Mental Health- Unit 2

During which phase of the nurse-client relationship does the client identify and explore specific problems?

Working

The nurse is meeting with a client experiencing a mood disorder. Which client statement indicates that the nurse-client relationship has been established?

"I feel worthless and have no real use in life."

A client explains feelings of sadness and loss after the death of a close friend. Which nursing statement best demonstrates empathy?

"I see this is hard for you. How can I help?"

Which statement by the nurse is an example of assertive communication?

"I understand that group can be difficult to attend but coming late is disruptive"

A client remarks, "You know, it's the same thing every time." Which is the most therapeutic response by the nurse?

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

A psychiatric-mental health nurse has been off of work for the past 4 days, as per the normal work schedule on the unit. On the nurse's first day back, a longterm client says, "I haven't seen you around here since Thursday. How was your time off?" What is the nurse's most appropriate response?

"I've been off for the past four days. What have you done since I last saw you?"

Which statement(s) made by a nurse whose family immigrated to the United States 4 years ago demonstrates an effective process of personal self-awareness? Select all that apply.

"Living through the stress of adjusting to a new country has taught me patience and empathy." "I work very hard at seeing all my clients as individuals not members of a group." "I realize that not everyone is comfortable with my heritage."

A client diagnosed with a mental illness asks the nurse, "Does mental illness run in your family?". Which response to the client by the nurse would be therapeutic?

"Mental illness does run in families. I've had a lot of experience caring for people with mental illnesses"

A client is being counseled by the nurse about family conflict. The client asks the nurse, "Should I go home for the weekend?" Which response by the nurse would demonstrate using the reflection communication technique?

"Should you go home for the weekend?"

The nurse educator is teaching the class about communication. Which statement by the student nurse best describes the basic elements of communication?

"The basic elements of communication include feedback, sender, receiver, and messages."

The client presents with signs and symptoms of anxiety. What conversation initiated by the nurse demonstrates an ineffective therapeutic use of self?

"What types of dresses do you like wearing?"

A client is sitting alone, slouched, with eyes closed. The nurse approaches. Which statement by the nurse is most likely to encourage the client to communicate?

"You look like you are in deep in thought"

During the admission interview, the nurse asks the client about what led to their hospitalization. The client responds, "They lied about me. They said I murdered my mother. You're the killers. You all killed my mother. She died before I was born." Which is the best response by the nurse?

"You're having very frightening thoughts. Let's talk about them."

Which statement is true of empathy? Select all that apply.

-It is the ability to place oneself into the experience of another for a moment in time. -It is developed by gathering information from the client.

Which form of messaging contain figures of speech that are difficult to interpret and can be a barrier to communication?

Abstract

A teenager is mad at the teenager's parents about not being able to drive the father's car. The teenager begins to stay out late with friends after curfew. What defense mechanism is the teenager using?

Acting out

The nurse observes the parent of a child client holding the child close on the lap during the initial assessment. Which distance zone is the parent exhibiting for people who mutually desire personal contact?

Intimate

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:

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

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.

Client's roles, norms of behavior, customs

The graduate nurse asks the nurse preceptor to observe them during a new client admission assessment to the inpatient mental health unit. "Can you help me evaluate whether my verbal and nonverbal behavior is congruent?" Which nursing responsibility does this activity represent?

Developing self-awareness

A nurse is communicating with a client who is highly anxious. During the conversation, the nurse notices that the nurse's speech is matching the fast pace of the client's speech, and the nurse's heart rate is increasing. The nurse identifies this as:

Empathetic linkage

The nurse is caring for a client with a psychotic disorder. The family is very supportive and asks, "What is the difference between a delusion and a hallucination. The nurse would include which information in the teaching? Select all that apply.

Hallucinations are false sensory perceptions that have no relation to reality; delusion consists of fixed, false ideas/beliefs without appropriate external stimuli; delusions are inconsistent with reality and cannot be changed by reasoning; hallucinations are not supported by actual environmental stimuli

A nurse is interviewing a client who is describing difficulties with their family. The client begins crying and says, "I don't want to talk about this anymore." What boundary would the nurse be mindful to avoid crossing with the client?

Psychological

A client is engaged in the orientation phase of the nurse-client relationship. The client should be involved in which activity?

Seeking assistance

The nurse is talking with the client about lowering cholesterol and raising high density lipoproteins (HDLs). The nurse states, "In my personal experience, niacin with applesauce helps to prevent the flushing sensation that often accompanies taking this drug." What is the nurse providing with this statement?

Self-disclosure

During a therapeutic communication session, the nurse tells the client of a past experience. Which statement best reflects the nurse's use of self-disclosure?

Self-disclosure on the nurse's part should benefit the client.

What should the nurse avoid when demonstrating genuine interest for a client by making a self-disclosure?

Shifting the emphasis to the nurse

Which is often considered the most difficult yet most effective communication technique?

Silence

Which form of nonverbal communication would be least effective for the nurse to engage in to demonstrate interest in and acceptance of the client?

Sitting behind a desk

A client diagnosed with an anxiety disorder feels anxious about leaving their house. Which type of therapy would the nurse recommend for the client?

Telemedicine services

A client experienced physical abuse by his father when he was a child. The client explains some of the intense financial and interpersonal stress that his father was experiencing at the time and describes the relationship between psychosocial stress and abuse. How should the nurse best interpret the client's statement?

The client is intellectualizing this traumatic event in order to deal with the emotions involved

A nurse recently began working with a client in the community. The client arrived 15 minutes late for the last appointment and did not show up for today's scheduled appointment, despite confirming the day before. How should the nurse best interpret this client's behavior?

The client is testing the parameters of the relationship.

A psychiatric-mental health nurse has entered a client's room, made an introduction, and asked if the nurse and the client could speak for a few minutes. The clients states, "Yep. Glad to talk." However, the nurse observes that the client is looking at the floor and the client's arms and legs are crossed. How should the nurse best interpret this situation?

The client may be reluctant to dialogue despite the statement to the contrary

A nurse is reading a journal article about the therapeutic relationship. The nurse demonstrates understanding of the information when the nurse identifies which aspect as the primary difference between social and therapeutic relationships?

The focus of the relationship.

The client tells the nurse, "I don't think you can help me. Every time I talk to you, I am reminded of my mother, and I hated her." How does the nurse interpret this behavior?

Transference

An advanced practice nurse has chosen to apply motivational interviewing (MI) in the care of a client who will transition back to the community from inpatient treatment. The nurse should begin to apply this method by:

Validating the client's ability to make decisions and effect change

The nurse asks the client, "What was it like for you when you first realized you had no place to go?" The client looks down and pauses for quite some time. Which action by the nurse is most therapeutic?

sit quietly until the client responds