Final TUOS

A woman is trying to cope after the sudden death of her husband during emergency heart surgery. Which of the following statments by the wife would indicate the first stage of grieving?

"He's not dead, there is a mistake"

A nurse is interviewing a patient who is having difficulty with staying focused during the conversation. Which of the following would be the most therapeutic by the nurse to say?

"It seems you are having trouble staying focused"

A patient tells the nurse, "I don't think I'll ever get out of here." Select the nurse's most therapeutic response:

"It sounds like you don't feel like you are making progress."

A patient tells the nurse, "I'm told that I should reduce the stress in my life, but I have no idea where to start". Which of the following would be the best initial response by the nurse?

"Let's talk about what is going on in your life and then look at possible options"

For each statement in questions 46 - 50 by a nurse engaged in an interaction with a client, mark an "A" if the statement is therapeutic, and "B" if it is not therapeutic. "Can you tell me more about your difficult relationships at work?"

A

A client is seeing their primary physiciam for a chief of complaint of elevated fever and fatigue. Upon entering room, the nurse discovers the patient putting heated packs under their armpits and hiding a cup of hot coffee. The nurse recognizes this behavior as

Munchhausens syndrome

The nurse notices her clinically depressed client break eye contact Andrew perching to her chest while staring at the floor. The nurse has made in assessment of the clients:

Non verbal communication

Nursing practice is a science and art, the art portion includes all of the following except

Personal agenda

A student nurse working with a depressed client uses humor to lift the client's spirits. At one point, the student nurse notices the patient smiled. Select the best answer for the nurse's analysis of this:

The student nurse identified an approach that may prove useful in other similar situations

At what point in the nurse client relationship can the nurse anticipate that all identified client issues will be fully explored and resolved?

The termination phase

A nurse educating a nursing student talks about the characteristics of the receiver and sender of a message and tells the student that:

They are the same

One of the major differences between a social and therapeutic relationship is the:

Type of responsibility involved

A younger male client in a therapy group currently is relating to an older female memeber of the group as a mother figure. The younger male is re experiencing and trying to solve conflicts he has as a youth. This phenomenon is called

corrective recapitulation

A patient that was admitted to the psychiatric unit 2 days ago approaches you and says, "I heard strange noises last night while I was trying to sleep" Which of the following responses would be the most therapeutic?

"That must have been very frightening. Tell me more about it"

Which of the following are examples of things that can influence the psycholigical effects in a crisis? SATA

*Situational supports *Perception of the event *Normal anxiety *Coping skills *Severity of the stressor

A nurse is educating a nursing student about communication specifically, the message filters of personal internal factors from the sender. Some of these are: SELECT ALL THAT APPLY

+Personal agenda *Values *Personal bias

"I noticed your hands trembling when you talked about your accident"

A

Of of the 4 clients describing low, which has the highest potential for attaining "the outcome, the client will cope effectively with current stressors?

A client who sought help from siblings with whom he has closed, conflict free relationship

The communication style that would be most effective for a culturally knowledgeable nurse to adopt during an assessment interview with a 40 year old Native American would be?

A software voice breaking eye contact occasionally and expressing general topic leads and reflective techniques

A nurse tells her patient, " I'm here to listen" while fumbling around with IV tubing. This would be a prime example of

Incongruent message

Which of the following statements is NOT true regarding defense mechanisms?

All of the defense mechanisms come from the unconscious mind

A nurse is counceling a client about different ays to deal with a crisis should one occur. The client asks what constitutes a crisis and the nurse replies

An event thayt occurs that will temporarily disrupt the quillibrium of the coping mechanisms of an individual

A nurse is explaining the difference between anxiety and fear to a client in an inpatient psychiatric unit. The nurse explains that

Anxiety is an unexplainable feeling of dread and apprehension while fear is a response to something specific

A client informs his nurse that he follows a culture tradition that involves spirtual healing. Which of the following questions would be appropriate for the nurse to ask to gain understanding of the healing options for this practice?

Are any ceramonies or prayers used to treat this illness

A 26-month toddler is beginning the process of toilet training, this phase of personality development was defined by Erikson as being called which of the following?

Autonomy vs. shame and doubt

"There are people with problems worse than yours"

B

"Why do you think these events happened to you?"

B

A nurse who is having a discussion with a client notices that there are some incongruent messages they are observing. What is the most important action for the nurse to do in this case?

Clarify meaning

"Hi how are you?" is an example of:

Cliché' conversation

An unconscious, intrapsychic process that serves to provide relief from emotional conflict or anxiety." This the definition of:

Defense mechanism

A desirable outcome for the initial stage of nurse client relationship is that the client will demonstrate behaviors that indicate they have:

Developed repport and trust with the nurse

Termination of the therapeutic nurse client relationship with a client has been handled sucessfully when the nurse:

Discussess with the client changed that have been hapening during their time together and evluates outcome attainment.

A client newly diagnosed with stage 4 lung cancer yells to the nurse, "All these lights and noises on this floor are intolerable. Why can't you people just do your job and let me rest!". This is an example of:

Displacement

Which of the following group rules characteristically minimizes tenstion within the group?

Harmanizer

A mother of a 26 month old boy is explaining the negative behavior he is displaying. She says he shouts no when encouraging training. Which of the following would be the most informative reply from the nurse?

He is behaving normally for his age as he strives for independence.

A client is in a group therapy session discussing their life and says, "My father was always overcritical and belittling of me that I just grew up thinking I was inferior to everyone else". This is an example of:

Introjection

A client expresses to a nurse during a group therapy session that people call him stingy but that they personally believe "They exemplify the virtue of thriftiness and there is not enough of that in the world". This is an example of:

Rationalization

A nurse replies to a patient, "So what I hear you saying is that you have a hard time with being alone now that your husband has died?" This therapeutic communication technique is known as:

Restating

A nurse can best communicate to a patient and demonstrate active listening by:

Restating the feeling or thought the patient has expressed

During an interview, a client attempts to change the focus from self to the nurse by asking personal questions. Which of the following would be the best reply by the nurse?

Silence provides meaningful moments for reflection

Which of the following principles can the nurse use as a guide to determine the extent of silence to use during client interview sessions?

Silence provides meaningful moments for reflection

A nurse in a group setting begins to express the importance of them making a contract, because contacts:

Spell out the participation expectation and responsibilies of both parties

A client tells the nurse, "My doctor thinks my problems with stress are related to the negative way I think about things, and he wants me to learn new ways of thinking." Which nursing response would be in keeping with the doctor's recommendations?

Teaching the client to recognize, reconsider, and reframe irrational thoughts

Documentation in a client's nursing note reads as follows: During 5-minute interaction, client fidgeted, tapped foot, periodically covered face with hands, and looked under chair. Client stated, "I enjoy spending time in these sessions." Which assessment is most accurate?

The client's verbal and non-verbal messages were incongruent

The action by a psychiatric nurse that supports the clients right to be treated with dignity and respect is when the nurse

adresses the client by their title and surname (examplle Mr. Jones)

Nurse has a client with stage 4 lung cancer that is struggling with making decision about whether to keep on with the chemotherapy or just let nature take its coutse, the client is experiencing:

ambivalence

A charge nurse on a nursing unit states, "I have a solution for giving lunches to everyone even though we are short staffed. I will cover the patients of the nurse that is taking lunch and then I will go after they come back okay?" This communication style is an example of:

assertive communication

The sum of all conscious and unconscious attitudes a individual has toward their body is known as

body image

When a nurse belives they are the only one who can truly understand a client and other staff are too critical of the client, this would be identified as?

boundary blurring

A client states to his nurse, "I've been buying my children everything they want because I have difficulty with showing my emotions to them". The nurse would identify this defense mechanism as:

compensation

Which of the following body systems is "NOT" a direct part of general adaption symdrome

cardiovasvular system

A nurse using pepiau's interpersonal therapy. While working with an anxious, withdrawn client will plan interventions focusing on:

changing the clients thoughts about self

The nurse therapist is planning to beging a therapy group in which new clients will be added as the present clients are discharged, this quakifies the group as

close

A client who confides in the nurse that he is experiencing a lot of internal conflict in anxity after making the decision to accept a blood transfusion, decline is experiencing:

cognitive dissonance

The next to last meeting of an interpersonal therapy group is taking place, the groups leaders task is to

help members prepare for separation

During group therapy a client states, when I first started this group, Josie was not able to make a decision, but now she is able to, which shows a lot of progress I am beginning to think I can conquer my fears also "according to yalom, this statement reflects?

hope

During an impatient group session discussing after care, one of the clients mentions a local social club and mentions its referral process and location. This client, as a member of the group, has taken a role of

information giver

A nurse is reviewing all the essential components of the communication process for a presentation on effective patient communication. The nurse is aware that the "stimulus" portion of this process pertains to the

need for information

A nurse support the parental praise of a mother gives a child who is behaving well and being very helpful. The nurse did this because they know that in an adulthood when a child behaves in a similar way, they will experience:

positive self esteem

A client is working in cognitive behavioral therpay with a nurse therapist, and they are discussing the clients thoughts patterns and how they influence behavior. The nurse tells a client that he can change how he thinks ahout a particiular situation or happening. Another name for this is

reframing

When the nurse uses maslaws hierarchy of needs to plan the care for a client who is psychotic, which client problem listed below would recieve priority?

refusal to eat

An ecample of a breach of client's constitutional right to privacy occurs when the nurse:

releases information to the clients employer without consent

Nurse understands a clients mental image of self and their feelings come believes come and values that directly affect their behavior is known as:

self concept

According to the tackmans group theory, the period through which issues are addressed and conflicts can arise is called

storming

A client in a group talks about the ultimate person he can see M self being one day and that he is trying to achieve. This concept is known as

tbe ideal self

The nurse attempts to explain to the family of a mentally ill client how the nurse client relationship differs from their interpersonal relationshops by explaining:

that the focus is on the client. problems are dsicusses by the nurse and client, and solution are implemented by the client

provision of culturally competent nursing care will be fostered when the nurse plans and implements care on the belief that:

the ability to work within the clients cultural context requires ongoing effort

Which of the following is the most correct reason for therapeutic boundaries in the clinical setting

to keep the focus on the patient in their beeds

A client with diabetes on a 1200 calorie diet continues to eat food without regard to the limits and the consequences to their health. This client is exhibiting:

undoing

When observing nonverbal communication, the nurse knows that:

Nonverbal cues provide significant information but must be validated

A student nurse is getting ready to take their NCLEX examination. They start to feel their heart race, palms sweat and feel a bit jittery. This is an example of which type of anxiety?

Normal

The nurses goal with his schizophrenia client is to demonstrate genuineness in the framework of the nurse client relationship. To accomplish this the nurse will need to :

Be aware of the nurses own feelings and use of congruity communication strategies

A nurse wishes to demonstrate genuiness within the context of the nurse client relationsup with a client who has been diagnsed with schizophrenia. The nurse on need to:

Be self aware of their own feelings in use congruent cummination strategies

A nurse asks a client who is estranged from his wife if he has considered the possibility of them coming together for counseling. The client replies, "Hey, I am not the one who walked out the door and has refused to talk for 2 weeks, so I don't know if that would work". Which communication pattern is being displayed here?

Blaming

Which of the following clients would be at the greatest risk of negative effects of stress?

Client D. Who choses to concentrate on work, life, and ignore the stress producing situation

A nurse is taking care of a 39 year old male client who's occupation is a sanitary engineer. The nurse is aware that the relationship factor that exists for the therapeutic communication between them is a ______________ one

Complementary

Which of the following nursing interventions would not be a therapeutic use of self as a nurse?

Control opportunities for client success as this reinforces positive feelings

A client who is an inpatient rehabilitation unit for a loss limb has recently been prone to angry outbursts and violent behaviors. As a results, the nurse staff removed all potential harmful objects, including a letter opener that was his fathers. The component nurse understands that his past and current behaviors are likely influenced by his perceptions of which of the following.

Feelings of powerlessness

A client states, "My pain isn't as bad as it usually is right now". The nurse replies, "I am not sure what you mean when you say "bad as usual" in reference to your pain, can you describe to me what that feels like for you?" This is an example of which therapeutic communication technique?

Focusing

A nurse uses an open ended question while having a conversation with a client. The nurse understands that this type of therapeutic communication is used to:

Let the client take the lead and elaborate

Which of the following does not accur duirng the alarm phase of general adaption syndromes. In response to a stressor?

Mass production of T cells in the thymis gland

A client states to the nurse, "people should be allowed to commit suicide with others not interfering." The nurse replies, "You cant be more wrong, nothing is bad enough to justify death.". Which of the following adequately describes communication interchange.

Non therapeutic with different opinions

Which statement would lead the nurse to suspect that the developemental task of trust vs mistrust and was not successfully acheived by the client?

I am afraif to allow anyone to really get to know me

A nurse is taking care of a 5 year old girl that dresses in her mother's shoes and dress and meets the father at the door when he comes home per the mother's report. The mother asks if this is normal to which the nurse informs her it is a normal part of learning at her age called:

Identification

At what point in the nurse client relationship should the nurse plan to first address the issue of termination?

In the orientation phase

During which phase of the nurse client relationship are the identified client issues explored and addressed.

In the working phase

A nurse states, "How are you feeling right now?". The client responds, "Oh I am doing very well, not a worry". As the client is saying this, the nurse notices his foot is shaking, and he has a slight quiver in his voice. This would be an example of what kind of message?

Incongruent

A patient says, "I dreamed I was being beat up and when I awoke, I felt emotionally drained as if I hadn't slept at all." Which comment would be appropriate for the nurse seeking clarification?

It sounds as though you were uncomfortable with the content of your dream."

A nurse is taking care of a 10 year old client who is hospitalized for unknown abdominal pain. Upon further discussion with the client, the nurse learns that the client is being bullied at school, and on the walk home everyday. The nurse realizes the abdominal pain may be a defense mechanism known as:

Somatization

When a client asks about the effects of lomg term stressors, the nurse basing the reponse on current research should reply:

Studies indicated stress acting on hypothalamus pituitary adrenal and sympathetic adrenal medulla affects the immune system

During a therapeutic conversation, the client becomes silent. The nurse does not say anything and lets the client begin the discussion when they are ready to. This strategy was utilized because:

The nurse allows the client to collect their thoughts

After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference is that:

The nurse fine she is preoccupied with thoughts of how declined will response to his course of care.

A nurse is working on a unit where a client has just been admitted who is terminal for stage 4 cancer. The client is still cognitively aware and asks about her DNR CC being valid. Which of the following is not an acceptable means for fullfilling the physicians responsibility with a DNR CC

The physician called in and gave a verbal order for it to be valid

Hans Seyle developed a theory conering how humans react to stressors and or major, sudden changed, it is composed of 3 stages, the 1 is alarm, the 2nd is resistance and the 3rd is

echaution

Is sitting in on a group sessions notes that 1 of the clients is talking about building self esteem, the nurse then chimes in and begins to explain that self esteem:

is developed thriugh personal comparison between ideal sef and self concept

A culturally competent nurse is told by a Haitian client, there's nothing that can be done for my illness because I'm being punished with a curse. The nurse would consider the client's perception influenced by his culture and 1st consider that he...

may believe the distress is a direct result of omone casting a spell on him

Holistic nursing is defines as having a connection that is

mind body and spirit

A mother asks the nurse if this is normal to feel the need to think about the loss of her child and fulfill the impulse to eventually not feel as much grief like she currently is experiencing. The nurse explains to the mother that this is called:

mourning

During an interview with a female client, a nurse discovers that the client is currently being abused by her husband. The client further reveals that her husbands fathers has done the same to his mother all his life. The nurse rocognizes this as

multigenerational transmission

The key essential scale a nurse can learn to effectively help their clients, is to strive to understand their _______ of events, actions, ideas, etc.

perception