Ch 11 Davis advantage for psychiatric mental
health nursing
1. An angry client on an inpatient unit approaches a nurse, stating, "Someone
took my
lunch! People need to respect others, and you need to do something about this
now!"
The nurse's response should be guided by which basic assumption of milieu
therapy?
1. Conflict should be avoided at all costs on inpatient psychiatric units.
2. Conflict should be resolved by the nursing staff.
3. Every interaction is an opportunity for therapeutic intervention.
4. Conflict resolution should be addressed only during group therapy. - ANS - 3.
This is correct. Every interaction is an opportunity for therapeutic intervention.
\1. Which of the following are basic assumptions of milieu therapy? (Select all
that apply.)
a. The person owns his or her own environment.
b. Each person owns his or her behavior.
c. Peer pressure is a useful and powerful tool.
d. Inappropriate behaviors are punished immediately. - ANS - A
B
C
\10. A group of clients in a long-term psychiatric hospital setting complains to the
nurse that they feel like there's not much to do during the day. One client says, "It
seems like we're just sitting around watching TV all day." Which of these actions
by the nurse best supports a therapeutic milieu?
a. Instruct clients that the milieu is intentionally designed to provide for relaxation
and minimal structured activities.
b. Suggest that the clients organize some games and activities for their peers.
c. Instruct these clients that they should be focusing on getting better rather than
complaining.
d. Explore with clients and IDT members activities that would create more
structure and support treatment goals. - ANS - D
\10. Which dining arrangement would the nurse use to best promote a sense of
community?
1. Arrange tables for two around the dining room
2. Allow clients to take their meals to their rooms
, 3. Set up rectangular tables in the shape of a large square around the room to
seat
everyone
4. Arrange tables seating 5 or 6 clients around the dining room - ANS - 4. This is
correct. Small group seating arrangements are encouraged to promote a sense
of community and facilitate conversation.
\11. Which client would benefit most from working with a dietitian?
1. A client with anxiety
2. A client with schizophrenia
3. A client with pica
4. A client with bipolar disorder - ANS - 3. This is correct. A client with pica craves
unusual substances with no nutritional
value (such as clay or dirt) and would benefit from working with a dietitian to
replace nutrients.
\12. The psychiatric-mental health nurse understands the goal of milieu therapy is
which
of the following?
1. To structure the environment to ensure a therapeutic experience
2. To demand clients to be active participants in their therapy
3. To provide spontaneous opportunities for therapeutic interactions
4. To design a homelike atmosphere that encourages communication - ANS - 1.
This is correct. The goal of milieu therapy is to manipulate the environment so
that
all aspects of the client's hospital experience are considered therapeutic.
\13. A client tells the nurse she is anxious and loudly demands the nurse give her
lorazepam right now. The nurse replies, "I understand you are having anxiety;
however,
demanding medication in a loud voice is unacceptable behavior." Which type of
intervention is the nurse implementing?
1. Establishing trust
2. Limit setting
3. Validating feelings
4. Client teaching - ANS - 2. This is correct. The nurse is responsible for setting
limits on unacceptable behavior
in the therapeutic milieu. This requires stating to the client in understandable
terminology which behaviors are not acceptable. All staff must be consistent in
setting limits.
\2. A client on an inpatient unit angrily states to a nurse, "Peter is not cleaning up
after
himself in the community bathroom. You need to address this problem." Which
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