PrepU Ques Week 2

During a conversation with a client, the client asks the nurse what should be done about the client's "cheating" spouse. The nurse replies, "You should divorce. You deserve better than that." Which nontherapeutic communication technique did the nurse use in the response to the client?

Giving advice

A nurse is assessing a client's immediate and short-term memory. Which would be most appropriate?

Giving the client three words and asking the client to recite them now and then again in 5 minutes

When the group leader uses team-building exercises, the leader is trying to promote what?

Group cohesiveness

A nurse is leading a group and notes that the group members are adopting opinions that are consistent with the nurse as the leader. The nurse interprets this as which situation?

Groupthink

When the nurse asks the client, "If you found a stamped addressed envelope on the ground, what would you do?" The nurse is assessing which component of the assessment?

Judgment

Which indicates that the nurse, acting as a leader for a group of recovering clients with alcohol abuse, is addressing the responsibility of maintaining the group's process?

Keeping the group on task by restating goals

In the space of five minutes, the client has been laughing and euphoric, then angry, and then crying for no reason that is apparent to the nurse. This behavior would be best described as ...

Labile mood

A nurse interviews a new client in the day room of the psychiatric unit. The nurse is wearing a jacket and a bag and frequently asks the client to repeat the last statement. The nurse's demeanor with the client is reflective of what?

Lacking genuine interest

For a psychiatric client's expected outcomes to be appropriate they must be ...

Measurable and realistic

After spending 15 minutes talking with a client, the client leaves the interaction feeling defensive. This is evidence that the communication can be described as what?

Nontherapeutic

The nurse watches the expressions the client is making as group therapy is conducted. Which statement about verbal and nonverbal communication skills is accurate?

Nonverbal communication is as important, if not more than, verbal communication.

When initiating an assessment, the nurse should use which type of questioning?

Open-ended questions

It is the nurse's responsibility to define the boundaries of the relationship during which phase of the nurse-client relationship?

Orientation

When the mental health nurse asks the client, "Do you recall what month and year this is?" the nurse is assessing which part of the mental status examination?

Orientation

A nurse is caring for a client on an inpatient mental health unit of a hospital. The nurse tells the client, "You are scheduled to attend therapy sessions every morning at 9:00 a.m. Please make sure that you complete your morning routine, such as using the restroom, bathing, and eating breakfast, before you come for the sessions." Which phase of the nurse-client relationship does this communication indicate, according to the Peplau's model?

Orientation phase

Considering the nature of its content, which areas may be the most uncomfortable or difficult for the nurse to assess?

Sexuality

During a group therapy session, a nurse restates the interaction with the client to check the client's meaning. The nurse is using which technique?

clarification

Enhancing knowledge and improving skills to solve problems, including task groups, refer to ...

psychoeducational groups.

What is part of the social component in a psychiatric-mental health nursing assessment?

quality of life

The most important tool of psychiatric nursing is the:

self.

A client diagnosed with borderline personality disorder is pitting one nurse against the other, calling one a best friend and declaring that the other is horrible. The client is using which defense mechanism?

splitting

A nurse is assessing a client's spirituality. Which question would be most appropriate to ask?

"What gives your life meaning?"

A client is being admitted to the psychiatric unit. The client explains their reason for seeking admission, describing how their 32-year-old son recently died of a heart attack. Which response by the nurse would enhance the effectiveness of this interview?

"This must be a very difficult time for you."

The nurse is trying to obtain some information about family relationships from the client. Which statement is best to obtain the information?

"Tell me your feelings about your family situation."

Which statement is the most empathic response to a client's disclosure that the client's father abandoned the family when the client was a young child?

"That must have been terribly hurtful experience for you."

A client's nursing diagnosis of "risk for self-directed violence" has been identified because of her recent history of cutting and self-mutilation. Which of the following expected outcomes is most appropriate for this client's plan of care during inpatient treatment?

"The client will refrain from cutting or self-mutilation."

A client states to the nurse, "my parent screamed at me in front of several people in the grocery store when I dropped the eggs." Which statement will be an empathetic response to this client?

"You must have been embarrassed when your parent yelled at you in the grocery store."

A client states, "It's been so long since I've been with my family." Which statement by the nurse demonstrates restating of the client's sentence?

"You say you haven't seen your family in a while."

During an admission assessment, the nurse asks a client the meaning of the proverb, "People in glass houses should not throw stones." Which clinical feature is the nurse assessing?

Abstract reasoning

A 35-year-old was discharged from care after recovery from depression. The nurse therapist and the client spent many hours working through issues related to the depression. Six months later, the client is admitted again for depression associated with issues similar to those that were previously addressed in the client's therapy. The nurse therapist says to a coworker, "This is unbelievable; we're back at square one again. The client should know better at this point." The nurse's comments reflect what?

A judgmental attitude

Which communication technique does a nurse use in establishing trust and developing empathy?

Acceptance

A teenager is mad at the teenager's parents about not being able to drive the father's car. The teenager begins to stay out late with friends after curfew. What defense mechanism is the teenager using?

Acting out

The nurse has been asked to sit in and observe a support group for individuals who were once addicted to drugs. The nurse notices that one group member disagrees with statements made by all other group members. What role is this individual playing in the group?

Blocker

A client is yelling, pacing, and becoming violent toward staff members. What technique should be tried first to control the situation initially?

Deescalation

A male client comes to the emergency department and appears to be intoxicated. He fell and hit his head at home and has a minor laceration. The nurse asks when his last drink was. The client states that he didn't have a drink and "never touches the stuff." The client is exhibiting which defense mechanism?

Denial

In what phase of the therapeutic relationship does the assessment process begin?

During the initiating or orienting phase

The nurse is in the process of developing a therapeutic nurse-client relationship with a newly admitted client. Which is the most important behavior the nurse demonstrates to enhance the relationship?

Empathy

The nurse is performing an admission assessment for a client on the behavioral health unit with depression and anxiety. Which goal of therapeutic communication will the nurse prioritize?

Establish a therapeutic nurse-client relationship.

A 22-year-old client who has been diagnosed with paranoid personality disorder has been receiving treatment. The final stage of the nursing process in the care of this client should focus on what?

Evaluating the effectiveness of the treatment

A nurse has been asked to complete a mental status examination of a psychiatric-mental health client. Which is a necessary component of this assessment?

Evaluation of insight and judgment

Which of the following is an accepting body position for therapeutic communication?

Hands at the side of the body

Which theorist was most widely known for the belief that the cornerstone of all nursing care is the therapeutic relationship?

Hildegard Peplau

When the nurse asks the client, "Are you thinking about killing yourself?" The nurse is questioning which component of a suicide assessment?

Ideation

A nurse develops a plan of care for a client with an eating disorder. The plan includes developing a contract with the client to modify behavior. What is the next step?

Implement nursing actions that have been identified

Which should the nurse expect may be a common problem of the members of an anger management group?

Impulsiveness

When a client talks about the recent loss of a family member while laughing or smiling, this type of affect would be labeled as which of the following?

Inappropriate

A mental health nurse is caring for a client with schizophrenia. The nurse observes the client laughing about the recent death of the client's father. The nurse would correctly document this mood as what?

Incongruent

A nurse awaits the arrival of a client who is being transferred from a nursing home. The client has a history of schizophrenia and has been behaving bizarrely. The nurse begins preparing the plan of care by outlining expected outcomes. The nurse's actions are which of the following?

Inconsistent with the nursing process, because assessment always comes first

The nurse is conducting a presentation on the importance of medication compliance to a community group. Which zone is an acceptable distance between a speaker and an audience?

Public

Which would not be considered a goal of therapeutic communication?

Self-exploration of feelings by the nurse

An experienced nurse is observing a novice nurse communicating with a client. Which behavior by the new nurse would the experienced nurse evaluate as evidence of positive body language?

Sitting at the client's eye level

A client has undergone diagnostic testing to determine whether she has breast cancer. She goes shopping at the mall to stop thinking about the possibility of cancer. She is using which of the following defense mechanisms?

Suppression

During which stage of group development may the group grieve the loss of group cohesiveness?

Termination

Because of his fear of poisoning, a client with a diagnosis of schizophrenia has severely limited his food intake over the past several months, causing a weight loss of nearly 40 pounds. What consideration would be the priority in the planning of this client's care?

The client's nutritional status

In planning the care of a client who has been admitted to the hospital after a suicide attempt, an expected outcome should relate directly to what?

The client's refraining from suicide attempts

When conducting a psycho-social assessment, the nurse inquires about the client's social supports. In order to effectively do this, which does the nurse need to explore?

The length and quality of relationships

Which observation should lead the nurse manager to recognize that countertransference is affecting the therapeutic effectiveness of an individual nurse on the unit?

The nurse frequently refers to an elderly, cognitively impaired client as "my granny"

It is brought to the nurse administrator's attention that a nurse has developed an intimate relationship with a client. Which behavior indicates the nurse has engaged in an intimate relationship with a client?

The nurse is having dinner with a client outside the hospital premises.

Which is inconsistent with principles of therapeutic communication?

The nurse is the primary focus of the relationship.

Which is an accurate characteristic of small groups?

They are usually no more than seven to eight members.

Which aspect of the mental status exam refers to information about how the client's thoughts connect to one another?

Thought process

The psychiatric nurse recognizes that excessive social communication with a client is to be avoided primarily due to which reason?

To prevent the client from viewing the nurse as a friend rather than health care provider

The client tells the nurse, "I don't think you can help me. Every time I talk to you, I am reminded of my mother, and I hated her." How does the nurse interpret this behavior?

Transference

Termination takes place during the resolution phase of a nurse-client relationship. During the termination process, a client brings up resolved problems and presents them as new issues toward which to work. The nurse interprets the client's action as indicating what feeling in the client?

Wish to prolong the nurse-client relationship.

A nurse is completing a mental health assessment. When the nurse asks a client to interpret a proverb, the nurse is assessing:

abstract reasoning

A nurse documents that "the client describes the recent breakup of a dating relationship with an emotionless tone and a flat facial expression." In which section of the mental status exam would the nurse have documented this statement?

affect

When arranging seating for a group, the nurse needs to consider ...

arranging chairs in a circle with chairs close to one another.

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:

become aware of possible barriers to developing therapeutic relationships.

When observing a client diagnosed with mania, the nurse observes his mood to be elated. What is another term for this type of mood?

euphoric

A nurse is completing an assessment interview, and is attempting to bring the conversation back to the questions at hand when the client goes off on a tangent. Which assessment interview behavior is the nurse using?

focusing