PrepU Qs Stress/Coping, Therapeutic Relationships/Comm, Aggression/Abuse, Addiction

a. "Should you go home for the weekend?" Reflection is used when a client wants a nurse's approval or judgment. The statement by the nurse that uses reflection is "should you go home for the weekend?" This allows the client the opportunity to discuss the matter further. The question, "Home means what to you?" seeks clarification. The statement, "It sounds as if you don't want to go home this weekend," reflects the technique of interpretation. The statement, "I doubt that you really should go home," offers the nurse's opinion and is judgmental.

A hospitalized client diagnosed with depression asks a nurse, "Should I go home this weekend?" Which response by the nurse uses the technique of reflection? a. "Should you go home for the weekend?" b. "Home means what to you?" c. "It sounds as if you don't want to go home this weekend." d. "I doubt that you really should go home this weekend."

b. Remind the client about the importance of boundaries to keep the relationship therapeutic Nurses need to set limits with clients so that the boundaries of the relationship remain intact. Becoming overly involved with clients in inappropriate ways is evidence of a lack of self-awareness (making extra visits when time does not allow for them or calling clients when off duty).

A nurse is conducting a 6-week social skills training program. A young adult with schizophrenia asks the nurse to call the client on the weekends so the client has someone to talk to who really cares. Which action should the nurse take? a. Tell the client the nurse will call once per week during office hours so that the client can practice phone skills b. Remind the client about the importance of boundaries to keep the relationship therapeutic c. Call the client once each weekend to build trust d. Tell the client to call the office answering service in case of an emergency

c. Use should be limited to emergencies in which the risk of a client physically harming self, staff, or others is imminent. Because of the risks of restraint and seclusion, a primary guideline is that use should be limited to emergencies in which the risk of a client physically harming self, staff, or others is imminent. Furthermore, restraint and seclusion should be applied only when other less restrictive methods to ensure client safety have failed. Nonphysical interventions are the first choice.

A nurse is considering using restraint and seclusion for a client who is acting out. Which is the primary guideline for the use of restraint and seclusion? a. Use should be limited to times when a client has demonstrated violence and has inflicted harm to self or others. b. Use should be limited to times when medications have been unsuccessful in de-escalating a situation. c. Use should be limited to emergencies in which the risk of a client physically harming self, staff, or others is imminent. d. Use should be limited to emergency situations in which the client is demonstrating a potential to be violent.

b. Negotiating a conversation with the client about the need to change Brief intervention involves a negotiated conversation between the nurse and the client that is designed to reduce the substance use. Asking the client questions about substance use refers to screening. Pointing out inconsistencies reflects confrontation. Helping the client change his or her way of thinking reflects a cognitive approach.

A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which action? a. Asking the client questions about alcohol use b. Negotiating a conversation with the client about the need to change c. Pointing out the inconsistencies in thoughts, feelings, and actions d. Helping the client change the way the client thinks about a situation

a. The nurse should address the client by name. b. The nurse should actively listen to the client. c. The nurse should respond openly to the client. Addressing the client by name, actively listening to the client, and responding openly and honestly to the client conveys positive regard. The nurse cannot practically be present all the time to look after the client. The nurse should try to spend some time with the client. The nurse cannot give the responsibility of planning therapy to the client. The nurse should consider the client's views while planning care. This action would also convey positive regard.

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. a. The nurse should address the client by name. b. The nurse should actively listen to the client. c. The nurse should respond openly to the client. d. The nurse should be available all the time for caring for the client. e. The nurse should give the responsibility of planning therapy to the client.

a. The loss of therapeutic effectiveness The priority reason the psychiatric nurse is careful to maintain professional boundaries with clients is to avoid the loss of therapeutic effectiveness. While the other options can result during the course of a relationship, none of them is the priority reason the psychiatric nurse is careful to maintain professional boundaries with clients.

Avoiding which outcome is the primary reason for establishing professional boundaries with clients? a. The loss of therapeutic effectiveness b. The possibility of losing control of the milieu c. The likelihood of a client becoming too dependent on the nurse d. The possibility of inappropriate sexual tension developing

a. Immediately approach the client to engage in communication The client's behavior and history of aggression indicates the nurse should explore the underlying cause of the escalating behavior in order to address the client's needs prior to moving into the escalation stage of aggression.

The nurse finds that a client with a history of aggressive behavior is restless, is pacing up and down in the hallway, and has clenched fists. The client also talks in a loud voice. Which intervention would be most appropriate at this point? a. Immediately approach the client to engage in communication b. Ask colleagues to contact hospital security for support c. Offer the client an antianxiolytic medication d. Prepare to seclude the client

A. "Will this conversation involve your desire to harm yourself?" Asking whether the conversation will involve the client's desire to hurt the client establishes whether the nurse can keep it confidential. Nurses may find it necessary to reassure a client that confidentiality will be maintained except when the information may be harmful to the client or others and except when the client threatens self-harm. The other options are not necessarily true; if the conversation does not affect the client's health or well-being, there is no reason to share the information with anyone. Further, if the conversation affects the client's health or well-being, it will be shared with the client's health care team. The option regarding the client's trust for the nurse is nursing-centered, not client-centered, and does not address the client's question.

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? A. "Will this conversation involve your desire to harm yourself?" B. "You know that I can't keep secrets from your health care team." C. "Without your permission I can't give any information to anyone." D. "Don't you trust me to respect your right to confidentiality?"