Nokea
A client is fearful and reluctant to talk. Which of the following techniques is most effective when trying to engage the client in interaction?
- A. Broad opening
- B. Focusing
- C. Giving information
- D. Silence
Correct Answer: A
Rationale: Broad openings allow a fearful client to choose what to discuss, reducing pressure and encouraging interaction, unlike focusing or silence which may intimidate.
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The client says to the nurse, 'I have special powers because I am the mother of God. I can heal everyone in the hospital.' The nurse's best response would be,
- A. That sounds interesting. What can you do?
- B. It would be unusual for anyone to have that kind of power.
- C. You could not heal everyone. No one has that much power.
- D. Well, you can certainly try.
Correct Answer: B
Rationale: Voicing doubt gently questions the client's delusional belief without confrontation, encouraging reflection while maintaining respect.
Which of the following statements about verbal and nonverbal communication skills is accurate?
- A. One third of meaning is transmitted nonverbally and two thirds is communicated verbally.
- B. Nonverbal communication is as important, if not more than, verbal communication.
- C. Verbal communication is most important because it is what the patient says.
- D. Verbal communication involves the unconscious mind.
Correct Answer: B
Rationale: Nonverbal communication, conveying two-thirds of meaning, is as critical as or more so than verbal communication, which is not solely driven by the unconscious mind.
Which of the following is the best reason that many psychiatric care units have policies against clients touching one another or staff?
- A. Because some clients with mental illness have difficulty knowing when touch is or is not appropriate
- B. Because clients often perceive being touched as a threat and may attempt to protect himself or herself by striking the staff person
- C. Because it can be threatening to both the client and the nurse
- D. Because touching always leads to more touching
Correct Answer: A
Rationale: Policies against touching in psychiatric units address clients' difficulty with understanding appropriate boundaries, reducing risks of misinterpretation or escalation.
Which of the following are nontherapeutic techniques?
- A. Silence
- B. Voicing doubt
- C. Agreeing
- D. Challenging
- E. Giving approval
- F. Accepting
Correct Answer: C,D,E
Rationale: Agreeing, challenging, and giving approval are nontherapeutic as they can imply judgment or reinforce misconceptions, unlike silence, voicing doubt, or accepting, which support therapeutic dialogue.
Patient says to the nurse, 'I wonder what's playing at the movie tonight.' The most therapeutic response would be,
- A. Are you telling me you would like to go to the movies?
- B. Why don't you look in the newspaper.
- C. There's nothing worth watching.
- D. Do you like to go to the movies?
Correct Answer: A
Rationale: Verbalizing the implied clarifies the client's hint about wanting to go to the movies, making the conversation more direct and therapeutic.