Psychiatric Mental Health Nursing with Questions and Accurate Answers and Detailed Rationales
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Course
Psychiatric/mental Health Nursing
Institution
Psychiatric/mental Health Nursing
Psychiatric Mental Health Nursing with
Questions and Accurate Answers and
Detailed Rationales
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 nurs...
Psychiatric Mental Health Nursing with
Questions and Accurate Answers and
Detailed Rationales
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. Correct Answer ANS: B
Mixed messages involve the transmission 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." Correct Answer ANS: 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." Correct Answer
ANS: 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." Correct Answer ANS:
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." Correct Answer ANS: 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. Correct
Answer ANS: C
When a verbal message is not reinforced with nonverbal
behavior, the message is confusing and incongruent. Some
clinicians 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
relevant to the situation because a cultural filter determines what
we will pay attention to and what we will ignore. Data are
insufficient to draw the conclusion that the patient is
demonstrating psychotic behaviors.
, While talking with a patient diagnosed with major depression, a
nurse notices the patient is unable to maintain eye contact. The
patient's chin lowers to the chest, while the patient looks at the
floor. Which aspect of communication has the nurse assessed?
a. Nonverbal communication
b. A message filter
c. A cultural barrier
d. Social skills Correct Answer ANS: A
Eye contact and body movements are considered nonverbal
communication. There are insufficient data to determine the level
of the patient's social skills or whether a cultural barrier exists.
During the first interview with a parent whose child died in a car
accident, the nurse feels empathic and reaches out to take the
patient's hand. Select the correct analysis of the nurse's behavior.
a. It shows empathy and compassion. It will encourage the patient
to continue to express feelings.
b. The gesture is premature. The patient's cultural and individual
interpretation of touch is unknown.
c. The patient will perceive the gesture as intrusive and
overstepping boundaries.
d. The action is inappropriate. Psychiatric patients should not be
touched. Correct Answer ANS: B
Touch has various cultural and individual interpretations. Nurses
should refrain from using touch until an assessment can be made
regarding the way in which the patient will perceive touch. The
other options present prematurely drawn conclusions.
During a one-on-one interaction with the nurse, a patient
frequently looks nervously at the door. Select the best comment
by the nurse regarding this nonverbal communication.
a. "I notice you keep looking toward the door."
b. "This is our time together. No one is going to interrupt us."
c. "It looks as if you are eager to end our discussion for today."
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