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A psychotherapist works with an anxious, dependent patient. Which strategy is most consistent with psychoanalytic psychotherapy?
- A. Identifying the patient's strengths and assets
- B. Praising the patient for describing feelings of isolation
- C. Focusing on feelings developed by the patient toward the therapist
- D. Providing psychoeducation and emphasizing medication adherence
Correct Answer: C
Rationale: The correct answer is C because focusing on the patient's feelings developed towards the therapist is consistent with psychoanalytic therapy. This approach allows the therapist to explore transference and countertransference dynamics, which are central in understanding the patient's inner conflicts and relational patterns. By addressing these feelings, the therapist can help the patient gain insight into unresolved issues from their past that are influencing their current behavior.
Choice A is incorrect because while it can be beneficial in therapy, it is more aligned with a strengths-based or humanistic approach rather than psychoanalytic therapy. Choice B is also incorrect because praising the patient for describing feelings of isolation does not directly address the deeper unconscious processes that psychoanalytic therapy aims to explore. Choice D is incorrect because providing psychoeducation and emphasizing medication adherence are more commonly associated with cognitive-behavioral or medication-focused therapies, rather than psychoanalytic therapy.
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A client on a psychiatric unit is telling the nurse about anger toward the airline after losing an only child in a plane crash. In which situation is the nurse demonstrating active listening?
- A. Agreeing with the client.
- B. Repeating everything that the client says to clarify.
- C. Assuming a relaxed posture and leaning toward the client.
- D. Expressing sorrow and sadness regarding the client's loss.
Correct Answer: C
Rationale: The correct answer is C because assuming a relaxed posture and leaning toward the client demonstrates active listening by showing empathy and interest in what the client is saying. This nonverbal behavior encourages the client to continue expressing their feelings.
A: Agreeing with the client can shut down communication and invalidate the client's emotions.
B: Repeating everything the client says may come across as robotic and not conducive to building rapport.
D: Expressing sorrow and sadness, while empathetic, may shift the focus from the client to the nurse's emotions.
In summary, actively listening involves nonverbal cues that show understanding and support without interjecting personal opinions or emotions.
The nurse is counseling a parent whose child has a communication disorder. Which of the following would the nurse emphasize when teaching the parent about this disorder?
- A. Providing the child with nonverbal activities
- B. Initiating conversations with the child frequently
- C. Stopping the child's conversation if stuttering begins
- D. Asking the physician for medication to improve the child's speech
Correct Answer: B
Rationale: The correct answer is B: Initiating conversations with the child frequently. This is important as it helps the child practice communication skills and improves their confidence. By engaging in regular conversations, the child gets more opportunities to develop their speech and language abilities. Option A is incorrect as solely focusing on nonverbal activities may neglect the child's speech development. Option C is incorrect as stopping the child's conversation when stuttering begins can lead to frustration and hinder progress. Option D is incorrect as medication is not typically the primary treatment for communication disorders in children.
A nurse documents: "Patient is mute despite repeated efforts to elicit speech. Makes no eye contact. Inattentive to staff. Gazes off to the side or looks upward rather than at speaker." Which nursing diagnosis should be considered?
- A. Defensive coping
- B. Decisional conflict
- C. Risk for other-directed violence
- D. Impaired verbal communication
Correct Answer: D
Rationale: The correct answer is D: Impaired verbal communication. The patient's inability to speak, make eye contact, and focus on the speaker indicates a communication issue. Impaired verbal communication relates to difficulty expressing thoughts, feelings, or needs. The patient's behavior aligns with this diagnosis as they are mute, inattentive, and not making eye contact. Defensive coping (A) involves protecting oneself from emotional pain. Decisional conflict (B) pertains to uncertainty about choices. Risk for other-directed violence (C) involves potential harm to others, which is not evident in the scenario. Thus, D is the most appropriate nursing diagnosis.
Johnny is twelve-year-old boy who has had an increase in aggressive behaviors, picking fights with other students at his school. Johnny's mother calls his doctor's office to ask if there is medication to help decrease these behaviors. After gathering more information about the recent increase in Johnny's outbursts, what is the best response from the nurse?
- A. Allow more freedom at home as that may be adding to his outbursts.'
- B. Medication may not be indicated right away; there are other options.'
- C. Tell Johnny that his behavior is unacceptable.'
- D. Allow Johnny to skip school if he is having a difficult time being there.'
Correct Answer: B
Rationale: The correct answer is B: Medication may not be indicated right away; there are other options.
Rationale:
1. Medication should not be the first line of intervention for behavior issues in children.
2. It is important to explore other options such as therapy, counseling, behavior modification techniques.
3. Understanding the root cause of Johnny's behavior is crucial before considering medication.
4. Rushing into medication without exploring other avenues may not address the underlying issues.
Summary:
A: Allowing more freedom at home could potentially worsen Johnny's behavior by reinforcing the negative actions.
C: Telling Johnny his behavior is unacceptable without addressing the underlying cause may not effectively reduce his aggression.
D: Allowing Johnny to skip school is not a solution; addressing the behavior and providing appropriate support is essential.
In the emergency department, the nurse assesses a client who is aggressive and experiencing auditory hallucinations. The client states,"The CIA is plotting to kill me." To which mental health setting would the nurse expect this client to be admitted?
- A. Long-term, inpatient facility.
- B. Day treatment.
- C. Short-term, inpatient, locked unit.
- D. Psychiatric case management.
Correct Answer: C
Rationale: The correct answer is C: Short-term, inpatient, locked unit. This setting is appropriate because the client is exhibiting acute symptoms of aggression and auditory hallucinations, indicating a need for close monitoring and safety precautions in a secure environment. Long-term inpatient facility (choice A) is not suitable for acute episodes. Day treatment (choice B) may not provide the level of supervision needed. Psychiatric case management (choice D) focuses on community-based care, not acute inpatient care. Therefore, choice C is the most appropriate for managing the client's current symptoms.