communication nursing

Which considerations should a nurse include when conducting a mental health assessment on a culturally diverse patient?( Select all that apply) A. Men and women are equally likely to seek psychiatric health care. B. The role that spirits and magic play in a patient's belief system is cultural based. C. Rituals are only deemed obsessive when applied to the patient's cultural standards. D. Agoraphobia is more difficult to assess in cultures that restrict female socialization. E. The nurse should consider the universal application of the Diagnostic and Statistical Manual DSM-IVTR

B. The role that spirits and magic play in a patient's belief system is cultural based. C. Rituals are only deemed obsessive when applied to the patient's cultural standards. D. Agoraphobia is more difficult to assess in cultures that restrict female socialization.

The nurse cares for an elderly patient in a long-term care center. Which would be inappropriate for the nurse to share with the client? A. Reminisce about birthday celebrations and inquire about the client's traditions. B. Use high levels of intimacy to help the client feel more comfortable with the nurse C. Establish a helping relationship based on trust by sharing a personal story with the client. D. Share with the client how meditation decreased nausea during chemotherapy treatment

B. Use high levels of intimacy to help the client feel more comfortable with the nurse

A nurse receptor is assigned to help several graduate nurses assess their ability to convey warmth to patients. Which activity, if selected by the nurse preceptor is best? a. Set up sessions for the graduate nurses to practice various nonverbal gestures. b. Ask the graduate nurses to record the behaviors of experienced nurses on the unit. c. Provide the graduate nurses with a list of nonverbal behaviors that convey warmth. d. Have the graduate nurses evaluate each other during simulated patient interviews.

d. Have the graduate nurses evaluate each other during simulated patient interviews.

As initiated at one children's hospital, Wacky Wednesday successfully decreased anxiety levels for children facing surgery, as well as their parents. As such, the nursing instructor encourages students to include an element of this into their nursing care plan. Wacky Wednesday is an example of a: a. Social experiment b. Empathic response c. Humorous addition d. Humor intervention

d. Humor intervention

The nurse care for the mother of a child who died in the ER as a result of a accidental poisoning. Which response by the nurse is appropriate? a. Place a greater emphasis on nonverbal aspects of empathy over verbal. b. Accurately reflect on the mother's feelings to convey understanding and concern. c. Repeat exact phrases stated by the mother to his in expressions of grief. d. Reflect on the expressed feelings of the mother but with the nurse's own words.

d. Reflect on the expressed feelings of the mother but with the nurse's own words.

Which facial feature, if displayed by the nurse, best convey warmth? a. Small pupils and a fixed gaze b. Furrowed brow and a wrinkled forehead c. Pursed lips and a forced smile d. Relaxed muscles and a concerned expression

d. Relaxed muscles and a concerned expression

The nurse has implemented a plan to improve expression of warmth to other nurses. It is most important for the nurse to include which evaluation method? a. Self-monitor interactions with the colleagues for feelings of relaxation and caring. b. Ask patients for their perception of the interactions that occur among nurses. c. Invite a supervisor to evaluate interactions and provide suggestions for improvement. d. Seek nominations for an award at the organization level or from an association.

a. Self-monitor interactions with the colleagues for feelings of relaxation and caring.

One study of Italian primary care physicians caring for diabetic patients showed that those scoring highest on the empathy test had patient with: a. Significantly fewer acute diabetic complications. b. Statistically fewer acute diabetic complications. c. Higher rates of chronic diabetic complications. d. Statistically higher poor outcomes for patients with diabetes.

a. Significantly fewer acute diabetic complications.

The nurse greets a patient who is admitted to the hospital. Which action by the nurse displays warmth and concern? a. Use a soft and relaxed tone of voice when speaking. b. Maintain a distance of 6 to 8 feet from the patient. c. Avoid attentive behaviors when interacting with the patient. d. Engage in a verbal exchange without physical contact.

a. Use a soft and relaxed tone of voice when speaking.

A young, married female patient is attracted to a male nurse. When the nurse sets clear boundaries, the patient falsely accuses him of sexual harassment. The nursing supervisor recognizes the defense mechanism of: A. Projection B. Splitting C. Suppression D. Displacement

A. Projection

Which individual is displaying thoughts or actions that are genuine? A. A nurse who advocates for clients in order to qualify for a raise in personal hourly pay. B. A nurse who takes action to increase awareness of the need for cultural sensitivity. C. A nurse who supports a change in a project in front of supervisors but complains to staff. D. A nurse who verbally supports a new policy but does not follow the policy in practice.

B. A nurse who takes action to increase awareness of the need for cultural sensitivity.

An experienced nurse is supervising a student nurse in an acute care setting. Which statement, if made by the experienced nurse, would be most appropriate to help the student nurse establish credibility with other nurses on the unit? A. "It is impossible to be credible when you are a student because you lack experience." B. "Try to hide your feelings of inadequacy and portray a sense of confidence." C. "Be honest with the nurses about your strengths and about areas that need improvement." D. "It would help if you bring special treats for the nurses so that they will like you."

C. "Be honest with the nurses about your strengths and about areas that need improvement."

A nurse manager has set a goal to improve professional communication on the unit. The staff nurses have attended a session on how to distinguish between expressing opinions and giving advice. Which statement, if made by a staff nurse, indicates that further teaching is needed? A. "Nurses who express opinions give patients the opportunity to make choices." B. "Patient safety is enhanced if nurses have confidence in their ability to communicate." C. "Giving advice leads to independent decision making by patients." D. "Expressing opinions or recommendations is an assertive behavior."

C. "Giving advice leads to independent decision making by patients."

A patient with OCD tells the nurse, "Thinking these thoughts and doing all my rituals is beyond being silly. I have few friends and I know others laugh behind my back. I sometimes think I can control things, but I always find I can't. I don't know if I can continue to live this way." Which assessment question shows the nurse has an understanding of this patient's priority risk? A. "Are you feeling hopeless?" B. "Do you think you are socially isolated?" C. "Have you been thinking about hurting yourself?" D. "Do the rituals affect how you feel about yourself?"

C. "Have you been thinking about hurting yourself?"

A patient asks the nurse to make a decision for her about whether or not to continue taking hormone replacement therapy (estrogen). Which response by the nurse is most appropriate? A. "You should check with a doctor; I cannot give you advice about drugs." B. "My friend has taken estrogen for more than 5 years without any problems." C. "I can answer any questions you have but it is up to you to make this decision." D. "Herbal supplements were much better for me than prescription-strength estrogen."

C. "I can answer any questions you have but it is up to you to make this decision."

A college-aged patient complains that, "when I begin to take a test, I freeze up and my mind goes blank." The nurse will react based on the understanding that this patient's anxiety level is: A. Mild B. Moderate C. Severe D. Panic

C. Severe

A patient who was savagely attacked by a bear has no memory of the event. Which statement best explains the patient's inability to remember the attack? A. The woman lost consciousness and was not cognitively aware of what happened during the attack B. The brain has produced a chemical anemia that will repress the memories of the attack indefinitely. C. The patient is unconsciously using a defense mechanism to protect against the repeated memory of the attack. D. It is a temporary suppression of the attack; her memory will return when she is physically and emotionally ready to handle the memories.

C. The patient is unconsciously using a defense mechanism to protect against the repeated memory of the attack.

The nurse is working with the family of a patient with obsessive-compulsive disorder (OCD). Which concept should the nurse incorporate in the teaching plan? A. The thoughts, images, and impulses are voluntary. B. The family should pay immediate attention to symptoms. C. The thoughts, images, and impulses tend to worsen with stress. D. OCD is a chronic disorder that does not respond to treatment.

C. The thoughts, images, and impulses tend to worsen with stress.

A nurse is caring for a client who is experiencing panic attack. Which of the following actions should the nurse take? A. Discuss new relaxation techniques B. Show the client how to change the behavior C. Distract the client with a television show. D. Stay with the client and remain quiet.

D. Stay with the client and remain quiet.

A nurse manager asks a colleague for a advice on strategies to improve communication with staff nurses. Which response by the nurse manager's colleague is best? a. "Be sensitive, show respect, and be genuine." b. "You need to be consistently nice to the staff nurses." c. "Work as a staff nurse every month to develop empathy." d. "Staff nurses need a leader who is not emotional."

a. "Be sensitive, show respect, and be genuine."

The nurse prepares to administer the first chemotherapy treatment to a patient. Which statement by the nurse encourages a positive attitude? a. "What brings joy to your life?" b. "Will you be upset if you lose your hair?" c. "What are your concerns about your treatment?" d. "How do you usually cope with stress?"

a. "What brings joy to your life?"

It would be most important for the nurse to temporarily withdraw expressions of warmth to which patient? a. 20-year-old patient who is angry and throwing objects. b. 32-year-old patient who is withdrawn and refuses nursing care. c. 48-year-old patient who is extremely anxious about surgery. d. 56-year-old patient who has a history of violent behavior

a. 20-year-old patient who is angry and throwing objects.

A non-Hispanic white nurse provides care to mostly Hispanic patients. It would be most important for the nurse to take which action? a. Discover cultural influences on healthcare perceptions and behaviors. b. Assist the patients to adapt to American culture and health beliefs. c. Avoid confrontation of underlying issues of discrimination. d. Improve communication by learning how to speak Spanish.

a. Discover cultural influences on healthcare perceptions and behaviors.

A nurse is caring for a client who has acute stress disorder and is experiencing severe anxiety. Which of the following statements should the nurse make? A "Tell me about how you are feeling right now" B. "You should focus on the positive things in your life to decrease your anxiety" C." Why do you believe you are experiencing this anxiety?" D. "Let's discuss the medications your provider is prescribing to decrease your anxiety".

A "Tell me about how you are feeling right now"

Which three nurse statements are examples of expressing opinions in an assertive way with colleagues? (Select all that apply.) A. "Do you think this project will help you learn about evidence-based practice?" B. "I will tell you about the evidence-based project, and you will want to help." C. "I recently attended an evidence-based conference. Can I share the highlights?" D. "I think we should be paid because this project will save money. What do you think?" E. "I really think you should read more evidence-based journal articles."

A. "Do you think this project will help you learn about evidence-based practice?" C. "I recently attended an evidence-based conference. Can I share the highlights?" D. "I think we should be paid because this project will save money. What do you think?"

Which question would assist the nurse in determining whether the patient has been experiencing anxiety? A. "Have you had difficulty concentrating lately?" B. "Have you been feeling sad and especially lonely?" C. "Do you have a history of failed personal relationships?" D. "Do you frequently experience difficulty controlling your anger?"

A. "Have you had difficulty concentrating lately?"

Which verbal intervention would the nurse use when helping a patient who is experiencing severe to panic-level anxiety? A. "I will stay with you to make sure you remain safe." B. "First, you must stop pacing and wringing your hands." C. "How can I help you get control of yourself and this anxiety?" D. "Can you tell me what was happening just before you got upset?"

A. "I will stay with you to make sure you remain safe."

The nurse is a member of a quality improvement project team to improve communication when a patient is transferred to another unit. Which statement by the nurse is appropriate to demonstrate positive regard for the team members? A. "We have done an excellent job." B. "We still have so much work to do." C. "Most of our suggestions did not work." D. "We won't win a prize for our work."

A. "We have done an excellent job."

During a nursing assessment, a teenage patient smiles and states, "I don't care what you say. I want to be just like Mike, the leader of our gang." The nurse understands the defense mechanism being used is: A. Denial B. Humor C. Splitting D. Identification

D. Identification

Which demonstrates the nurse's genuine concern for clients? A. Tell a patient who has a terminal illness that everything will be fine. B. Delay notifying the patient about the death of a dependent child. C. Provide a placebo to a patient in severe pain to assess for substance abuse. D. Inform the patient about a medication error along with symptoms to report.

D. Inform the patient about a medication error along with symptoms to report.

The nurse is working with a patient with an anxiety disorder whose treatment includes cognitive behavioral therapy. Which statement by the patient gives the nurse reason to assume that the patient has an understanding of the basis of this type of therapy? A. "My abusive childhood has resulted in my overreaction to stress." B. "My delusional thoughts of extreme anxiety are what cause my panic attacks." C. "My brain chemistry causes me to overreact to common stress by getting so anxious." D. "I've learned to react to my daily stress by having anxious thoughts and panic attacks."

D. "I've learned to react to my daily stress by having anxious thoughts and panic attacks."

According to the NCSBN, appropriate self-disclosure is a part of maintaining professional boundaries. Appropriate self-disclosure includes the following: A. Discussing intimate or personal values with patients B. Keeping secrets with a patient or for a patient C. Expressing you are the only one who truly understands patient D. Brief, focused, and only used if experience is similar

D. Brief, focused, and only used if experience is similar

According to Kimble and Bamford-Wade, what distinguishes the behavior of one caring and competent nurse form another nurse who is simply competent but not engaged with the patient? a. Immediacy, the availability of the nurse b. Warmth, the hallmark of compassion c. Attention, the focus of the nurse d. Communication, the instructional side of the nurse

b. Warmth, the hallmark of compassion

A nurse instructs colleagues about the use of humor with patients. Which statement, if made by a colleague, indicates that the teaching is effective? a. "Telling a joke is the best way to use humor." b. "Humor can help patients to be less afraid." c. "I should avoid humor when giving a bath." d. "Patients will not talk to me if I use humor."

b. "Humor can help patients to be less afraid."

A patient is irritable and complains to the nurse about difficulty sleeping last night. Which response by the nurse is most appropriate? a. "I know you will sleep better tonight." b. "Tell me more about what happened last night." c. "Did you drink too much caffeine yesterday?" d. "No one sleeps well in the hospitals."

b. "Tell me more about what happened last night."

The author said that laughter is an instant vacation, but as nurses, incorporating humor into our daily work can be a challenge. One of the reasons for this, according to Povine's research as presented by Dutton (2012), is that for adults, laughter does not come as easily as it did for them when they were young. How much more do babies laugh than adults? a. 50 times more b. 15 times more c. 10 times more d. 100 times more

b. 15 times more

In which situation(s) would it be appropriate for the nurse to communicate with empathy?(Select all that apply.) a. An acquaintance who seeks a long-standing social relationship that is superficial. b. A patient who is anxious about a change in body image after a mastectomy. c. A supervisor who is searching for approval and recognition from staff. d. A colleague who expected a promotion but was not awarded the promotion. e. A client who has been alienated from family because of sexual orientation.

b. A patient who is anxious about a change in body image after a mastectomy. d. A colleague who expected a promotion but was not awarded the promotion. e. A client who has been alienated from family because of sexual orientation.

A Patient report to the nurse, "My doctor is not doing anything about my pain." Which response is assertive and expresses warmth? a. "If I were you, I would see a different doctor." b. "What you really mean is you do not like your doctor." c. "It is wrong for you to blame your doctor." d. "You seem frustrated with your doctor."

d. "You seem frustrated with your doctor."

The nurse supervises the care of residents in an assisted living center. The nurse should intervene if which is observed? a. A nursing assistant remains silent when a resident tells a demeaning joke. b. A nursing assistant and resident laugh together while watching television. c. Two nursing assistants laugh at themselves after spilling a pitcher of water. d. A nursing assistant makes a joke about a confused resident to other residents.

d. A nursing assistant makes a joke about a confused resident to other residents

The patient was an awkward child who was ridiculed by his father for his inability to catch a ball. As an adult, the patient developed panic attacks at the time his company established after-work team sporting activities. Which data discussed during the nursing interview provides insight to the possible cause of this anxiety disorder when applying the behavioral model? A. He always avoids sports because "I'm short and not the least bit athletic." B. When in fifth grade, the patient caused his team to "lose the big softball game." C. The company he works for places tremendous emphasis of successful team work. D. As a child he wore a leg brace that prevented him from participating in school sports.

A. He always avoids sports because "I'm short and not the least bit athletic."

A patient is being evaluated for a possible diagnosis of panic disorder with agoraphobia. Which nursing assessment findings support this diagnosis? Select all that apply. A. Patient states, I've had these fears for more than 6 years. B. Patient describes having a panic attack several times a month. C. Patient is embarrassed by the limitations the disorder causes. D. Stated, I never even think about going shopping in a crowded mall. E. Condition began after beginning treatment for a chronic intestinal problem.

A. Patient states, I've had these fears for more than 6 years. B. Patient describes having a panic attack several times a month. C. Patient is embarrassed by the limitations the disorder causes. D. Stated, I never even think about going shopping in a crowded mall.

Which lifestyle changes should the nurse incorporate in the nursing care plan for a patient with generalized anxiety disorder? Select all that apply. A. Stop smoking. B. Limit caffeine intake. C. Eliminate stress from your life. D. Practice a relaxation technique daily. E. Limit worrying to specific times each day.

A. Stop smoking. B. Limit caffeine intake D. Practice a relaxation technique daily. E. Limit worrying to specific times each day.

A nursing interview for a patient being admitted for depression reveals that the patient has been taking a benzodiazepine for anxiety for 3 years. Which actions by the nurse reflect an understanding of the effects of this classification of drugs? Select all that apply. A. The nurse asks how much of the drug the patient takes daily. B. The admitting physician is notified of the patient's medication history. C. The nurse prepares to discuss the process of detoxification with the patient. D. The nurse suggests to the patient that the dosage is likely to be increased. E. The patient is interviewed regarding how well the anxiety has been controlled.

A. The nurse asks how much of the drug the patient takes daily. B. The admitting physician is notified of the patient's medication history. C. The nurse prepares to discuss the process of detoxification with the patient.

A nurse who frequently corrects other staff nurses is trying to avoid making comments when it really does not matter. In which three situation(s) would it be appropriate for the nurse to remain silent and not share an opinion? (Select all that apply.) A. A staff nurse reports a blood pressure as 110/60, but it is recorded in the chart as 114/62. B. A staff nurse takes a lunch break for 33 minutes instead of 30 minutes. C. A staff nurse gives a medication orally instead of by injection. D. A staff nurse reports no discrepancy for the narcotic count, but one is missing. E. A staff nurse does not pronounce the generic name of a medication correctly

A. A staff nurse reports a blood pressure as 110/60, but it is recorded in the chart as 114/62. B. A staff nurse takes a lunch break for 33 minutes instead of 30 minutes. E. A staff nurse does not pronounce the generic name of a medication correctly

As an experienced staff nurse, you have been asked to create a teaching guide for nursing orientation on respect. Accessing the list from Ehow about being genuine, you would include all of the following. (Select all that apply.) A. Acting natural around others B. Listening when others are speaking C. Denying your mistakes D. Compliment only when you sincerely mean it E. Lying to make friends F. Skipping invitations to event you wouldn't genuinely enjoy

A. Acting natural around others B. Listening when others are speaking D. Compliment only when you sincerely mean it F. Skipping invitations to event you wouldn't genuinely enjoy

The nurse has been working with a patient who experiences anxiety. Which intervention should the nurse implement initially when the patient is observed pacing and wring her hands? A. Asking how she has managed anxiety effectively in the past B. Distracting her by offering to help her make a telephone call C. Asking her what she believes is causing her increased anxiety D. Teaching her to take deep, relaxing breaths to manage the anxiety

A. Asking how she has managed anxiety effectively in the past

A patient comes to the ED exhibiting severe physical and emotional symptomology. When no physical cause can be found for the symptoms, the patient is diagnosed with severe anxiety with panic attack symptoms. Which assessment data supports this diagnosis? Select all that apply. A. Blood pressure 158/90; 15 minutes later 130/80 B. Claims that she feels like she going to die C. Random but controlled thoughts D. Unable to follow instructions E. Dry, flushed skin

A. Blood pressure 158/90; 15 minutes later 130/80 B. Claims that she feels like she going to die D. Unable to follow instructions

The nurse has identified a nursing diagnosis of disturbed thought processes for a patient with obsessive-compulsive disorder. What abilities displayed by the patient would be related to an appropriate outcome for this problem? Select all that apply. A. Can identify when obsessions are worsening B. Speaks of obsessions as being embarrassing behaviors C. Describes lessening anxiety when compulsive rituals are interrupted D. Plans to ignore obsessive thoughts and so minimizes resulting stress E. Limits time focusing on obsessive thoughts to 15 minutes, 4 times a day

A. Can identify when obsessions are worsening C. Describes lessening anxiety when compulsive rituals are interrupted E. Limits time focusing on obsessive thoughts to 15 minutes, 4 times a day

A nurse is assisting with the plan of care for a client who has body dysmorphic disorder. Which of the following actions should the nurse plan to take first? A. Determine the client's risk of self-harm. B. Instill hope for positive outcomes C. Encourage the client to participate in group therapy sessions. D. Encourage the client to participate in treatment decisions.

A. Determine the client's risk of self-harm.

A nurse is reprimanded by the nurse manager. Shortly thereafter, a patient's family member reports that the nurse curtly told them "You can't come in now. You know you need to wait until visiting hours." The incidence should be discussed based on the knowledge that the defense mechanism the nurse used was: A. Displacement B. Projection C. Sublimation D. Suppression

A. Displacement

A patient is admitted for treatment for persistent, severe anxiety. Which nursing diagnosis would help effectively direct patient care? A. Disturbed sensory perception related to narrowed perceptual field B. Risk for injury related to closed perception C. Hopelessness related to total loss of control D. Risk for other-directed violence related to combative behavior

A. Disturbed sensory perception related to narrowed perceptual field

A nurse is collecting data from a client who has generalized anxiety disorder. Which of the following findings should the nurse expect?( Select all that apply) A. Excessive worry for 6 months B. Impulsive decision-making C. Delayed reflexes D. Restlessness E. Need for reassurance

A. Excessive worry for 6 months D. Restlessness E. Need for reassurance

What is the basis for assessing a male patient who is agoraphobic for panic attacks? A. Men are more likely to experience panic attacks. B. An overwhelming number of agoraphobic patients also have panic attacks. C. Patients are often unaware that the symptoms they are experiencing are those of panic. D. Panic attacks are generally the cause of a patient developing phobias like agoraphobia.

B. An overwhelming number of agoraphobic patients also have panic attacks.

According to a study by Robinson (2014), three parts of our true presence (how we connect with patients) are found in being: A. Friendly, kind, and sweet B. Genuine, gifted, and creative C. Humorous, partial, and grateful D. Genuine, attentive, and immersed

B. Genuine, gifted, and creative

The nurse plans to use self-disclosure to aid a mother and father in the grieving process after the death of their child. The steps of a helpful self-disclosure appear below. What is the first step? A. Succinctly share a personal experience that is a similar grieving experience. B. Listen to the parents talk about their child and observe their movements and gestures. C. Reflect upon the parent's statements to communicate understanding. D. Seek verification that the self-disclosure was helpful to the child's parent

B. Listen to the parents talk about their child and observe their movements and gestures.

The nurse working with patients diagnosed with posttraumatic stress disorder (PTSD) is aware of the need to intervene early in order to de-escalate a patient's increasing anxiety level. Which patient behavior is likely an early indication of escalating anxiety? A. Talking rapidly B. Pacing around the unit C. Staring out the window D. Refusing to go to therapy

B. Pacing around the unit

The nurse notes that a patient being treated for an anxiety disorder is becoming more anxious sitting in a congested, noisy room waiting to see the therapist. Which intervention will the nurse implement initially to assist the patient in de-escalating his anxiety? A. Offering to reschedule the patient's appointment B. Taking the patient to an unoccupied interview room C. Notifying the therapist of the need to see the patient stat D. Requesting oral prn anxiolytic medication for the patient

B. Taking the patient to an unoccupied interview room

A nurse openly and genuinely discusses thoughts and feelings about sexually transmitted infections with a group of college students. Which benefit(s) may occur for these college students? (Select all that apply.) A. The college students are reluctant to continue discussions with the nurse. B. The college students develop a trusting relationship with the nurse. C. The college students question the nurse's credibility. D. The college students believe the information is reliable and accurate. E. The college students are able to express important concerns.

B. The college students develop a trusting relationship with the nurse. D. The college students believe the information is reliable and accurate. E. The college students are able to express important concerns.

A college student diagnosed with high levels of anxiety is being prepared for discharge. Which discharge criteria is appropriate for this patient? A. The patient will avoid situations that cause anxiety. B. The patient will use learned anxiety-reducing strategies. C. The patient will return to living at home with supportive parents. D. The patient will state, "I know medication is what I need to control my anxiety."

B. The patient will use learned anxiety-reducing strategies.

A new blood glucose bedside monitoring system is introduced at a staff meeting. A nurse who has previously used this system remembers that the meter would show error messages frequently. Which statement by the nurse demonstrates assertiveness? A. "Why did no one ask for my opinion? I should have been involved in this decision." B. "This meter does not work like it should, and I refuse to use this system ever again." C. "I had problems with this meter before, but I will use it and let you know what I think." D. "I have experience with this system, and there were never any serious problems."

C. "I had problems with this meter before, but I will use it and let you know what I think."

A patient is ordered medication therapy to manage the symptoms of anxiety disorder. Which statement by the patient indicates an understanding of the typical classification of medication prescribed for this disorder? A. "Tricyclic antidepressants are particular good for panic attacks." B. "I have to give up beer while taking monamine oxidase inhibitors (MAOIs)." C. "Selective serotonin reuptake inhibitors (SSRIs) help with panic attacks as well." D. "Benzodiazepines are usually effective when taken for chronic anxiety like mine."

C. "Selective serotonin reuptake inhibitors (SSRIs) help with panic attacks as well."

The nursing supervisor instructs a group of novice nurses about the appropriate use of self-disclosure with patients. The nursing supervisor determines that teaching was successful if the novice nurse makes which statement? A. "Self-disclosure provides an opportunity for the patient to understand the nurse." B. "It is better to disclose stories about others to maintain professional boundaries." C. "Self-disclosure may be used to build a trusting relationship with the patient." D. "A fabricated personal experience can be shared if the patient remains the main focus."

C. "Self-disclosure may be used to build a trusting relationship with the patient."

Discharge preparation for a patient includes the administration of the Hamilton Anxiety Scale (HAS). When asked by the patient to explain the purpose of the assessment the nurse responds: A. "It is an assessment tool used to evaluate the symptoms of anxiety." B. "The tool is used to help confirm the diagnosis of anxiety disorder." C. "This tool helps determine if your symptoms have improved with treatment." D. "It helps identify the presence of any other disorder associated with anxiety."

C. "This tool helps determine if your symptoms have improved with treatment."

The head nurse in the ED has received word that a major fire in a high-rise office tower will result in many injured persons being brought to the hospital within the next few minutes. The head nurse tells the staff, "You will need to assess for acute stress reactions as well as treating physical problems." Which patient is exhibiting symptoms characteristic of acute stress reaction? A. A male whose moods swing between mania and depression B. A female who reports still hearing her daughter's pleas for help C. A male who keeps repeating "I don't understand what's going on?" D. A female who is rocking her young son and repeating "it will be okay."

C. A male who keeps repeating "I don't understand what's going on?"

A nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. The nurse identifies that repetitive behavior in a client who has OCD is due to which of the following underlying reasons? A. Narcissistic behavior B. Fear of rejection from staff C. Attempt to reduce anxiety D. Adverse effect of antidepressant medication.

C. Attempt to reduce anxiety

Which assessment finding exhibited by a patient being assessed for posttraumatic stress disorder (PTSD) would be considered a defining behavior and support such a diagnosis? A. Can describe the attack in great detail B. Experiences dramatic swings in affect C. Describes vivid "flashbacks" of being attacked D. Is preoccupied with the need to "tell someone about the attack"

C. Describes vivid "flashbacks" of being attacked

A patient is attracted to the nurse and attempts to initiate a social relationship. It is most appropriate for the nurse to take which action? A. Encourage the client's behavior to develop a trusting nurse-client relationship. B. Inform the charge nurse of the situation and ask for a different patient assignment. C. Tell the patient that the relationship must remain professional at all times D. Determine if the patient can be transferred to another nursing care unit.

C. Tell the patient that the relationship must remain professional at all times

A young mother who fractured her leg is sobbing with her face behind her hands. She says to the nurse, "I will not be able to work for t least 2 months. Without my job, I cannot pay my bills or take care of my baby. I am alone and do not have anyone to help me." Which response by the nurse accurately conveys empathy? a. "Why do you think that no one cares about you or will refuse to help you?" b. "I can see that you are hesitant about relying on others because of low-esteem." c. "You seem worried about how you will be able to take care of yourself and your baby." d. "I am sorry that you are uncomfortable with asking others for help right now."

c. "You seem worried about how you will be able to take care of yourself and your baby."

The nurse cares for diverse clients in a community health setting. Which action should the nurse take first to learn about delivering care to diverse clients? a. Adopt a transcultural framework to develop culturally appropriate care. b. Ask clients about their personal healthcare beliefs. c. Develop a self-awareness of personal healthcare beliefs. d. Recognize ethnocentric beliefs of minorities in the community.

c. Develop a self-awareness of personal healthcare beliefs

The nurse needs to obtain a health history from a Spanish-speaking patient. Which action by the nurse is best? a. Ask a bilingual friend of the patient to interpret. b. Use nonverbal communication and draw pictures. c. Request a Spanish-speaking medical interpreter. d. Interview the patient's English-speaking daughter.

c. Request a Spanish-speaking medical interpreter.

The nurse provides care to a client from Nigeria who is visiting the United States. Which should the nurse use to communicate with this client? a. Review the predominant health beliefs of the Nigerian population. b. Appraise the client's health beliefs and behaviors with a cultural assessment. c. Consult with other nurses who have taken care of clients from other countries. d. Use standard communication techniques to establish a helping relationship.

b. Appraise the client's health beliefs and behaviors with a cultural assessment.

The nurse cares for a patient who becomes confused and a vest restraint is applied. The nurse should take which action when notifying the patient's family? a. Avoid discussing the treatment plan to reduce anxiety and worry. b. Ask another nurse who has rapport with the family to be present. c. Use medical terms to demonstrate competence. d. Assume that the family wants a detailed explanation.

b. Ask another nurse who has rapport with the family to be present.

The nurse provides care for a male patient. When the nurse addresses the patient, which would be most appropriate? a. Use both first and last name with each encounter. b. Ask the patient how he prefers to be addressed. c. Call the patient by his first name. d. Address the patient by his last name

b. Ask the patient how he prefers to be addressed.

The nurse is interviewing a Native American client. It is most important for the nurse to take which action? a. Maintain eye contact to show respect and interest. b. Assess whether the client is comfortable with eye contact. c. Avoid prolonged eye contact with this client. d. Sit next to the patient to avoid any eye contact.

b. Assess whether the client is comfortable with eye contact.

The nurse cares for a patient with a terminal illness. Which way would be the most therapeutic for the nurse to communicate with this patient? a. Use an honest, judgmental attitude. b. Demonstrate understanding with empathy. c. Acknowledge hope by expressions of sympathy. d. Consistently evaluate the patient's feelings.

b. Demonstrate understanding with empathy.

The nurse cares for a patient who has metastatic cancer. Which action(s) by the nurse conveys warmth? (Select all that apply.) a. Avoid distracting actions such as hand gestures. b. Show interest by occasional head nodding. c. Lean forward toward the patient at a 45-degree angle. d. Place arms across the chest to prevent fidgeting. e. Sit or stand to keep eyes level with the patient's eyes.

b. Show interest by occasional head nodding. e. Sit or stand to keep eyes level with the patient's eyes.

The nurse observes a student nurse who demonstrates nonverbal expressions that are cold and convey disinterest when caring for patients. Which statement, if made by the nurse is best? a. "Patients will complain about you because your behaviors are unprofessional." b. "Have you noticed that your patients do not like you very much." c. "For the next shifts, closely observe how I display warmth to patients." d. "You need to change your behavior when interacting with your patients.:

c. "For the next shifts, closely observe how I display warmth to patients."

A patient who is scheduled for open heart surgery is nervous and tense. The nurse tries to use humor to reduce tension, but the patient seems offended. Which response by the nurse is most appropriate? a. "That joke usually works to relieve tension. Let me try another one to make you laugh." b. "You need to lighten up a little bit because patients who are anxious have more pain." c. "I was trying to ease your tension about surgery, and I am sorry for my insensitivity." d. "Haven't you ever heard that laughter is the best medicine? Just try to at least smile."

c. "I was trying to ease your tension about surgery, and I am sorry for my insensitivity."

The nurse observes a nursing assistant interacting with an elderly patient. Which statement by the nursing assistant requires an immediate intervention by the nurse? a. "I will help you remember where your room is located." b. "Would you like me to read from your Bible today?" c. "Tell me a story about when you were young." d. "Sweetie, I will bring your coffee in a few minutes."

d. "Sweetie, I will bring your coffee in a few minutes."