Test bank for davis advantage for psychiatric mental health nursing 10th edition morgan full chapter
TTest Bank For Davis Advantage for Psychiatric Mental Health Nursing 10th Edition By Karyn I. Morgan; Mary C. Townsend
Test Bank for Davis Advantage for Psychiatric Mental Health Nursing, 10th Edition, Karyn I. Morgan, Mary C. Townsend Chapter 1-43|Complete Guide A+
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Test Bank for Davis Advantage for Psychiatric Mental Health
Nursing, 10th Edition, Karyn I. Morgan, Mary C. Townsend
Chapter 1-43| 9780803699670 | All Chapters with Answers
and Rationals
A client has been voluntarily admitted to an inpatient psychiatric unit. After evaluation, the treatment
team has determined that the client is a danger to self. The client states, "I now want to leave." Which
is the priority nursing intervention?
1. Teach the client the benefits of psychiatric interventions.
2. Notify the treatment team of the client's intentions.
3. Initiate forced medication protocols, and administer antianxiety medications STAT.
4. Provide the client with forms related to leaving "against medical advice" (AMA). - ANSWER: ANS: 2
#1: Incorrect. Teaching the client about the benefits of psychiatric interventions would be
inappropriate at this time and would not address the immediate client safety risk.
#2: Correct. This is the priority intervention for the nurse. Because the treatment team believes this
client is a danger to self, the physician can change the admission status by submitting appropriate
court paperwork to hold a client against his or her will for a legally determined period. State law
determines the amount of time a client can be held.
#3 Incorrect. Only if the client is an immediate danger to self or others can forced medication be
administered.
#4 Incorrect. If the client is determined to be a danger to self, leaving "against medical advice" (AMA)
is not an option, and therefore this intervention is not appropriate.
Which therapeutic communication technique is an example of "making an observation"?
1. "You say you're happy, but I notice that you're frowning."
2. "Are you saying that you want to be seen in the outpatient clinic?"
3. "Tell me again about your divorce and your feelings during that time."
4. "I see you are wringing your hands. Tell me what you're thinking." - ANSWER: ANS: 4
#1 Incorrect. This is an example of "confrontation," not "making an observation." The nurse uses a
therapeutic technique of "confrontation" to bring incongruence or inconsistencies into awareness.
#2 Incorrect. This is an example of "clarification," not "making an observation." The nurse uses the
therapeutic technique of "clarification" to check the understanding of what has been said by the
client and helps the client make his or her thoughts or feelings more explicit.
#3 Incorrect. This is an example of "focusing," not "making an observation." The nurse uses the
therapeutic technique of "focusing" to direct the conversation on a particular topic of importance or
relevance to the client.
#4 Correct. When the nurse notices what the client is doing, in this case "wringing the hands," the
nurse is using the therapeutic communication technique of "making an observation."
A client on an inpatient psychiatric unit has been raised in an extremely religious and judgmental
family. The client exhibits uncontrolled guilt and poor self-esteem. Applying psychoanalytic theory,
which is true?
1. The client is experiencing guilt as a result of inherited tendencies from parents.
2. The client is having developmental issues associated with industry versus inferiority.
3. The client had an inconsistent mother figure during separation-individuation.
4. The client is experiencing poor self-worth as a result of an overdeveloped superego. - ANSWER:
ANS: 4
,#1 Incorrect. Inherited tendencies are not part of psychoanalytic theory. Biological theory describes
the etiology of mental illness based on genetic predisposition.
#2 Incorrect. Because age is not presented in the question, it is impossible to determine the client's
stage of development according to Erikson. The age range for the developmental conflict of industry
versus inferiority is 6 to 12 years.
#3 Incorrect. An inconsistent mother figure during separation-individuation is part of Mahler's theory
of object relations, not psychoanalytic theory. Inconsistency during subphase 3 of separation-
individuation, called rapprochement, can cause self-esteem and abandonment issues.
#4 Correct. According to psychoanalytic theory, struggles with uncontrolled guilt and poor self-esteem
arise from the overdevelopment of the superego. The superego, which develops between the ages of
3 and 6, internalizes the values and morals set forth by primary caregivers. When these caregivers are
rigid and judgmental, overdevelopment can occur, leading to uncontrolled guilt and poor self-esteem.
A client on an inpatient unit states, "Did they tell you that I killed my cat?" The nurse maintains an
open posture, maintains eye contact, and leans toward the client. Which describes the purpose of the
nurse's action?
1. To provide time for the nurse and client to gather thoughts and reflect
2. To present new ideas for consideration
3. To take note and expand on a single topic of conversation
4. To have the client choose a topic of conversation - ANSWER: ANS: 1
#1 Correct. The therapeutic communication technique being used here is "silence." The purpose of
silence is to provide time for the nurse and client to gather thoughts and reflect. Also, if the topic of
conversation is controversial or disturbing, the nurse buys time to avoid a spontaneous negative
reaction.
#2 Incorrect. Presenting new ideas for consideration is the purpose of the therapeutic communication
technique of "suggesting," not "silence."
#3 Incorrect. To assist the client to take note of a single idea or even a single word is the purpose of
the therapeutic communication technique of "focusing," not "silence."
#4 Incorrect. The therapeutic communication technique of a "broad opening," not "silence," is used to
help the client initiate the conversation and puts the client in control of the content.
A client experiencing agitation states, "I'm ready to jump out of my skin." Which nursing response
would be an example of the therapeutic communication technique of restating?
1. "What do you mean by 'jumping out of your skin'?"
2. "You're ready to jump out of your skin?"
3. "I hate to hear you make such a comment."
4. "Why do you feel like you are going to jump out of your skin?" - ANSWER: ANS: 2
#1 Incorrect. By asking, "What do you mean by 'jumping out of your skin'?" the nurse is striving to
understand that which is vague and incomprehensible and searching for mutual understanding. This is
the therapeutic communication technique of clarification, not restating.
#2 Correct. By asking, "You're ready to jump out of your skin?" the nurse is using the therapeutic
technique of restating. This technique lets the client know that the nurse is engaged in the
conversation and encourages the client to continue discussing the topic at hand.
#3 Incorrect. By stating, "I hate to hear you make such a comment," the nurse is using the
nontherapeutic block to communication of rejecting. By using this block the nurse refuses to consider
the client's ideas and may be communicating contempt.
#4 Incorrect. By asking, "Why do you feel like you are going to jump out of your skin?" the nurse is
using the nontherapeutic communication block of requesting an explanation. By using this
intimidating block to communication, the nurse asks the client to provide the reasons for thoughts,
feelings, behaviors, and events. This implies that the client must defend his or her behaviors and
feelings.
, Which of the following physician situations reflect the ethical principle of veracity? Select all that
apply.
1. The physician decides not to tell the client about the stage 4 cancer diagnosis because it would take
away hope.
2. The physician volunteers at a free clinic to provide care for the indigent.
3. The physician provides and explains to the client the positive results of the client's HIV test.
4. The physician refuses to give out confidential information over the telephone.
5. The physician reviews the risks, benefits, and interactions of the client's newly prescribed
medication. - ANSWER: ANS: 3, 5
Answer 1 is incorrect because in this scenario, the physician has withheld information. Because
veracity refers to the duty to always be truthful and not mislead, this is not reflective of this ethical
principle. Answer 2 is incorrect because this situation is reflective of beneficence, not veracity.
Beneficence is the duty to benefit or promote the good of others. Answer 3 is correct because the
physician is not misleading the client and is providing truthful data; the physician is implementing the
ethical principle of veracity. Answer 4 is incorrect because this situation is reflective of
nonmaleficence—the duty to do no harm, such as divulging a professionally held confidence—not
veracity. Answer 5 is correct because the physician is not misleading the client and is providing
truthful data; the physician is implementing the ethical principle of veracity.
A client states, "I don't know why I should go to group therapy, so I don't want to go." Which nursing
statement is an example of the nontherapeutic communication block of "giving advice"?
1. "If I were you, I would attend groups in order to get better."
2. "The doctor wouldn't prescribe these treatments if they were harmful."
3. "Do you feel this way about all your therapies?"
4. "Let me tell you about how group therapy works." - ANSWER: ANS: 1
#1 Correct. Here the nurse is "giving advice," which is a nontherapeutic block to communication
because the statement does not allow the client to make personal decisions.
#2 Incorrect. This is an example of "defending," not "giving advice." This statement is a
nontherapeutic block to communication because it would put the client on the defensive.
#3Incorrect. This is an example of "exploring," but the nurse has changed the topic and ignored the
client's concerns. This introduction of an unrelated topic is a nontherapeutic block to communication.
#4 Incorrect. This is an example of "giving information," not "giving advice." Here, the nurse has
assessed from the client's statement that information is needed. Also "giving information" is a
therapeutic, not nontherapeutic, communication technique.
Which therapeutic communication exchange is an example of "restating"?
1. Client: "I get depressed because I know I'm going to lose the game."Nurse: "So, you start feeling sad
every time you play a game?"
2. Client: "I forgot to attend group therapy this morning."Nurse: "Attending all therapies may reduce
your symptoms."
3. Client: "I hate my passive nature."Nurse: "Have you considered assertiveness training?"
4. Client: "I'm happy that I divorced my wife."Nurse: "You were happy to have divorced your wife?" -
ANSWER: ANS: 4
#1 Incorrect. This is an example of "reflection," not "restating." This technique is used when directing
back what the nurse understands in regard to the client's ideas, feelings, questions, and content.
"Reflection" is used to put the client's feelings in the context of when and where they occur.
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