

Appeared in: UP NHM CHO 7 Sept 2022(shift-1st)

Explanation

• The working phase is where the nurse and patient actively work on behavioral change.
• Practicing assertive communication and giving feedback are interventions typical of the working phase.
• This phase focuses on problem-solving, developing insight, and promoting coping mechanisms.
• The nurse supports the patient in applying new skills and evaluating progress.

Why Other Options Were Wrong

• Option A: The pre-interaction phase occurs before the nurse meets the patient. It involves reviewing records and self-reflection, not direct patient interaction or behavioral interventions.
• Option C: The termination phase is the final stage, focused on reviewing progress, evaluating goal attainment, and preparing for discharge. It does not involve practicing new behaviors or giving feedback on communication techniques.
• Option D: The introductory (orientation) phase is when the nurse and patient first meet, establish trust, clarify roles, and set goals. It does not involve active behavioral change or practicing new skills.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Phases of the nurse-patient relationship and their key activities to guide bedside assessment, documentation, and the next nursing action.
• Nurses must recognize which phase of the relationship they are in to use appropriate interventions.
• Practicing assertive communication in the working phase helps patients develop healthier coping and interpersonal skills.
• What if? If the nurse only established trust and set goals but did not practice new behaviors, the interaction would be in the orientation phase, not the working phase.

How to Approach the Question

• Identify the main action described (practicing assertive communication, giving feedback).
• Recall the four phases of the nurse-patient relationship and their key activities.
• Match the described activity to the correct phase (behavioral change = working phase).
• Eliminate options that focus on preparation, initial meeting, or ending the relationship.
• Use clinical reasoning to connect the intervention to the appropriate phase.

Concept Tested & Keywords

• Concept Tested: Phases of the nurse-patient relationship and their key activities
• Stem keywords: in-patient psychiatric unit, nurse helps patient practice assertive communication, positive feedback, passive-aggressive interactions
• Lead-in keywords: would occur in which phase
• Clinical cues: Behavioral change and skill practice indicate working phase

Question ID

QhRSO77K-vaetUdUmzb2Jn

Copy ID

Reference Book

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

E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 114-116