1. 1. Question
Which nursing intervention is best for facilitating communication with
a psychiatric client who speaks a foreign language?
o A. Rely on nonverbal communication
o B. Select symbolic pictures as aids
o C. Speak in universal phrases
o D. Use the services of an interpreter
Incorrect
Correct Answer: D. Use the services of an interpreter
An interpreter will enable the nurse to better assess the client’s
problems and concerns. Language barriers pose challenges in terms of
achieving high levels of satisfaction among medical professionals and
patients, providing high- quality healthcare and maintaining patient
safety. To address these challenges, many larger healthcare
institutions offer interpreter services to improve healthcare access,
patient satisfaction, and communication.
Option A: Nonverbal communication is important; however for
the nurse to fully determine the client’s problems and concerns,
the assistance of an interpreter is essential. Language barriers
have negative implications for the delivery of healthcare and
patient satisfaction. One study showed that among patients who
received treatment from nurses who did not speak the local
language, 30% had difficulty understanding medical instructions,
30% had a problem with the reliability of information, and 50%
believed that the language barrier contributed to errors.
Option B: Online translation tools such as Google Translate and
MediBabble present possible solutions for overcoming these
challenges. Further studies on the implications of language
barriers and the effectiveness of online translation tools are
recommended. Furthermore, new updates with more medical
phrases for Google Translate and with more languages included
for MediBabble application are recommended.
Option C: The use of universal phrases may assist the nurse in
understanding the basic needs of the client; however these are
insufficient to assess the client with a psychiatric problem. Some
healthcare organizations use online translation tools such as
, Google Translate and MediBabble to address the challenges of
language barriers. These tools are free and easy to access, and
they contribute to improving healthcare delivery, patient safety,
and increase (up to 92%) the satisfaction of both medical
professionals and patients.
2. 2. Question
The nurse explains to a mental health care technician that a client’s
obsessive-compulsive behaviors are related to an unconscious conflict
between id impulses and the superego (or conscience). On which of
the following theories does the nurse base this statement?
A. Behavioral theory
B. Cognitive theory
C. Interpersonal theory
D. Psychoanalytic theory
Incorrect
Correct Answer: D. Psychoanalytic theory
Psychoanalytic is based on Freud’s beliefs regarding the importance of
unconscious motivation for behavior and the role of the id and
superego in opposition to each other. Psychoanalysis is defined as a
set of psychological theories and therapeutic methods which have their
origin in the work and theories of Sigmund Freud . The primary
assumption of psychoanalysis is the belief that all people possess
unconscious thoughts, feelings, desires, and memories. The aim of
psychoanalysis therapy is to release repressed emotions and
experiences, i.e., make the unconscious conscious. It is only having a
cathartic (i.e., healing) experience can the person be helped and
“cured.”
Option A: Behaviorism, also known as behavioral psychology, is
a theory of learning based on the idea that all behaviors are
acquired through conditioning. Conditioning occurs through
interaction with the environment. Behaviorists believe that our
responses to environmental stimuli shape our actions. According
to this school of thought, behavior can be studied in a systematic
and observable manner regardless of internal mental states.
According to this perspective, only observable behavior should be
, considered—cognitions, emotions, and moods are far too
subjective.
Option B: Cognitive theory is an approach to psychology that
attempts to explain human behavior by understanding your
thought processes. For example, a therapist is using principles of
cognitive theory when they teach you how to identify
maladaptive thought patterns and transform them into
constructive ones. The assumption of cognitive theory is that
thoughts are the primary determinants of emotions and behavior.
Information processing is a common description of this mental
process. Theorists compare the way the human mind functions to
a computer.
Option C: Interpersonal theory emphasizes the importance of
various developmental stages—infancy, childhood, the juvenile
era, preadolescence, early adolescence, late adolescence, and
adulthood. Like Freud and Jung, Sullivan (1953b) saw personality
as an energy system. Energy can exist either as tension
(potentiality for action) or as actions themselves (energy
transformations). Energy transformations transform tensions into
either covert or overt behaviors and are aimed at satisfying
needs and reducing anxiety.
3. 3. Question
The nurse observes a client pacing in the hall. Which statement by the
nurse may help the client recognize his anxiety?
A. “I guess you’re worried about something, aren’t you?
B. “Can I get you some medication to help calm you?”
C. “Have you been pacing for a long time?”
D. “I notice that you’re pacing. How are you feeling?”
Incorrect
Correct Answer: D. “I notice that you’re pacing. How are you
feeling?”
By acknowledging the observed behavior and asking the client to
express his feelings the nurse can best assist the client to become
aware of his anxiety. Recognition acknowledges a patient’s behavior
and highlights it without giving an overt compliment. A compliment
, can sometimes be taken as condescending, especially when it
concerns a routine task like making the bed. However, saying
something like “I noticed you took all of your medications” draws
attention to the action and encourages it without requiring a
compliment.
Option A: The nurse is offering an interpretation that may or
may not be accurate; the nurse is also asking a question that
may be answered by a “yes” or “no” response, which is not
therapeutic. Therapeutic communication is often most effective
when patients direct the flow of conversation and decide what to
talk about. To that end, giving patients a broad opening such as
“What’s on your mind today?” or “What would you like to talk
about?” can be a good way to allow patients an opportunity to
discuss what’s on their mind.
Option B: The nurse is intervening before accurately assessing
the problem. By using nonverbal and verbal cues such as nodding
and saying “I see,” nurses can encourage patients to continue
talking. Active listening involves showing interest in what patients
have to say, acknowledging that you’re listening and
understanding, and engaging with them throughout the
conversation. Nurses can offer general leads such as “What
happened next?” to guide the conversation or propel it forward.
Option C: This statement encourages a “yes” or “no” response,
avoids focusing on the client’s anxiety, which is the reason for his
pacing. Observations about the appearance, demeanor, or
behavior of patients can help draw attention to areas that might
pose a problem for them. Observing that they look tired may
prompt patients to explain why they haven’t been getting much
sleep lately; making an observation that they haven’t been
eating much may lead to the discovery of a new symptom.
4. 4. Question
A client with obsessive-compulsive disorder is hospitalized in an
inpatient unit. Which nursing response is most therapeutic?
A. Accepting the client’s obsessive-compulsive behaviors.
B. Challenging the client’s obsessive-compulsive behaviors.
C. Preventing the client’s obsessive-compulsive behaviors.