Psych - Ch. 5 - PrepU

When a client states, "I will solve my own problems without asking my family for help," which response by the nurse demonstrates a therapeutic use of self?

"Asking for help from those who care about us isn't a sign of weakness."

A client treated for depression is ready for discharge from the hospital and tells the nurse, "It would be great if we could meet for coffee should I start feeling low again." Which statement indicates that the nurse understands the boundaries of the therapeutic relationship?

"Before you leave the hospital, I will make sure you have information about the crisis center."

A nursing instructor is teaching a class on empathy. The instructor determines that the class needs additional education when the students identify that empathy involves what?

Feeling the same emotions that the client is feeling at a given time

"Will this conversation involve your desire to harm yourself?"

Assessing

The nurse is caring for a client with schizophrenia. The client tells the nurse, "My dead mother is calling me, I will finally be with her tonight. Please do not tell anyone." What is the most appropriate nursing response?

"I cannot keep this a secret. I will ensure that the staff helps keep you safe."

Which statement by the nurse demonstrates acceptance to the client who has made a sexually inappropriate comment?

"Our relationship is one of a professional nature."

A nurse has approached a new client on the psychiatric care unit in order to establish a therapeutic relationship and conduct a focused assessment. As the nurse approaches the client, the client says, "Oh good. Here comes one more person to tell me that I'm crazy." Which of the nurse's following responses would constitute countertransference?

"There's no need to get rude with me. I'm just trying to do my job and to help you out."

When a 23-year-old client is admitted to the psychiatric unit after a suicide attempt, the client states the client is willing to speak to the nurse but only if the conversation remains confidential. Which is the nurse's best response?

"Will this conversation involve your desire to harm yourself?"

A nurse is speaking to a client with a soft smile and eye contact. Which statement said by the nurse would indicate a congruent message?

"Your hard work and determination has helped you recover."

A nurse administrator is observing the behavior of nurses in the hospital. Which behaviors would the nurse administrator consider inappropriate? Select all that apply.

- A nurse hugging a client who had come in for an initial visit - A nurse speaking to a depressed client in a very strict, disciplinarian tone

When interacting with a client for the first time, which information would be appropriate for the nurse to disclose? Select all that apply.

- Name - Level of education - Reason for being on the unit

During the termination phase, a client begins to raise old problems that have already been resolved. Which would be appropriate nursing responses? Select all that apply.

- Reassure the client that they already covered these issues. - Review with the client the learned methods to control the problems.

A nurse understands that giving positive regard to the client helps in building trust for the nurse. Which actions are appropriate while conveying positive regard? Select all that apply.

- The nurse should address the client by name. - The nurse should actively listen to the client. - The nurse should respond openly to the client.

Which situation would most likely indicate a violation of professional boundaries? Select all that apply.

- 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.

Which clinical situation provides an example of transference?

A female client with a history of sexual abuse exhibits a profound mistrust of male caregivers.

During the orientation phase of a nurse-client relationship, the nurse notes a change in the client's behavior. The client has forgotten a scheduled session and then accuses the nurse of breaking confidentiality. The nurse interprets this as suggesting what?

Acting out

A 68-year-old parent is the sole care provider for a 39-year-old child who has a diagnosis of bipolar disorder. The 39-year-old has been experiencing worsening of the illness over several years. The nurse should recognize that the parent is at risk for what?

Compassion fatigue

While providing care to a client with psychosis, the psychiatric nurse uses communication initially for which reason?

Eliciting the client's cooperation through the establishment of trust

A nurse is caring for a client with anxiety disorder. The nurse knows that the client will have dyspnea and tachycardia if she has an anxiety attack. According to the Carper's patterns of nursing knowledge, which pattern of knowing is this indicative of?

Empirical knowing

At the end of a 12-hour shift, the nurse overhears that a client that the nurse has cared for before is being readmitted to the mental health facility. The nurse says to the charge nurse, "I better stay around for a couple of hours. I am the only one the client will talk to." This is a warning sign that the nurse is experiencing which obstacle to establishing a therapeutic relationship?

Lack of self-awareness

A client relates that the client has panic attacks and, during the attacks, rushes to the emergency department because the client feels like the client is dying. The nurse discloses that the nurse has had panic attacks during which the nurse also felt very fearful. Which statement represents an accurate statement about this self-disclosure?

Self-disclosure can help normalize the client's experience.

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.

Which would indicate that the nurse-client relationship has passed from the orienting phase to the working phase?

The client recognizes feelings of anger and expresses them appropriately

A nurse is assessing an adolescent client who has recently been self-mutilating. The nurse asks the client questions that seek to uncover the motivation underlying the behavior. The nurse's approach best reflects what?

The exploration of behaviors to uncover the client perspective

A client expresses worry about the client's child's aggressive behavior. The nurse says "You are in a very challenging situation. Your child's aggressive behavior is very stressful for you, is this correct?" What does this nurse's statement indicate?

The nurse is empathizing with the client

Which is a nurse's primary tool for treating clients with mental disorders?

The therapeutic use of self

The psychiatric nurse recognizes that excessive social communication with a client is to be avoided primarily due to which reason?

To prevent the client from viewing the nurse as a friend rather than health care provider

While interviewing a client, the nurse imagines what it would be like to be in the client's situation and how it would feel. The nurse is demonstrating:

empathy

What activity should be included in the first step of self-reflection?

identifying one's own values, attitudes, strengths and weakness

A nursing student is working with a client who has a history of abusing alcohol. Although the nurse has an aversive feeling toward people who abuse alcohol, the nurse feels that the client is worthy of respect and attention regardless of the nurse's own personal feelings. Which correctly describes the nurse's response to the client?

Unconditional positive regard