Psych ch 6

17. The client frequently attempts to touch the nurse and the nurse has explained the prohibition against this. Which of the following is the best reason that many psychiatric care units have policies against clients touching one another or staff? A) Because some clients with mental illness have difficulty knowing when touch is or is not appropriate B) Because clients often perceive being touched as a threat and may attempt to protect himself or herself by striking the staff person C) Because it can be threatening to both the client and the nurse D) Because touching always leads to more touching

A

27. The client says to the nurse, "I wonder what's playing at the movies tonight." The most therapeutic response would be what? A) "Are you telling me you would like to go to the movies?" B) "Why don't you look in the newspaper?" C) "There's nothing worth watching." D) "We may have some DVD's available."

A

30. 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?" A) Changing the subject B) Offering advice C) Challenging D) Disapproving

A

33. A client is fearful and reluctant to talk. Which of the following techniques is most effective when trying to engage the client in interaction? A) Broad opening B) Focusing C) Giving information D) Silence

A

36. The nurse fails to assess personal values surrounding homosexuality before caring for a client who is openly gay. The nurse is most at risk for which of the following when working with this client? A) Holding a prejudice toward this client B) Neglecting to include the client's desires in the plan of care C) Being manipulated by this client D) Expressing shock when assessing the client's history

A

37. How can a nurse avoid the possibility of finding the client's behavior unacceptable or distasteful? A) By being aware of the client's behavior and background before beginning the relationship, and exploring with a colleague the possibility of a conflict. B) By using silence instead of verbal responses for all instance of the client describing his or her behavior C) By using facial expressions of annoyance if the client expresses behavior that the nurse disapproves of D) By turning away from the client when the nurse does not want the client to see his or her facial expression

A

40. Nurses develop empathy with their clients while gathering information about the client. Which of the following hinders the development of empathy? A) interjecting personal experiences B) asking the client to restate for clarity C) asking leading questions D) focusing on one issue

A

9. Which of the following statements would be an empathetic response in a client interaction? A) "You must have been embarrassed when your father yelled at you in the grocery store." B) "You really should find your own housing and get out of the situation with your father." C) "Well, it sounds like your father has difficulty controlling his temper." D) "Why do you think your father chose that time and place to yell at you?"

A

A client says, "Its' been so long since I've been with my family." Which statement by the nurse is an example of restating? A) "You say you haven't seen your family in a while." B) "Tell me what happened when you last saw your family." C) "Go on. Tell me more." D) "When was the last time you saw your family?"

A

The nurse asks the client to describe the quality of an experience. Which communication skill is the nurse using? A) Encouraging expression B) Encouraging description of perceptions C) Accepting D) Requesting an explanation

A

The nurse using therapeutic communication asks the client what he would like to talk about. This is an example of which of the following? A) Broad opening B) Encouraging expression C) Focusing D) Offering self

A

20. The nurse should use clear, concrete messages when working with clients displaying which of the following conditions? Select all that apply. A) Anxiety B) Anorexia C) Dementia D) Schizophrenia E) Illness anxiety disorder

A,C,D

21. The nurse and the client are using therapeutic communication skills. 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. B) Abstract messages are important for accurate information exchange. C) Concrete messages require the listener to interpret what the speaker says. D) Concrete messages are clear, direct, and easy to understand. E) Abstract messages are best used for persons who are anxious.

A,D

10. While the nurse and client are in a therapy session, 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? A) Confronting behavior B) Making an observation C) Translating into feelings D) Verbalizing the implied

B

13. The nurse watches the expressions the client is making as group therapy is conducted. Which of the following statements about verbal and nonverbal communication skills is accurate? A) One third of meaning is transmitted nonverbally and two thirds is communicated verbally. B) Nonverbal communication is as important, if not more than, verbal communication. C) Verbal communication is most important because it is what the patient says. D) Verbal communication involves the unconscious mind.

B

15. A nurse has invited a client to sit down and have a conversation. The client takes the first seat. The nurse pulls up another chair to sit with the client. Approximately how far from the client should the nurse place her chair? A) 1 to 2 feet B) 3 to 6 feet C) 6 to 8 feet D) 8 to 10 feet

B

19. The mother of a small client holds her child close during the initial assessment. Which of the following distance zones is acceptable for people who mutually desire personal contact? A) Social B) Intimate C) Personal D) Public

B

25. A client is sitting alone, slouched, with eyes closed. The nurse approaches. Which statement is most likely to encourage the client to talk? A) "If you are sleepy, would you like me to help you back to your room?" B) "You look like you are deep in thought." C) "Is something wrong?" D) "Why are you sitting with your eyes closed?"

B

28. 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... A) "That sounds interesting. I'm not sure that I follow." B) "It would be unusual for anyone to have that kind of power." C) "You could not heal everyone. No one has that much power." D) "Well, you can certainly try."

B

29. 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." What would be the best initial response by the nurse? A) "I just saw your mother. She's fine." B) "You're having very frightening thoughts." C) "We'll put you in a private room until you're in better control." D) "If your mother died before you were born, you wouldn't be here."

B

38. A nurse has interactions with several clients throughout the day. When would a formal setting for discussion be indicated? A) when a client is displaying aggressive behaviors B) when a client has difficulty maintaining boundaries C) when a client is showing signs of sadness D) when a client is displaying hearing voices

B

42. A nurse has been waiting for over an hour for the ancillary department of laboratory to draw blood on a non-critical client with bipolar disorder in the ED. Which response is an example of assertive communication from the nurse to the laboratory personnel? A) "So nice of you to join us, it's about time." B) "When you are late to draw blood the family gets upset, and I don't like having to repeat that you are on your way." C) "When you work, we never get blood drawn on time." D) "It's about time, we were beginning to think I would have to do your job and mine too."

B

The client expresses frustration that the doctor does not spend enough time with her 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? A) Belittling B) Defending C) Disagreeing D) Introducing an unrelated topic

B

The nurse uses a variety of therapeutic communication skills when working with clients. Which of the following is a therapeutic goal that can be accomplished through the use of therapeutic communication skills? A) Inform the client of priority problems B) Assess the client's perception of a problem C) Assist the client to control emotions D) Provide the client with a plan of action

B

Which one of the following goals of therapeutic communication would the nurse strive to attain first? A) Facilitate the client's expression of emotions. B) Establish a therapeutic nurse-client relationship. C) Teach the client and family necessary self-care skills. D) Implement interventions designed to address the client's needs.

B

16. The nurse is sitting with a client who is crying. After a few minutes the nurse places one hand on the client's shoulder. Which of the following best describes the purpose of the nurse's touch with this client? A) To express sympathy to the client B) To assess the client's skin temperature and circulation status C) To offer comfort and support for the client D) To extend an offer of friendship to the client

C

23. A client remarks, "You know, it's the same thing every time." The nurse should respond by stating, A) "I understand." B) "I'm sure everyone is doing their best." C) "I'm not sure what you mean. Please explain." D) "It's the same thing every time?"

C

31. During the mental status assessment, the client expresses the belief that the CIA is stalking him and plans to kidnap him. Which would be the best response by the nurse? A) "That makes no sense at all." B) "You can tell me about that after I finish asking these questions." C) "What kinds of things have been happening?" D) "Why would the CIA be interested in you?"

C

35. A nurse is working with a client whose background is very different from hers. A good question to ask herself to assure she can be effective working with this client would be... A) "Can this person understand me?" B) "Do I understand this patient's expectations of me?" C) "What experiences do I have with people with different backgrounds?" D) "Is this person going to be able to relate to me?"

C

39. A student nurse is helping with discussion with a client. Which of these is an explanation why a student nurse does not use active listening? A) The student nurse is bored with the unit. B) The student nurse is uncomfortable with the client. C) The student nurse is thinking ahead for answers. D) The student nurse is unable to understand cues.

C

During a session with a client, the client 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 nontherapeutic communication technique? A) Giving information B) Verbalizing the implied C) Giving advice D) Agreeing

C

The nurse should avoid nontherapeutic techniques. Which of the following are nontherapeutic techniques? Select all that apply. A) Silence B) Voicing doubt C) Agreeing D) Challenging E) Giving approval F) Exploring

C,D,E

11. The nurse is sitting down with a client to begin a conversation. Which of the following positions should the nurse take to convey acceptance of the client? A) Leaning forward with arms on the table sitting directly across for the client B) Turned slightly to the side of the clients with arms folded across the chest C) Leaning back in the chair next to the client with legs crossed at the knees D) Sitting upright facing the client with both feet on the floor

D

12. A client states, "I feel fine. It's a good day." The nurse notes the client looking away, and a decreasing pitch in his voice while speaking. Which of the following is the most therapeutic response by the nurse? A) "I'm glad you are feeling good today." B) "I'm not sure I believe you." C) "Tell me what is good about today." D) "You say you feel fine, but you don't really sound fine."

D

18. A client has been making sexual comments when communicating with the nurse. The nurse wants to spend some time talking to the client while respecting the client's right to privacy. Which setting would be the most appropriate setting for the nurse to talk with the client? A) In the client's room when the client's roommate is present and 3 feet away B) At the nurse's station when other clients and visitors are less than 4 feet away C) In an interview room in a remote section of the unit with the nurse 1 foot away from the client D) In a quiet corner of the dayroom at least 4 feet away from others

D

22. The nurse asks the client, "What was it like for you when you first knew you had no place to go?" The client looks down and pauses for quite some time. Which action by the nurse is most therapeutic? A) Change the subject to something the patient will discuss B) Encourage the patient to express any unpleasant feelings C) Apologize for asking such a personal question D) Sit quietly until the patient responds

D

24. A client states, "Right before I got here I was doing all right. 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? A) Encouraging comparison B) General lead C) Restating D) Exploring

D

26. A client yells, "All the nurses here are so mean. None of you really care about us!" The most therapeutic response would be what? A) "I cannot allow you to yell like that." B) "We care about you." C) "Oh, really?!" D) "You seem very irritated."

D

32. The nurse is trying to obtain some information about family relationships from the client. Which of the following statements is best? A) "Is it upsetting for you to talk about your family?" B) "Is your family ready for you to come home?" C) "So, how is your family?" D) "Tell me your feelings about your family situation."

D

34. When preparing for the first clinical experience with clients on a forensic unit at a psychiatric hospital, the nursing instructor discusses students' beliefs and fears surrounding forensic clients. The primary reason for discussing personal beliefs is to... A) practice reflective communication skills in a role-play situation. B) assign the most compatible patients to the students. C) assess the appropriateness of the setting for implementing nursing skills. D) become aware of possible barriers to developing therapeutic relationships.

D

41. A nurse is developing a therapeutic relationship with the client. To do this, the nurse must respect the client's religious and spiritual beliefs. Which of the following will occur if the nurse does not show this respect? A) frustration for the client B) longer rehabilitation C) leads to mental health relapse D) eroding trust

D

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... A) increase the client's awareness of nonverbal behavior. B) investigate the source of nonverbal behavior. C) validate the client's feelings. D) validate the meaning of the nonverbal behavior.

D