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A client who is at risk for suicide following their partner's death is speaking with a nurse. Which of the following statements should the nurse make?
- A. "I feel very sorry for the loneliness you must be experiencing."
- B. "Suicide is not the appropriate way to cope with loss."
- C. "Losing someone close to you must be very upsetting."
- D. "I know how difficult it is to lose a loved one."
Correct Answer: C
Rationale: When a client is at risk for suicide, it is crucial for the nurse to acknowledge the emotional impact of losing a loved one without downplaying or judging their feelings. Statement C demonstrates empathy and understanding without making assumptions or providing unsolicited advice, making it the most appropriate response in this situation. Choice A focuses more on the nurse's feelings rather than the client's, which might not effectively address the client's emotional state. Choice B is judgmental and dismissive, which could further isolate the client. Choice D, although empathetic, shifts the focus to the nurse's experience rather than validating the client's feelings.
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A healthcare professional is caring for a group of clients. Which of the following clients should the healthcare professional consider for referral to an assertive community treatment (ACT) group?
- A. A client in an acute care mental health facility who has fallen several times while running down the hallway
- B. A client who lives at home and keeps forgetting to come in for a scheduled monthly antipsychotic injection for schizophrenia
- C. A client in a day treatment program who reports increasing anxiety during group therapy
- D. A client in a weekly grief support group who reports still missing a deceased partner who has been dead for 3 months
Correct Answer: B
Rationale: The client who lives at home and repeatedly forgets to come in for a scheduled monthly antipsychotic injection for schizophrenia should be considered for referral to an assertive community treatment (ACT) group. ACT teams provide intensive community-based treatment and support for individuals with severe mental illness who may have difficulty adhering to treatment on their own. Choices A, C, and D do not describe individuals with severe mental illness who have difficulty adhering to treatment or need intensive community-based support, which are the typical candidates for referral to an ACT group.
When the caregiver of a child asks the nurse for reassurance about their child's condition, which of the following responses should the nurse make?
- A. "I think your child is getting better. What have you noticed?"
- B. "I'm sure everything will be okay. It just takes time to heal."
- C. "I'm not sure what's wrong. Have you asked the doctor about your concerns?"
- D. "I understand you're concerned. Let's discuss what concerns you specifically."
Correct Answer: D
Rationale: When providing reassurance to a caregiver about their child's condition, it's essential to acknowledge their concern and address it specifically. Response D demonstrates empathy and a willingness to discuss the caregiver's specific concerns, which can help in providing accurate information and support to them. Choices A and B provide general reassurance without addressing the caregiver's specific concerns, which may not alleviate their worries effectively. Choice C deflects the question back to the caregiver and suggests consulting the doctor without directly engaging with the caregiver's worries, which may not offer the needed support and reassurance.
What principle about patient communication should guide a nurse's fear of 'saying the wrong thing' to a patient?
- A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
- B. Patients are more interested in talking to you than listening to what you have to say, so they are not likely to be offended.
- C. Considering the patient's history, there is little chance that the comment will do any actual harm.
- D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.
Correct Answer: A
Rationale: Effective patient communication is guided by the principle that patients value genuine acceptance, respect, and concern from their caregivers. This approach helps to build trust and fosters effective communication, enhancing the nurse-patient relationship. Choice B is incorrect because patients value both talking and listening in effective communication. Choice C is incorrect because a nurse should always consider the impact of their words on the patient, regardless of the patient's history. Choice D is incorrect as it generalizes about people with mental illness and forgiveness, which is not directly relevant to patient communication.
A client is undergoing systematic desensitization for an extreme fear of elevators. Which of the following actions should be implemented with this form of therapy?
- A. Demonstrate riding in an elevator, then ask the client to imitate the behavior.
- B. Advise the client to say "stop" out loud every time they begin to feel an anxiety response related to an elevator.
- C. Gradually expose the client to an elevator while practicing relaxation techniques.
- D. Stay with the client in an elevator until the anxiety response diminishes.
Correct Answer: C
Rationale: Systematic desensitization is a type of therapy used to help individuals overcome phobias or anxieties. It involves gradually exposing the client to the feared object or situation, in this case, an elevator, while simultaneously practicing relaxation techniques. This process helps the client associate relaxation with the previously feared stimulus, gradually reducing anxiety levels over time. Choice A is incorrect as it involves imitation rather than gradual exposure. Choice B is incorrect as it focuses on a verbal response rather than the systematic process of exposure and relaxation. Choice D is incorrect as it does not involve the systematic approach of gradually exposing the client while teaching relaxation techniques.
During the working phase of a therapeutic relationship, a client with methamphetamine use disorder displays transference behavior. Which action by the client indicates transference behavior?
- A. The client asks the nurse if they will go out to dinner together
- B. The client accuses the nurse of being controlling just like an ex-partner
- C. The client reminds the nurse of a friend who died from substance toxicity
- D. The client becomes angry and threatens to engage in self-harm
Correct Answer: B
Rationale: Transference occurs when a client projects feelings, often unconscious, onto the nurse that are associated with significant figures in their past or present life. In this scenario, the client accusing the nurse of being controlling like an ex-partner demonstrates transference behavior by attributing characteristics of someone from their past onto the nurse. Choices A, C, and D do not reflect transference behavior. Choice A involves a social invitation, which is not necessarily transference. Choice C is more related to countertransference as it triggers memories in the nurse, not the client. Choice D describes aggressive behavior and self-harm threats, which are not indicative of transference.