Psych Nursing Chapter 10

A client remarks, "You know, it's the same thing every time." Which is the most therapeutic response by the nurse? "I understand what you mean." "I'm sure everyone is doing their best." "I'm not sure what you mean. Please explain." "It's the same thing every time?"

"I'm not sure what you mean. Please explain."

During the next meeting during the working phase of the relationship the client brings the nurse homemade chocolate chip cookies and a box of chocolates. Which response should the nurse make to the client about these gifts? "Thank you so much. I will share them with the other nurses." "They look delicious and I love candy but I'm on a diet and really can't accept them." "How did you know that I'm a chocoholic? Will you have a cookie with me while we talk?" "Thank you but I will not accept these gifts because they extend over our discussed boundaries."

"Thank you but I will not accept these gifts because they extend over our discussed boundaries."

The nurse is working in the mental health clinic communicating with a client who is having auditory hallucinations. Which response by the nurse indicates effective communication with this client? "My aunt hears voices too; she has the same diagnosis." "Do you recognize any of the voices you hear?" "The voices seem real to you, but I don't hear them." "Don't worry about the voices. Medications will help."

"The voices seem real to you, but I don't hear them."

The client presents with signs and symptoms of anxiety. What conversation initiated by the nurse demonstrates an ineffective therapeutic use of self? "How did the pain start?" "What types of dresses do you like wearing?" "Do you take a vegetarian or nonvegetarian diet?" "Do you want me to inform your spouse about your illness?"

"What types of dresses do you like wearing?"

Which form of messaging contain figures of speech that are difficult to interpret and can be a barrier to communication? Abstract Cliché Proverb Overt cue

Abstract

A psychiatric-mental health nurse is assessing the boundaries of a client. Which area would the nurse address when assessing social boundaries? Select all that apply. Sharing of innermost feelings Customs Client's roles Norms of behavior Proximity to others

Customs Client's roles Norms of behavior Physical boundaries are those established in terms of physical closeness to others—who we allow to touch us or how close we want others to stand near us. Psychological boundaries are established in terms of emotional distance from others—how much of our innermost feelings and thoughts we want to share. Social boundaries, such as norms, customs, and roles, help us establish our closeness and place within the family, culture, and community.

Which action by the nurse or client represents the working phase of the therapeutic relationship? Testing the relationship Communicating interest in the client Identifying past ineffective behaviors Reviewing work that has been done

Identifying past ineffective behaviors

A client states, "Right before I got here I was doing all right. My job was going well, my spouse and I were happy, and we just moved into a new apartment." The nurse responds, "You said you and your spouse were happy. Tell me more about that." Which therapeutic communication is the nurse using with the client? Encouraging comparison General lead Restating Exploring

Exploring

The nurse fails to assess personal values surrounding a client's gender assignment before caring for a client who is transgender. Which issue is the nurse at most at risk for that may hinder development of the nurse-client relationship? Holding a prejudice toward this client Neglecting to include the client's desires in the plan of care Being manipulated by this client Expressing shock when assessing the client's history

Holding a prejudice toward this client

A psychiatric-mental health nurse is developing a therapeutic relationship with a client. The nurse demonstrates acceptance by which action? The nurse approves of the demonstration of any inappropriate behavior by the client. The nurse avoids judgments about the client, no matter what the behavior is. The nurse implements actions to punish the client for inappropriate behavior. The nurse communicates perception of the meanings and feelings of the client.

The nurse avoids judgments about the client, no matter what the behavior is.

Which situation would most likely indicate a violation of professional boundaries? Select all that apply. The nurse refuses a gift from a client and the client's family. The nurse strongly defends a client's behavior during a staff meeting. A nurse tells other staff that the nurse is the only one who understands the client. A nurse begins to spend increasing amounts of time with one client on the unit. A nurse reports information to the physician after the client asks that it be kept a secret.

The nurse strongly defends a client's behavior during a staff meeting. A nurse tells other staff that the nurse is the only one who understands the client. A nurse begins to spend increasing amounts of time with one client on the unit.

A male client is a successful insurance salesperson; however, because of market changes, his level of sales has dropped. His boss tells him he will consequently be receiving a $2,000 per year cut in his salary. When the client arrives home from work, the family dog runs to greet him as he always does, barking and jumping up and down and begging for attention. The client yells at the dog, "Get away from me; I can't take your barking right now." The client's response reflects a defense mechanism because it was: an intentional behavior performed to let the dog know his behavior was inappropriate. automatic, protecting the client from the anxiety related to his upcoming pay cut. implemented to keep the client from having to cope with his upcoming pay cut. implemented so the client could rationalize his upcoming pay cut.

automatic, protecting the client from the anxiety related to his upcoming pay cut.

A client with a mental health condition has issues with transportation and cannot always attend scheduled meetings with the nurse. For which condition would the nurse consider telehealth visits with this client? depression schizophrenia bipolar disorder obsessive-compulsive disorder

depression

A student nurse is preparing for a clinical placement in a psychiatric-mental health context. In order to best prepare to engage in therapeutic communication with clients, the student should: reflect critically on the student's own life experiences, perspectives, and characteristics. diligently study the pathophysiology, epidemiology, and nursing diagnoses related to mental illness. seek out a mentor who has extensive experience in the psychiatric-mental health area. decide what aspects of the student's life and experience the student is willing to disclose to clients.

reflect critically on the student's own life experiences, perspectives, and characteristics.