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A client diagnosed with post-traumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which therapeutic communication technique used by the nurse is an example of a broad opening?
- A. What occurred prior to the rape, and when did you go to the emergency department?
- B. What would you like to talk about?
- C. I notice you seem uncomfortable discussing this.
- D. How can we help you feel safe during your stay here?
Correct Answer: B
Rationale: The correct answer is B because it allows the client to lead the conversation and express their concerns freely. By asking, "What would you like to talk about?" the nurse demonstrates empathy, respect, and openness to the client's needs, facilitating a client-centered approach. Choice A is specific and may not be what the client wants to discuss. Choice C reflects the nurse's observation rather than encouraging the client to share. Choice D focuses on the nurse's agenda rather than the client's preferences.
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When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at her about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial?
- A. Hiding liquor bottles in a closet
- B. Yelling at their son for slouching in his chair
- C. Burning dinner on purpose
- D. Saying to the spouse, I dont drink too much!
Correct Answer: D
Rationale: The correct answer is D because the client is using denial as a defense mechanism to cope with the stress of being confronted about her alcohol abuse. By saying "I don't drink too much," she is refusing to acknowledge the reality of her excessive alcohol consumption. This denial allows her to avoid facing the uncomfortable truth and the need for change.
A: Hiding liquor bottles in a closet is an example of a defense mechanism called displacement, not denial.
B: Yelling at their son for slouching in his chair is an example of a defense mechanism called projection, not denial.
C: Burning dinner on purpose is an example of a defense mechanism called passive-aggression, not denial.
A psychiatric nurse uses Sullivans theories in group and individual therapy. According to Sullivan and other theorists like him, how are client symptoms viewed behaviors that are maintained because they are reinforced?
- A. Client symptoms are viewed as responses to anxiety arising from interpersonal relationships.
- B. Client symptoms are viewed as internal conflicts arising from early childhood trauma.
- C. Client symptoms are viewed as the misinterpretations of experiences.
- D. Client symptoms are viewed as learned
Correct Answer: B
Rationale: The correct answer is B because Sullivan and other theorists like him believe that client symptoms are viewed as internal conflicts arising from early childhood trauma. Sullivan emphasized the impact of early relationships on personality development, suggesting that unresolved conflicts from childhood can manifest as symptoms in adulthood. This perspective aligns with psychodynamic theories that emphasize the role of unconscious processes and early experiences in shaping behavior.
Choice A is incorrect because it focuses on anxiety arising from interpersonal relationships, which is more aligned with interpersonal theories rather than Sullivan's emphasis on childhood experiences. Choice C is incorrect as it suggests misinterpretations of experiences, which does not fully capture the depth of internal conflicts highlighted by Sullivan. Choice D is incorrect as it simplifies client symptoms as learned behaviors without considering the underlying emotional conflicts rooted in early childhood experiences, as emphasized by Sullivan.
Which client statement reflects an understanding of the effect of circadian rhythms on a person?
- A. When I dream about my mothers horrible train accident, I become hysterical. B. I get really irritable during my menstrual cycle.C. Im a morning person. I get my best work done in the a.m.
- B. Every February, I tend to experience periods of sadness.
Correct Answer: C
Rationale: The correct answer is C because the client statement "I'm a morning person. I get my best work done in the a.m." reflects an understanding of circadian rhythms. Circadian rhythms are the body's internal clock that regulates the sleep-wake cycle and influences energy levels and productivity throughout the day. Being a morning person indicates that this individual's peak productivity aligns with their body's natural circadian rhythm, which typically results in better performance during the morning hours.
Choice A is incorrect as it relates to a traumatic dream triggering hysteria, not circadian rhythms. Choice B is incorrect as it mentions experiencing sadness in February, which is more likely related to seasonal affective disorder rather than circadian rhythms.
A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should the nurse characterize the clients appraisal of the job loss stressor?
- A. Irrelevant
- B. Harm/loss
- C. Threatening
- D. Challenging
Correct Answer: D
Rationale: The correct answer is D: Challenging. The client's statement indicates a positive reframing of the job loss as an opportunity for personal growth. This suggests that the client views the situation as a challenge to adapt and pursue a new path. This perspective aligns with the concept of stress as a potential source of growth and development, known as the challenge appraisal.
Summary:
A: Irrelevant - The client's statement demonstrates relevance to his future plans, making this choice incorrect.
B: Harm/loss - The client's positive outlook does not reflect a perception of harm or loss, making this choice incorrect.
C: Threatening - The client's statement does not convey a perception of threat, making this choice incorrect.
A newly admitted client diagnosed with obsessive-compulsive disorder (OCD) washes hands continually. This behavior prevents unit activity attendance. Which nursing statement best addresses this situation?
- A. Everyone diagnosed with OCD needs to control their ritualistic behaviors.
- B. It is important for you to discontinue these ritualistic behaviors.
- C. Why are you asking for help if you wont participate in unit therapy?
- D. Lets figure out a way for you to attend unit activities and still wash your hands.
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the client's need to wash their hands due to OCD while also addressing the issue of missing unit activities. By suggesting finding a way for the client to attend activities while still accommodating their need to wash hands, it promotes a collaborative approach and respects the client's autonomy. Option A is incorrect as not everyone with OCD can completely control their behaviors. Option B is too directive and may increase resistance. Option C is confrontational and may discourage the client from seeking help.