Mental Health Ch 9, 10 Evolve

During a clinical interview the client falls silent after disclosing that she was sexually abused as a child. The nurse should engage in which intervention in response to the client's silence?

Allow the client to break the silence.

Which communication techniques should the nurse use with a client who has been identified as having difficulty expressing thoughts and feelings?

Asking open-ended questions and seeking clarification

A nurse teaches a client a technique for examining negative thoughts and restating them in positive ways. What term is used to identify this technique?

cognitive reframing

What is the physiologic basis for the success of guided imagery?

β-Endorphin release raises the pain threshold.

Which of the following statements represent a nontherapeutic communication technique?

"Why didn't you attend group this morning?" "What did your boyfriend do that made you leave? Are you angry at him? Did he abuse you in some way?" "If I were you, I would quit the stressful job and find something else." "I'm really proud of you for the way you stood up to your brother when he visited today."

Which statement by a patient who has been taught cognitive reframing indicates that the teaching was successful?

"I can be successful if I do all the things required to learn the job."

A patient is presenting with behaviors that indicate anger. When approached, the patient states harshly, "I'm fine! Everything's great." Which response should the nurse provide to the patient?

"It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?"

What is the most helpful nursing response to a client who reports thinking of dropping out of college because it is too stressful?

"School is stressful. What do you find most stressful?"

A patient admitted with anxiety asks, "What exactly are stressors?" What is the nurse's best response to the patient's question?

"Stressors are events that happen that threaten your current functioning and require you to adapt."

With which client should the nurse make the assessment that not using touch would probably be in the client's best interests?

A Chinese American client

Which client behavior illustrates eustress?

A bride is planning for her wedding.

Of the following environments, which would be most conducive to a therapeutic session?

A quiet section of the day room

When discussing her husband, a client shares that "I would be better off alone. At least I would be able to come and go as I please and not have to be interrogated all the time." What therapeutic communication technique is the nurse using when responding, "Are you saying that things would be better if you left your husband?"

Clarification

Which approach to reducing client stress is most effective in people with low to moderate hypnotic ability?

Biofeedback

Which assessment monitors the effect of stress attributed to the stimulation of the hypothalamus-pituitary-adrenal cortex?

Blood glucose levels

After a client discusses his/her relationship with his/her father, the nurse asks, "Tell me if I'm correct that you feel dominated and controlled by him?" What is the purpose of the nurse's question?

Clarifying the message

During a therapeutic encounter, the nurse makes an effort to ensure the use of two congruent levels of communication. What is the rationale for this?

Content of messages may be contradicted by process.

The first stage of the general adaptation syndrome (GAS) can be characterized by which response?

Fight or flight

A recent immigrant to the United States from which country would find direct eye contact a positive therapeutic technique?

Germany

What would a client experience during a progressive relaxation session?

Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed

Stress can be attributed to stimulation of the hypothalamus-pituitary-adrenal cortex. Which assessment finding would confirm the long-term effects of such stress?

Insulin resistance

What tool should the nurse use in assessing the amount of stress a client has experienced in the past year?

Life-Changing Event Questionnaire

A patient is sitting with arms crossed over his or her chest, his or her left leg is rapidly moving up and down, and there is an angry expression on his or her face. When approached by the nurse, the patient states harshly, "I'm fine! Everything's great." Which statement related to communication should the nurse focus on when working with this patient?

Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message.

The relaxation response calls upon the initiation of what process?

Parasympathetic activation

Jacob is a college student whose friend recently committed suicide. Jacob rates his stress as low. Melissa was also friend with the person who committed suicide, but she rates her stress as high. The difference in how Jacob and Melissa rate their stress may be explained by which coping mechanism?

Perception

During a therapeutic encounter the nurse remarks to a client, "I noticed anger in your voice when you spoke of your father. Tell me about that." What communication techniques is the nurse using?

Reflecting and exploring

Self-help groups are useful for reducing stress because they provide the individual with the stress mediator that take what form?

Social support

A client, whose friend recently committed suicide, asks the nurse about some ways to help cope with the stress regarding the event. Which option should the nurse discuss with the client?

Talking with friends and attending a loss support group

What factor exerts the greatest influence on the degree to which various life events upset a specific individual?

The individual's perception of the event

The preferred seating arrangement for a nurse-client interview should incorporate which positioning?

The nurse and client sitting at a 90-degree angle to each other.

When preparing to hold an admission interview with a client, the nurse pulls up a chair and sits facing the client with his or her knees almost touching. When the nurse leans in close to speak, the client becomes visibly flustered and gets up and leaves the room. What is the most likely explanation for client's behavior?

The nurse violated the client's personal space by physically being too close.

What is the focus during clinical supervision?

The nurse's behavior in the nurse-client relationship

A 55-year-old patient recently came to the United States from England on a work visa. The patient was admitted for severe depression following the death of a life partner weeks ago. While discussing the death and its effects the patient shows little emotion. Which of the following explanations is most plausible for this lack of emotion?

The response may reflect cultural norms.

The client makes the decision to sit about 5 feet away from the nurse during the assessment interview. The nurse can accurately make what assumption about the client's perception of the nurse?

They view the nurse as a stranger.

What therapeutic communication technique is the nurse using by asking a newly admitted patient, "Please tell me what was happening that led to your hospitalization here?"

Using an open-ended question

A client with hypertension uses an automatic cycling blood pressure cuff with audible changing tones. The client uses relaxation techniques to lower her blood pressure and is informed of her ongoing success by the tone. This process describes

biofeedback.

An effective stress-reduction technique a nurse might teach an individual with performance anxiety is

deep breathing.

Meditation is successful in promoting stress reduction because it brings about which outcome?

quiets the sympathetic nervous system