Nokea
A client is discussing free associations as a therapeutic tool with a nurse. Which of the following client statements indicates an understanding of this technique?
- A. "I will write down my dreams as soon as I wake up."
- B. "I might begin to associate my therapist with important people in my life."
- C. "I can learn to express myself in a nonaggressive manner."
- D. "I should say the first thing that comes to my mind."
Correct Answer: D
Rationale: Free association is a psychoanalytic technique where the client is encouraged to say the first thing that comes to their mind without censoring or filtering. This technique helps uncover unconscious thoughts and emotions. Choice D, "I should say the first thing that comes to my mind," indicates an understanding of free association as it aligns with the principle of allowing thoughts to flow freely without inhibition. Choices A, B, and C do not reflect an understanding of free association and its purpose, making them incorrect. A, focusing on writing down dreams, does not relate to the immediate expression of thoughts. B, associating the therapist with important people, and C, learning to express oneself nonaggressively, do not capture the essence of free association as a technique for exploring unconscious processes.
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When communicating with a client admitted for treatment of a substance use disorder, which of the following communication techniques should be identified as a barrier to therapeutic communication?
- A. Offering advice
- B. Reflecting
- C. Listening attentively
- D. Giving information
Correct Answer: A
Rationale: Offering advice is a barrier to therapeutic communication because it can hinder the client's ability to explore their own solutions and feelings. It may come across as judgmental or dismissive of the client's experience, leading to a breakdown in trust and hindering the therapeutic relationship. Reflecting (choice B) is a helpful technique that involves paraphrasing or restating the client's words to show understanding. Listening attentively (choice C) is crucial for building rapport and demonstrating empathy. Giving information (choice D) is also important but should be done in a way that supports the client's understanding and autonomy, rather than directing their choices.
When orienting a new client to a mental health unit, which of the following statements should the nurse make about the unit's community meetings?
- A. "Clients gather to discuss their treatment plans together."
- B. "Staff establish a specific agenda for community meetings."
- C. "Clients meet with staff to discuss common problems."
- D. "Community meetings provide an opportunity to explore personal mental health issues."
Correct Answer: C
Rationale: During community meetings in a mental health unit, clients come together with staff to discuss common problems they may be facing. These meetings are designed to foster a sense of community and provide support and guidance to clients. Choice A is incorrect because community meetings focus on discussions beyond individual treatment plans. Choice B is incorrect as while staff may facilitate the meetings, the focus is on clients' concerns, not a predetermined agenda. Choice D is incorrect as the primary purpose of community meetings is to address shared challenges, not individual mental health issues.
In an outpatient mental health clinic, a nurse is preparing to conduct an initial client interview. Which of the following actions should the nurse identify as a priority?
- A. Coordinate holistic care with social services
- B. Identify the client's perception of their mental health status
- C. Include the client's family in the interview
- D. Educate the client about their current mental health disorder
Correct Answer: B
Rationale: During an initial client interview in a mental health clinic, it is essential for the nurse to prioritize identifying the client's perception of their mental health status. Understanding how the client views their mental health can provide valuable insights into their condition, concerns, and needs, facilitating the development of a tailored and effective care plan. Coordinating holistic care with social services, including the client's family in the interview, and educating the client about their current mental health disorder are important aspects of care but may not be the priority during the initial interview, where understanding the client's own perspective is crucial.
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.
A nurse is planning care for several clients attending community-based mental health programs. Which of the following clients should the nurse visit first?
- A. A client who received a burn on the arm while using a hot iron at home
- B. A client who requests a change of antipsychotic medication due to new adverse effects
- C. A client who reports hearing a voice saying that life is not worth living anymore
- D. A client who tells the nurse about experiencing manifestations of severe anxiety before and during a job interview
Correct Answer: C
Rationale: The nurse should visit the client who reports hearing a voice saying that life is not worth living anymore first. This statement indicates potential suicidal ideation, which requires immediate intervention to ensure the client's safety. Choices A, B, and D do not present an immediate threat to the client's life. While burns, adverse effects of medication, and severe anxiety are important concerns, they do not pose an immediate risk of self-harm or suicide.