Chapter 6 - 8

A client from which of the following cultural groups is likely to prefer closeness in personal space?

Arab Americans

Patient says to the nurse, I wonder what's playing at the movie tonight. The most therapeutic response would be,

Are you telling me you would like to go to the movies?

A client is fearful and reluctant to talk. Which of the following techniques is most effective when trying to engage the client in interaction?

Broad opening

A patient shows no facial expression when engaging in a game with peers during an outing at a park. The nurse uses which of the following terms when documenting the patient's affect?

Flat affect

A patient asks the nurse what she should do about her cheating husband. The nurse replies, You should divorce him. You deserve better than that. The nurse used which communication technique?

Giving advice

Several family members arrive to visit an African American client. The nurse can best meet this client's need for socialization by providing the client and family which of the following?

Group gatherings and open conversation

The nurse is preparing to conduct an admission assessment interview with a Mexican American client. During the interview, the nurse should respect the client's culture through which behavior?

Introduce self with a handshake

The client says to the nurse, I have special powers because I am the mother of God. I can heal everyone in the hospital. The nurse's best response would be,

It would be unusual for anyone to have that kind of power

Culture has the most influence on a person's health beliefs and practices. African Americans believe that the cause of mental illness occurs because of which of the following?

Lack of spiritual balance

The nurse has completed the psychosocial assessment. Which of the following is the best approach toward analysis of the data to identify nursing diagnoses and develop an appropriate plan of care?

Look for patterns reflected in the overall assessment.

Throughout the assessment, the client displays disorganized thinking, jumping from one idea to another with no clear relationship between the thoughts. The nurse would assess the client as having which of the following?

Loose associations

The nurse says to the client, You become very anxious when we start talking about your drinking. Which of the following techniques is the nurse using?

Making an observation

Which of the following statements about verbal and nonverbal communication skills is accurate?

Nonverbal communication is as important, if not more than, verbal communication.

The nurse considers cultural variations pertaining to a client's nonverbal communication. Which of the following is the primary rationale for considering alternative meanings of nonverbal communication?

Nonverbal messages have different meanings in various cultures.

. Which of the following factors influencing assessment is under the nurse's control?

Nurse's attitude and approach

Genetics have been shown to play which of the following roles in a person's mental and emotional health?

Several mental disorders appear to run in families

The nurse asks the patient what he would like to talk about. This is an example of

broad opening.

During the assessment, the nurse asks the client to describe his problems. The purpose of this question is to obtain information about the client's

perception of the problem

Beliefs about the causes of pain and illness vary among cultures. In the United States (Western culture), pain and illness are generally attributed to

physiologic causes.

The client says to the nurse, I know I can learn to cope with my family situation. By getting help here at the clinic, I'll be able to deal with them more effectively, and I won't be so stressed out all the time. This client is demonstrating a high level of

self-efficacy

The nurse is making a cultural assessment of a client. The most important data about a client's cultural beliefs are

subjective data from the client

The nurse is preparing to administer PRN medication to a client of a Japanese descent who is anxious. The prescription reads, Alprazolam (Xanax) 0.25 to 1.0 mg PO PRN. The best dose for the nurse to give initially is

0.25 mg.

A nurse has invited a patient to sit down and have a conversation. The patient takes the first seat. The nurse pulls up another chair to sit with the patient. Approximately how far from the patient should the nurse place her chair?

3 to 4 feet

Which of the following situations would most likely provide social support to a client?

A friend who will share his or her perspective on an issue

Which statements are true of concrete and abstract messages? Select all that apply.

A) Abstract messages include figures of speech that are difficult to interpret. D) Concrete messages are clear, direct, and easy to understand.

The nurse should use clear concrete messages when working with patients displaying which of the following conditions? Select all that apply.

A) Anxiety C) Dementia D) Schizophrenia

. The nurse plans to assess a patient's self-concept in the admission assessment knowing that self-concept influences which of the following? Select all that apply.

A) Body image C) Frequently experienced emotions D) Coping strategies

Which of the following are the types of roles that are usually included when assessing roles and relationships? Select all that apply.

A) Family B) Hobbies C) Occupation D) Activities

Which of the following statements is true of empathy? Select all that apply

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

Which of the following statements about spirituality are true? Select all that apply

A) Many clients with mental disorders have disturbing religious delusions. B) Religious activities have been shown to be linked with better health and a sense of well-being. D) Hope and faith are two critical factors in psychiatric and physical rehabilitation. E) Spirituality may include a relationship with the environment.

Which of the following personal characteristics influence a client's response to stressors? Select all that apply.

A) Self-efficacy C) Spirituality D) Hardiness E) Resilience F) Resourcefulness

When assessing a patient's mental health status, which of the following describe the purpose of the psychosocial assessment? Select all that apply.

A) To assess the client's current emotional state B) To assess the client's mental capacity C) To assess the client's behavioral function

Which of the following are components of the assessment of thought process and content? Select all that apply.

A) What the client is thinking C) How the client is thinking D) Clarity of ideas E) Self-harm or suicide urges

The nurse is assessing suicide potential in a patient who has expressed hopelessness. In what order does the nurse question the patient about suicidal thoughts?

A. How would you carry out this plan? B. Do you have a plan to kill yourself? C. Are you thinking of killing yourself? D. How do you plan to kill yourself?

A holistic plan of recovery would be especially important to a client from which of the following cultural groups?

American Indian

The nurse uses a variety of therapeutic communication skills when working with patients. Which of the following is a therapeutic goal that can be accomplished through the use of therapeutic communication skills?

Assess the patient's perception of a problem

It is recorded in the client's chart that the family is resilient. The nurse concludes which of the following characteristics about the family life of this client? Select all that apply.

B) Family members spend time together. C) Family members engage in recreational activities together

Which of the following individual factors can a person modify to improve mental and emotional health? Select all that apply.

B) Lack of exercise C) Poor nutrition E) Sleeplessness

Which of the following statements about hope and symptoms of mental illness are true? Select all that apply.

B) Persons having more hope experienced fewer actual symptoms. E) A possible way to help clients manage and decrease symptoms would be to support the development of hope.

Which of the following is the best reason that many psychiatric care units have policies against clients touching one another or staff?

Because some clients with mental illness have difficulty knowing when touch is or is not appropriate

Which one of the following statements about the roles that biologic makeup plays in a client's emotional responses is most accurate?

Biologic differences can affect a client's response to treatment with psychotropic drugs

Which of the following are nontherapeutic techniques? Select all that apply.

C) Agreeing D) Challenging E) Giving approval

The client stated, I was so upset about my sister ignoring me when I was talking about being ashamed. Which nontherapeutic communication technique would the nurse be using if the nurse would state, How are your stress reduction classes going?

Changing the subject

The nurse is assessing the anxiety level of a young school-age child. The nurse encourages the child to express feelings through the use of toys in a play situation. The purpose for this approach to assessment is largely related to which of the following?

Children may not have developed the language to fully describe their feelings.

. During the admission assessment, the nurse asks the client, How are you feeling? The client responds, I was able to purchase gas for 7 cents a gallon less than yesterday, which saved me a total of 84 cents. My car has a 12-gallon gas tank. Usually I am able to put in 11.7 gallons. I am very happy to have saved so much money. The nurse recognizes this response as which of the following?

Circumstantial thinking

A nurse is working with a Middle-Eastern client being treated for major depression. The client is expressing feelings of guilt for not being able to snap out of it. A therapeutic response by the nurse would be

Clinical depression is not something you have brought on yourself.

Which of the following cultural phenomena that should be assessed by the nurse includes preference such as touch and eye contact?

Communication

The nurse asks a patient to list the days of the week in reverse order. The nurse is assessing which of the following?

Concentration

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

D) Sit quietly until the patient responds

The patient expresses frustration that the doctor does not spend enough time with the patient when making rounds. The nurse replies, The doctors are very busy. What can I help you with? The nurse incorporated which nontherapeutic technique in this response?

Defending

A client is admitted to the psychiatric unit and states, I am president of the largest corporation in the world. Everyone comes to me for advice. The client is exhibiting which of the following?

Delusion

The patient states that he is 14 trillion years old and created the world. The nurse documents this statement as an example of which type of thinking displayed by the patient?

Delusional thinking

Knowing that relationships with others are significant to mental health, the nurse effectively assesses a patient's family relationships through which of the following?

Describe your relationships with your family.

Which of the following would best assess a client's judgment?

Discussing hypothetical situations

A nurse suspects that a patient is abusing alcohol while taking prescribed medications. The nurse plans to educate the patient on the dangers of mixing medicine with alcohol. Which of the following would be the most effective way for the nurse to approach this subject with the patient?

Emphasize the importance of truthful information using a nonjudgmental approach

The nurse asks the client what that experience was like. Which communication skill is the nurse using?

Encouraging expression

A patient states, Right before I got here I was doing alright. My job was going well, my wife and I were happy, and we just moved into a new apartment. The nurse responds, You said you and your wife were happy. Tell me more about that. This is an example of which therapeutic technique?

Exploring

Which one of the following goals of therapeutic communication would the nurse strive to attain first?

Facilitate the client's expression of emotions

How might the nurse best provide culturally competent care?

Find out as much as possible about a client's cultural values, beliefs, and health practices.

A client is actively involved in community service activities. The benefit of involvement in meaningful daily activities will most directly contribute to which of the following attributes?

Hardiness

Which of the following questions best encourages the client to disclose information the nurse must assess to provide culturally competent care?

How do you want me to help you?

A patient remarks, You know, it's the same thing every time. The nurse should respond by stating,

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

Which of the following questions is best to ask when assessing the client's judgment?

If you found yourself downtown without money or a car, how would you get home?

A client has been making sexual comments when communicating with the nurse. The nurse wants to spend some time talking to the patient while respecting the patient's right to privacy. Which setting would be the most appropriate setting for the nurse to talk with the client?

In a quiet corner of the dayroom at least 4 feet away from others

A nurse is teaching decision-making skills to a client with dependent personality disorder. According to Erikson, the likely cause of the client developing dependent personality is failure to meet the critical task of which developmental stage?

Industry

The nurse asks the client, What is similar about a cow and a horse and What do a bus and an airplane have in common? These questions would best assess which of the following areas?

Intellectual function

Which of the following distance zones is acceptable for people who mutually desire personal contact?

Intimate

Which one of the following statements is most accurate regarding the age at onset of a mental illness such as schizophrenia?

Persons who are diagnosed at a younger age will more likely have a poorer outcome.

Individuals who grow up in at-risk environments but are able to become productive, successful citizens are believed to possess which of the following characteristics?

Resilience

Direct eye contact is preferred by which of the following cultures?

Russians

The nurse is sitting down with a patient to begin a conversation. Which of the following positions should the nurse take to convey acceptance of the patient?

Sitting upright facing the patient with both feet on the floor

Females from which of the following cultures are most likely to be expected to move in with husband's family?

South Asians

Spirituality is especially important in helping people cope primarily for which of the following reasons?

Spirituality guides beliefs about the meaning of life events.

The nurse is trying to obtain some information about family relationships from the client. Which of the following statements is best?

Tell me your feelings about your family situation.

A client's prognosis is said to be good due to a high degree of self-efficacy. Which of the following is evidence of a high degree of self-efficacy?

The client is self-motivated and asks for help when needed.

A nurse and a client of Chinese heritage are collaborating on treatment goals. The nurse would document which of the following as the client's priority goal?

The client will express a feeling of balance and harmony

A client reports feeling like he belongs among his peers with whom he shares a group home. The nurse incorporates this sense of belonging when formulating discharge plans because the nurse understands which of the following?

The client will likely feel needed by his peers.

When the nurse asks the client to restate the following in his or her own words, which sensorium and intellectual process is the nurse attempting to identify? The nurse states, A stitch in time saves nine.

The client's ability to use abstract thinking

A patient reported to the nurse that on his way to the clinic, a policeman in a patrol car turned on his lights and pulled him over. When asked what he did next, the patient stated, I pulled over, of course. Which of the following was the nurse trying to assess?

The client's judgment

Which of the following factors would be the most influential in determining a client's response to a particular stressor?

The client's perception of the stressor

The nurse reviews results of the Minnesota Multiphasic Personality Inventory (MMPI) recorded in a patient record. While considering the usefulness of these data, the nurse is mindful that the MMPI has which limitation?

The results of the MMPI could be culturally biased.

A delusion represents a problem in which of the following areas?

Thinking

The nurse is sitting with a patient who is crying. After a few minutes the nurse places one hand on the patient's shoulder. Which of the following best describes the purpose of the nurse's touch with this patient?

To offer comfort and support for the patient

A patient is known to express tangential thinking. The nurse would assess for which of the following when interacting with the patient?

Wandering off the topic and never answering the question

A nurse can best assess a patient's ability to use abstract thinking by asking the patient which of the following questions?

What do I mean when I say, 'Don't sweat the small stuff?

During the mental status assessment, the client expresses the belief that the CIA is stalking him and plans to kidnap him. The best response by the nurse would be,

What kinds of things have been happening?

The client spoke of a current event in the national news and described it as it relates to the client. Then the client spoke of a historical event and described it as it relates to the client. Which of the following questions might the nurse ask to determine if the client is experiencing ideas of reference?

Where were you when this happened?

The nurse best assesses a patient's memory by asking which of the following questions?

Who is the current president?

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

You look like you are deep in thought.

. Which of the following statements would be an empathetic response in a client interaction?

You must have been embarrassed when your father yelled at you in the grocery store

A patient states, I feel fine. It's a good day. The nurse notes the patient looking away, and a decreasing pitch in his voice while speaking. Which of the following is the most therapeutic response by the nurse?

You say you feel fine, but you don't really sound fine.

A patient says, Its' been so long since I've been with my family. Which statement by the nurse is an example of restating?

You say you haven't seen your family in a while

A patient yells, All the nurses here are so mean. None of you really care about us! The most therapeutic response would be,

You seem very irritated.

During the admission interview, the nurse asks the client what led to his 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. The best initial response by the nurse would be,

You're having very frightening thoughts.

A client is being evaluated for dementia. The nurse knows that a client who is able to complete very few tasks is most likely to have

a greater cognitive deficit.

A Filipino client meets the nurse for the first time. The client simply smiles at the nurse when introduced. The nurse interprets this behavior as

a typical greeting for a Filipino client.

The client tells the nurse, That new TV anchor is telling the world about me. This is an example of

ideas of reference

In the space of 5 minutes, the client has been laughing and euphoric, then angry, and then crying for no reason that is apparent to the nurse. This behavior would be best described as

labile mood.

A nurse assesses that a depressed patient is lethargic during the day and does not actively participate in unit activities. The notes from the night shift document that the patient did not sleep well. The most probable interpretation of these data is

the patient's depressed mood is impairing restful sleep patterns.

The nurse must be alert to the nonverbal expressions of the client. Because the meaning attached to nonverbal behavior is subjective, it is important for the nurse to

validate the meaning of the nonverbal behavior.