ATI psych treatment setting/communication

A nurse is planning care for a group of clients on a mental health unit. Which of the following actions should the nurse plan to take to create a therapeutic environment. A. Plan to discuss any topic that is presented B. Focus on client weaknesses to increase adaption C. Provide continuity of care by assigning the same staff D. Allow clients to determine the boundaries of the nurse-client relationship

C. Provide continuity of care by assigning the same staff consistent interactions -should not discuss "any topic" -don't focus on weaknesses -nurse determines nurse-client relationship boundaries

A nurse is caring for a group of clients on a mental health unit. Which of the following actions should the nurse implement to establish therapeutic relationships with the clients? A. Provide sympathy during interactions B. Focus on the words of the clients C. Control the pace of establishing the nurse-client relationship D. Demonstrate genuineness when communicating

D. Demonstrate genuineness when communicating establishes trust -- honest, caring attitude facilitates emotional connection with the client -focus on verbal and non-verbal communication (not just words) -empathy NOT sympathy -allow clients to set the pace of the relationship

A nurse in an inpatient mental health unit is planning care for a client who is in restraints. Which of the following findings should indicate to the nurse that the client is ready to reintegrate into the unit? A. The client's VS are within the expected reference range B. The client requests to use the bathroom C. The client eats all the food provided for each of her meals D. The client follows directions

D. The client follows directions reintegration involves client ability to follow directions and control behaviors -VS, amount of food eaten and requesting the bathroom = not indications client is ready to reintegrate

During a group therapy session, a nurse notes several clients using multiple defense mechanisms. Which of the following client statements demonstrates the maladaptive use of regression? A. "I wrote a short story about a heroic women when I was really mad at my boss." B. "I don't care about work anymore since I was not given a promotion." C. "I mentally separate myself from distractions around me when I paint on canvas." D. "I still cannot remember the scene of my husband's car accident."

B. "I don't care about work anymore since I was not given a promotion." pg. 42-43 // table 3.1 regression - reverting to earlier, more primitive/child-like behavior ex. if promotion is lost = poor work performance, missing appts, being late -sublimation is unconscious process of substituting an acceptable activity for unacceptable impulses -dissociation -repression

A nurse in a mental health facility is caring for a client who is upset about the loss of privileges due to repetitive negative behavior. Which of the following statements by the nurse demonstrates the effective use of assertive communication? A. "You were made aware of the consequences of negative behavior." B. "I understand that you are angry. However, I followed the appropriate protocol." C. "You need to calm down before discussing this matter any further." D. "Why did you make the choice to behave negatively?"

B. "I understand that you are angry. However, I followed the appropriate protocol." "I" statements are assertive = states position clearly and firmly and non-aggressive -"you" statements are aggressive -no "why" questions

A nurse on an inpatient mental health unit is admitting a client who has a panic-level anxiety. After showing the client to his room, which of the following actions is the most therapeutic at this time? A. Suggest that the client rest in bed. B. Remain with the client for a while. C. Medicate the client with a sedative. D. Have the client joint a therapy group.

B. Remain with the client for a while. nurse should not leave a client who has severe anxiety alone - priority = lease restrictive intervention ex. staying with client and calmly encouraging him to express feelings

A nurse is leading a family therapy session for a mother, father, and two adolescent siblings. Which of the following statements should the nurse recognize as an example of effective communication among family members? A. "If you keep saying that, I will tell everyone what you did last night." B. "She is always bossing me around. Should she do that?" C. "Can you tell me the reason you get upset each time I go to the mall?" D. "Please do not raise your voice at the children. I am the one who left the dishes in the sink."

C. "Can you tell me the reason you get upset each time I go to the mall?" clear, understandable, direct messages -placating - when one family member takes responsibility for problems in order to keep the peace and avoid confrontation

A nurse is caring for a client who has a hx of alcohol use disorder and has been hospitalized for detoxification. The nurse enters the room and finds the client shouting in a terrified voice, "get these bugs off of me!". Which of the following responses by the nurse is appropriate? A. "I'm sure that the bugs you see will not harm you." B. "Tell me more about the bugs that you see in your room." C. "I don't see any bugs, but you seem very frightened." D. "I do not see anything. This is part of the withdrawal process."

C. "I don't see any bugs, but you seem very frightened." tactile hallucination = show empathy by presenting reality and acknowledging the clients feelings -avoid talking about hallucinations as though they are true -don't argue with what they are seeing

A nurse is evaluating the outcomes for an outpatient client who has depression. Which of the following client statements indicates the need for further evaluation? A. "I had a great trip to the Smokey Mountains." B. "Going back to work has been okay." C. "I just don't like going to the movies like I used to." D. "I can't wait to have my family together next weekend."

C. "I just don't like going to the movies like I used to." client is having difficulty enjoying activities that were previous pleasurable and requires further evaluation -work: adjusting to responsibilities in life -mountains: finding pleasure and positive outcomes -family: looking forward to events

A nurse is caring for a client who has depression observes the client comes to breakfast freshly bathed, wearing clean clothes, and with combed and styled hair. Which of the following responses by the nurse is therapeutic? A. "Everyone feels better after showering." B. "You must be getting better. You look great!" C. "I see you have done some grooming today." D. "Why are you all dressed up today? Is it a special occasion?"

C. "I see you have done some grooming today." open-ended, recognition of positive behavior -avoid stereotyping -avoid assumptions -no "why" questions

A nurse is teaching a client who has depression about a new prescription for fluoxetine 20 mg daily. Which of the following statements by the client indicates understanding of the teaching? A. "I should expect relief from depression within 3 to 4 days." B. "I will take my fluoxetine at bedtime so I can sleep better." C. "I should notify my provider if I develop a skin rash." D. "I will notice an improvement in my sex drive."

C. "I should notify my provider if I develop a skin rash." -Antidepressant effects of Prozac begin 1-4 weeks -when prescribed once daily, should take in AM to prevent sleep disturbances -cause sexual dysfunction

A client becomes very dejected and states, "No one really cares what happens to me. Life isn't worth living anymore." Which of the following responses should the nurse make? A. "Of course people care. Your family comes to visit every day." B. "Why do you feel that way?" C. "Tell me who you think doesn't care about you?" D. "I care about you, and I am concerned that you feel so sad."

D. "I care about you, and I am concerned that you feel so sad." open-ended statement focusing on client feelings, shows empathy, allows for further exploration of clients beliefs -by asking the client to tell what people don't care about him, nurse is challenging the clients beliefs and changing the focus away from feelings of client

A nurse is leading a group therapy session for clients who are newly diagnosed with cancer. Which of the following statements should the nurse make? A. "Antidepressants are not your solution, but this group therapy is." B. "I notice you keep clenching your fists. This needs to stop." C. "You need to work hard on resolving conflict with those closest to you." D. "Let's discuss what you mean when you say that you cannot ever return to work."

D. "Let's discuss what you mean when you say that you cannot ever return to work." clarification (therapeutic communication technique) -never "you should or you need" statements -"I noticed you are clenching your fists. What are you feeling right now?"

A nurse observes a client's spouse sitting alone in the waiting room crying. When approached, the spouse says, "I am really concerned about my husband." Which of the following is a therapeutic nursing response? A. "Your husband is making really good progress." B. "Crying helps us let things out and we feel better." C. "Did your husband say something to upset you?" D. "Tell me what is concerning you."

D. "Tell me what is concerning you." clarification -focusing on the wrong person (spouse) -what nurse believes, doesn't encourage communication about spouses concerns

A nurse is caring for a client who was admitted for suspected abuse. The client is quiet and withdrawn. Which of the following actions should the nurse take to promote client communication? A. Invite a family member to be present for the nursing hx. B. Provide basic wound care for obvious physical injuries. C. Probe the client to offer a factual account of the abuse. D. Be direct and honest when speaking with the client

D. Be direct and honest when speaking with the client promotes communication -provide privacy -no probing -care for wounds doesnt promote communication