Mental Health - Week 3 - Ch 9 - EVOLVE Questions

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. Social distance (4-12 feet) is reserved for strangers or acquaintances. This is often the client's perception of staff during the initial phase of relationship-building. This behavior is not associated with any perception provided by any other option.

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?" This response uses the therapeutic technique of clarifying; it addresses the difference between the patient's verbal and nonverbal communication and encourages sharing of feelings. The other options do not address the patient's obvious distress or are confrontational and judgmental. None of the other options provides this support.

Which of the following statements represent a nontherapeutic communication technique? (Select all that apply.)

*"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."

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 Chinese Americans may not like to be touched by strangers since it is a cultural characteristics

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

A quiet section of the day room a quiet corner of the day room offers the safest, quietest, most private environment for a therapeutic encounter. None of the other options offer these characteristics.

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. Silence is not a "bad" thing. It gives the speaker time to think through a point or collect his or her thoughts. None of the other options will assist with further communication with this client.

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 Open-ended questions give the client the widest possible latitude in answering. Also, the client can take the lead in the interview. Seeking clarification helps the client clarify his or her own thoughts and promotes mutual understanding. None of the options provide this support.

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 Clarification verifies the nurse's interpretation of the client's message. None of the other options are associated with the verification of the client's meaning.

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 Clarification helps the nurse understand and correctly interpret the client's message. It gives the client the opportunity to correct misconceptions. This is not the purpose of any of the other options.

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. Verbal messages may be contradicted by the nonverbal message that is conveyed. The nonverbal message is usually more consistent with the client's feelings than the verbal message. None of the remaining options are so directly associated with assuring congruency.

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

Germany Eye contact conveys interest to most northern European individuals. Eye contact would be considered intrusive to the others.

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.

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 Reflecting conveys the nurse's observations of the client when a sensitive issue is being discussed. Exploring seeks to examine a certain idea more fully.

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?" This response acknowledges the speaker's perception of school as difficult and asks for further information. This response suggests the nurse is listening actively and is concerned.

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. This arrangement allows the nurse to observe the client but places no barriers between the principals. The two are at the same height, so neither is in an inferior position. Face-to-face seating is a more confrontational arrangement and therefore more anxiety producing.

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 By sitting and leaning in so closely, the nurse has entered into intimate space (0 to 18 inches), rather than social distance. This has likely made the patient may feel uncomfortable with being so close to someone unknown to them. All the other options lack evidence and jump to conclusions regarding the patient's behavior.

What is the focus during clinical supervision?

The nurse's behavior in the nurse-client relationship Clinical supervision helps the nurse look at his or her own behavior and determine more effective approaches to working with clients. None of the other options are associated with clinical supervision.

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. Showing little emotion while in distress may be a cultural phenomenon. Some cultures, such as the British and German cultures, tend to value highly the concept of self-control and may show little facial emotion in the presence of emotional turmoil. There is no evidence to suggest the patient's lack of emotion is a result of any of the other options.

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