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NSG Exam 1 - Psychiatric/Mental Health Nursing practice questions
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NSG Exam 1 - Psychiatric/Mental HealthNursing practice questions
A patient says to the nurse, "I dreamed I was stoned. When I
woke up, I felt emotionally drained, as though I hadn't rested
well." Which response should the nurse use to clarify the patient's
comment?
a. "It sounds as though you were uncomfortable with the content
of your dream."
b. "I understand what you're saying. Bad dreams leave me feeling
tired, too."
c. "So you feel as though you did not get enough quality sleep last
night?"
d. "Can you give me an example of what you mean by 'stoned'?" -
ANSWER>> : D
The technique of clarification is therapeutic and helps the nurse
examine the meaning of the patient's statement. Asking for a
definition of "stoned" directly asks for clarification. Restating that
the patient is uncomfortable with the dream's content is parroting,
a non-therapeutic technique. The other responses fail to clarify
the meaning of the patient's comment.
A patient diagnosed with schizophrenia tells the nurse, "The CIA
is monitoring us through the fluorescent lights in this room. Be
careful what you say." Which response by the nurse would be
most therapeutic?
a. "Let's talk about something other than the CIA."
b. "It sounds like you're concerned about your privacy."
c. "The CIA is prohibited from operating in health care facilities."
d. "You have lost touch with reality, which is a symptom of your
illness." - ANSWER>> : B
It is important not to challenge the patient's beliefs, even if they
are unrealistic. Challenging undermines the patient's trust in the
nurse. The nurse should try to understand the underlying feelings
,or thoughts the patient's message conveys. The correct response
uses the therapeutic technique of reflection. The other comments
are non-therapeutic. Asking to talk about something other than
the concern at hand is changing the subject. Saying that the CIA
is prohibited from operating in health care facilities gives false
reassurance. Stating that the patient has lost touch with reality is
truthful, but uncompassionate.
The patient says, "My marriage is just great. My spouse and I
always agree." The nurse observes the patient's foot moving
continuously as the patient twirls a shirt button. The conclusion
the nurse can draw is that the patient's communication is:
a. clear.
b. mixed.
c. precise.
d. inadequate. - ANSWER>> : B
Mixed messages involve the trAnswer>> mission of conflicting
or incongruent messages by the speaker. The patient's verbal
message that all was well in the relationship was modified by the
nonverbal behaviors denoting anxiety. Data are not present to
support the choice of the verbal message being clear, explicit, or
inadequate.
A nurse interacts with a newly hospitalized patient. Select the
nurse's comment that applies the communication technique of
"offering self."
a. "I've also had traumatic life experiences. Maybe it would help if
I told you about them."
b. "Why do you think you had so much difficulty adjusting to this
change in your life?"
c. "I hope you will feel better after getting accustomed to how this
unit operates."
d. "I'd like to sit with you for a while to help you get comfortable
talking to me." - ANSWER>> : D
,"Offering self" is a technique that should be used in the orientation
phase of the nurse-patient relationship. Sitting with the patient, an
example of "offering self," helps to build trust and convey that the
nurse cares about the patient. Two incorrect responses are
ineffective and non-therapeutic. The other incorrect response is
therapeutic but is an example of "offering hope."
Which technique will best communicate to a patient that the nurse
is interested in listening?
a. Restating a feeling or thought the patient has expressed.
b. Asking a direct question, such as "Did you feel angry?"
c. Making a judgment about the patient's problem.
d. Saying, "I understand what you're saying." - ANSWER>> : A
Restating allows the patient to validate the nurse's understanding
of what has been communicated. Restating is an active listening
technique. Judgments should be suspended in a nurse-patient
relationship. Close-ended questions such as "Did you feel angry?"
ask for specific information rather than showing understanding.
When the nurse simply states that he or she understands the
patient's words, the patient has no way of measuring the
understanding.
A patient discloses several concerns and associated feelings. If
the nurse wants to seek clarification, which comment would be
appropriate?
a. "What are the common elements here?"
b. "Tell me again about your experiences."
c. "Am I correct in understanding that . . ."
d. "Tell me everything from the beginning." - ANSWER>> : C
Asking, "Am I correct in understanding that..." permits clarification
to ensure that both the nurse and patient share mutual
understanding of the communication. Asking about common
elements encourages comparison rather than clarification. The
, remaining responses are implied questions that suggest the nurse
was not listening.
A patient tells the nurse, "I don't think I'll ever get out of here."
Select the nurse's most therapeutic response.
a. "Don't talk that way. Of course you will leave here!"
b. "Keep up the good work, and you certainly will."
c. "You don't think you're making progress?"
d. "Everyone feels that way sometimes." - ANSWER>> : C
By asking if the patient does not believe that progress has been
made, the nurse is reflecting by putting into words what the
patient is hinting. By making communication more explicit, issues
are easier to identify and resolve. The remaining options are non-
therapeutic techniques. Telling the patient not to "talk that way" is
disapproving. Saying that everyone feels that way at times
minimizes feelings. Telling the patient that good work will always
result in success is falsely reassuring.
Documentation in a patient's chart shows, "Throughout a 5-minute
interaction, patient fidgeted and tapped left foot, periodically
covered face with hands, and looked under chair while stating, 'I
enjoy spending time with you.'" Which analysis is most accurate?
a. The patient is giving positive feedback about the nurse's
communication techniques.
b. The nurse is viewing the patient's behavior through a cultural
filter.
c. The patient's verbal and nonverbal messages are incongruent.
d. The patient is demonstrating psychotic behaviors. -
ANSWER>> : C
When a verbal message is not reinforced with nonverbal
behavior, the message is confusing and incongruent. Some
cliniciAnswer>> call it a "mixed message." It is inaccurate to
say that the patient is giving positive feedback about the nurse's
communication techniques. The concept of a cultural filter is not
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