# Situation: A public health nurse trained in the World Health Organization Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) makes a home visit to a 9-year-old boy. His mother says he still cannot dress himself or read simple words, and he has always reached milestones later than his siblings. His growth and nutrition are normal, and he attends a mainstream public school. The nurse plans weekly home visits with his mother for the next 2 months. At the third visit, the mother asks the nurse to fill in her son's school support form for her. She reads and writes well and has most of the information the form asks for. The nurse sits with her while she completes it herself. What principle guides this choice?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630003  
> language: ko  
> subject: Nursing Practice V — Care of Clients with Maladaptive Patterns of Behavior; Care of Clients with Life-Threatening Conditions, Acute Multi-Organ Problems, High Acuity and Emergency Situations

## 문제

Situation: A public health nurse trained in the World Health Organization Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) makes a home visit to a 9-year-old boy. His mother says he still cannot dress himself or read simple words, and he has always reached milestones later than his siblings. His growth and nutrition are normal, and he attends a mainstream public school. The nurse plans weekly home visits with his mother for the next 2 months.

At the third visit, the mother asks the nurse to fill in her son's school support form for her. She reads and writes well and has most of the information the form asks for. The nurse sits with her while she completes it herself. What principle guides this choice?

## 보기

1. Doing what she can do alone would build reliance on the nurse **✔ 정답**
2. Forms completed by parents are more accurate than a nurse's
3. Filling in the form would make the nurse liable for what it says
4. Helping with paperwork is outside a public health nurse's role

**정답: 1**

## 해설

In a helping relationship the nurse promotes independence by encouraging the client to make decisions and by not doing things the client can do. Doing tasks the client is able to do fosters dependency, which keeps the client from building her own skills and makes ending the relationship harder.

## 심화 해설

Core Principle: Promoting Client Independence

The nurse’s decision to sit with the mother while she completes the form herself reflects a foundational concept in the therapeutic nurse–client relationship. In a helping relationship, the nurse deliberately avoids performing tasks that the client is capable of doing independently. When a nurse steps in to complete a task the client can manage, it may feel helpful in the moment, but it actually encourages reliance on the nurse rather than strengthening the client’s own abilities. This is especially relevant in community and home-visit settings, where the nurse’s presence is time-limited and the goal is to build sustainable family capacity.

Doing for a client what the client can do alone fosters dependency, reduces confidence, and makes termination of the nursing relationship more difficult. The mother reads and writes well and already possesses most of the required information. By guiding her to complete the form herself, the nurse reinforces her competence and supports her role as the primary advocate for her child.

Watch out! The question is not about accuracy, liability, or scope of practice. Even if a parent-completed form could be accurate, and even if paperwork is not the nurse’s primary role, the guiding principle here is the promotion of independence. The nurse is not refusing to help; the nurse is helping in a way that builds the mother’s skill.

This aligns with the broader nursing process perspective. In the planning and implementation phases, interventions should be selected not only to solve an immediate problem but also to enhance the client’s capacity for self-care. A nurse who consistently performs tasks the client can do undermines the client’s active participation and long-term coping.

Therapeutic use of self means offering support while keeping responsibility with the client whenever possible. In this scenario, the nurse’s physical presence and guidance are the intervention; the mother’s own completion of the form is the desired outcome.

Key point! For licensure exams, questions about “doing for” versus “doing with” almost always test the principle of fostering independence. The correct answer is the one that prevents dependency and supports client autonomy.

## 임상 시나리오

Promoting Independence in Home VisitsDoing with, not for, the client
In a therapeutic relationship, the nurse avoids performing tasks the client can do alone. Stepping in may feel helpful but fosters dependency and weakens the client's confidence.

The goal of home visits is to build sustainable family capacity, especially when the nurse's presence is time-limited. Guiding the mother to complete the form herself reinforces her role as the child's primary advocate.

CautionDoing tasks the client can manage makes ending the relationship harder and reduces the client's skill building. The nurse is not refusing to help; she is helping in a way that builds the mother's competence.

## 핵심 개념

- **Therapeutic Nurse-Client Relationship** — A professional, goal-directed relationship in which the nurse uses communication and actions to promote client health and independence.
- **Client Independence** — A core nursing goal where clients are encouraged to perform tasks and make decisions they are capable of, building their own skills and confidence.
- **Dependency** — A state where a client relies on the nurse for tasks they can do themselves, which can reduce confidence and hinder skill development.
- **mhGAP-IG** — World Health Organization Mental Health Gap Action Programme Intervention Guide, a tool for non-specialists to deliver mental health care.
- **Home Visit** — A community health nursing strategy where care is delivered in the client's home, focusing on family capacity and sustainable support.

## 같은 주제 문제

- [Situation: A 29-year-old man is admitted to the psychiatric unit of a general hospital aft…](https://mymerci.kr/pages/nclex_q.php?qn_id=629986)
- [Situation: A 29-year-old man is admitted to the psychiatric unit of a general hospital aft…](https://mymerci.kr/pages/nclex_q.php?qn_id=629987)
- [Situation: A 29-year-old man is admitted to the psychiatric unit of a general hospital aft…](https://mymerci.kr/pages/nclex_q.php?qn_id=629988)
- [Situation: A 29-year-old man is admitted to the psychiatric unit of a general hospital aft…](https://mymerci.kr/pages/nclex_q.php?qn_id=629989)
- [Situation: A 52-year-old man is seen at the outpatient mental health clinic of a provincia…](https://mymerci.kr/pages/nclex_q.php?qn_id=629990)
- [Situation: A 52-year-old man is seen at the outpatient mental health clinic of a provincia…](https://mymerci.kr/pages/nclex_q.php?qn_id=629991)
- [Situation: A 52-year-old man is seen at the outpatient mental health clinic of a provincia…](https://mymerci.kr/pages/nclex_q.php?qn_id=629992)
- [Situation: A 40-year-old woman is admitted to the psychiatric ward with major depressive d…](https://mymerci.kr/pages/nclex_q.php?qn_id=629993)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._