Psychiatric Nursing Pt. 6

2.

The nurse’s therapeutic response is:

“I will refer you to a clergy who can help you understand what is happening to you.”
“ It isn’t fair that an innocent like you will suffer from AIDS.”
“That is a negative attitude.”
”It must really be frustrating for you. How can I best help you?”

Correct Answer

A. ”It must really be frustrating for you. How can I best help you?”

Explanation

”It must really be frustrating for you. How can I best help you?”
This response reflects the pain due to loss. A helping relationship can be forged by showing empathy and concern. A. This is not therapeutic since it passes the buck or responsibility to the clergy. B. This response is not therapeutic because it gives the client the impression that she is right which prevents the client from reconsidering her thoughts. C. This statement passes judgment on the client.

Rate this question:

3.

One morning the nurse sees the client in a depressed mood. The nurse asks her “What are you thinking about?” This communication technique is:

Focusing
Validating
Reflecting
Giving broad opening

Correct Answer

A. Giving broad opening

Explanation

giving broad opening
Broad opening technique allows the client to take the initiative in introducing the topic. A,B and C are all therapeutic techniques but these are not exemplified by the nurse’s statement.

Rate this question:

4.

The client says to the nurse ” Pray for me” and entrusts her wedding ring to the nurse. The nurse knows that this may signal which of the following:

Anxiety
Suicidal ideation
Major depression
Hopelessness

Correct Answer

A. Suicidal ideation

Explanation

suicidal ideation
The client’s statement is a verbal cue of suicidal ideation not anxiety. While suicide is common among clients with major depression, this occurs when their depression starts to lift. Hopelessness indicates no alternatives available and may lead to suicide, the statement and non verbal cue of the client indicate suicide.

Rate this question:

5.

Which of the following interventions should be prioritized in the care of the suicidal client?

Remove all potentially harmful items from the client’s room.
Allow the client to express feelings of hopelessness.
Note the client’s capabilities to increase self esteem.
Set a “no suicide” contract with the client.

Correct Answer

A. Remove all potentially harmful items from the client’s room.

Explanation

Remove all potentially harmful items from the client’s room.
Accessibility of the means of suicide increases the lethality. Allowing patient to express feelings and setting a no suicide contract are interventions for suicidal client but blocking the means of suicide is priority. Increasing self esteem is an intervention for depressed clients bur not specifically for suicide.

Rate this question:

6.

Situation: A 14 year old male was admitted to a medical ward due to bronchial asthma after learning that his mother was leaving soon for U.K. to work as nurse. The client has which of the following developmental focus:

Establishing relationship with the opposite sex and career planning.
Parental and societal responsibilities.
Establishing ones sense of competence in school.
Developing initial commitments and collaboration in work

Correct Answer

A. Establishing relationship with the opposite sex and career planning.

Explanation

Establishing relationship with the opposite sex and career planning.
The client belongs to the adolescent stage. The adolescent establishes his sense of identity by making decisions regarding familial, occupational and social roles. The adolescent emancipates himself from the family and decides what career to pursue, what set of friends to have and what value system to uphold. B. This refers to the middle adulthood stage concerned with transmitting his values to the next generation to ensure his immortality through the perpetuation of his culture. C. This reflects school age which is concerned with the pursuit of knowledge and skills to deal with the environment both in the present and in the future. D. The stage of young adulthood is concerned with development of intimate relationship with the opposite sex, establishment of a safe and congenial family environment and building of one’s lifework.

Rate this question:

7.

The personality type of Ryan is:

Conforming
Dependent
Perfectionist
Masochistic

Correct Answer

A. Dependent

Explanation

dependent
A client with dependent personality is predisposed to develop asthma. A. The conforming non-assertive client is predisposed to develop hypertension because of the tendency to repress rage. C. The perfectionist and compulsive tend to develop migraine. D. The masochistic, self sacrificing type are prone to develop rheumatoid arthritis.

Rate this question:

8.

The nurse ensures a therapeutic environment for the client. Which of the following best describes a therapeutic milieu?

A therapy that rewards adaptive behavior
A cognitive approach to change behavior
A living, learning or working environment
A permissive and congenial environment

Correct Answer

A. A living, learning or working environment

Explanation

A living, learning or working environment.
A therapeutic milieu refers to a broad conceptual approach in which all aspects of the environment are channeled to provide a therapeutic environment for the client. The six environmental elements include structure, safety, norms, limit setting, balance and unit modification. A. Behavioral approach in psychiatric care is based on the premise that behavior can be learned or unlearned through the use of reward and punishment. B. Cognitive approach to change behavior is done by correcting distorted perceptions and irrational beliefs to correct maladaptive behaviors. D. This is not congruent with therapeutic milieu.

Rate this question:

9.

Included as priority of care for the client will be:

Encourage verbalization of concerns instead of demonstrating them through the body
Divert attention to ward activities
Place in semi-fowlers position and render O2 inhalation as ordered
Help her recognize that her physical condition has an emotional component

Correct Answer

A. Place in semi-fowlers position and render O2 inhalation as ordered

Explanation

Place in semi-fowlers position and render O2 inhalation as ordered
Since psychopysiologic disorder has organic basis, priority intervention is directed towards disease-specific management. Failure to address the medical condition of the client may be a life threat. A and B. The client has physical symptom that is adversely affected by psychological factors. Verbalization of feelings in a non threatening environment and involvement in relaxing activities are adaptive way of dealing with stressors. However, these are not the priority. D. Helping the client connect the physical symptoms with the emotional problems can be done when the client is ready.

Rate this question:

10.

The client is concerned about his coming discharge, manifested by being unusually sad. Which is the most therapeutic approach by the nurse?

“You are much better than when you were admitted so there’s no reason to worry.”
“What would you like to do now that you’re about to go home?”
“You seem to have concerns about going home.”
“Aren’t you glad that you’re going home soon?”

Correct Answer

A. “You seem to have concerns about going home.”

Explanation

“You seem to have concerns about going home.”
. This statement reflects how the client feels. Showing empathy can encourage the client to talk which is important as an alternative more adaptive way of coping with stressors.. A. Giving false reassurance is not therapeutic. B. While this technique explores plans after discharge, it does not focus on expression of feelings. D. This close ended question does not encourage verbalization of feelings.

Rate this question:

Psychiatric Nursing Pt. 6

Situation: A widow age 28, whose husband died one year ago due to AIDS, has just been told that she has AIDS. Pamela says to the nurse, “Why me? How could God do this to me?” This reaction is one of:

Quiz Preview

The nurse’s therapeutic response is:

One morning the nurse sees the client in a depressed mood. The nurse asks her “What are you thinking about?” This communication technique is:

The client says to the nurse ” Pray for me” and entrusts her wedding ring to the nurse. The nurse knows that this may signal which of the following:

Which of the following interventions should be prioritized in the care of the suicidal client?

Situation: A 14 year old male was admitted to a medical ward due to bronchial asthma after learning that his mother was leaving soon for U.K. to work as nurse. The client has which of the following developmental focus:

The personality type of Ryan is:

The nurse ensures a therapeutic environment for the client. Which of the following best describes a therapeutic milieu?

Included as priority of care for the client will be:

The client is concerned about his coming discharge, manifested by being unusually sad. Which is the most therapeutic approach by the nurse?