NCLEX-PN® ExaminationPsychosocial IntegrityMedium
A practical nurse is admitting a client who is experiencing homelessness and chronic mental illness. The client reports feeling unsafe and has difficulty trusting healthcare providers. Which action by the nurse would be most effective in establishing a therapeutic environment?
- AAssign the client to a private room for comfort and safety.
- BClearly explain unit rules and expectations upon admission.
- CConsistently provide care and maintain clear, honest communication.
- DOffer the client immediate access to group therapy sessions.
Show answer & explanationAnswer & explanation
Correct answer: C. Consistently provide care and maintain clear, honest communication.
For clients with a history of trauma, homelessness, and mental illness, establishing trust is paramount. Consistent care and clear, honest communication build predictability and reliability, which are foundational for a therapeutic relationship and a sense of safety in an unfamiliar environment.
Why the other options are wrong
- A. While a private room can offer comfort, it doesn't directly address the core issue of trust and safety, and some clients may feel isolated.
- B. Explaining rules is necessary, but doing so too early or without first establishing rapport can be perceived as authoritarian and further erode trust.
- D. Immediate group therapy may be overwhelming for a client struggling with trust and feeling unsafe; individual rapport building is usually a precursor.
Therapeutic Environment: Trust Building
Building trust within a therapeutic environment involves consistent care, clear communication, and demonstrating reliability, especially for clients with histories of trauma or distrust.
- Essential for clients to feel safe and engaged in care.
- Requires patience and genuine empathy.
- Consistency in actions and words is key.
Memory trick: Consistent Care, Honest Words, Safe Space.