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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.
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The nurse is caring for an elderly client who has been taking an antipsychotic medication for 1 week. The nurse notifies the physician when he observes that the client has muscle rigidity that resembles Parkinson's disease. Which agent would the nurse expect the physician to prescribe?
- A. Anticholinergic
- B. Anxiolytic
- C. Benzodiazepine
- D. Beta-blocker
Correct Answer: A
Rationale: The correct answer is A: Anticholinergic. Antipsychotic medications can cause extrapyramidal symptoms like muscle rigidity resembling Parkinson's disease. Anticholinergics are used to manage these symptoms by blocking the effects of acetylcholine, which helps alleviate muscle rigidity. Anxiolytics (B), benzodiazepines (C), and beta-blockers (D) are not typically used to treat extrapyramidal symptoms associated with antipsychotic medications. Anxiolytics are for anxiety, benzodiazepines are for sedation or anxiety, and beta-blockers are for conditions like hypertension or heart-related issues.
The nurse has instructed a client with panic disorder about how to use the technique of positive self-talk. The nurse determines that the client has understood the instructions when the client verbalizes which statement to use during an impending panic attack?
- A. I am feeling very nervous right now.
- B. I can handle this anxiety; it will be over shortly.
- C. I am taking medication to eliminate these symptoms.
- D. Relax your muscles, relax your muscles.
Correct Answer: B
Rationale: The correct answer is B: "I can handle this anxiety; it will be over shortly." This statement reflects positive self-talk by acknowledging the anxiety but also affirming the client's ability to cope and that the situation is temporary. This empowers the client to manage the panic attack effectively.
Incorrect Choices:
A: "I am feeling very nervous right now." This choice focuses only on acknowledging the feeling without providing a positive coping strategy.
C: "I am taking medication to eliminate these symptoms." This choice relies solely on medication and does not address the client's ability to cope with the panic attack.
D: "Relax your muscles, relax your muscles." This choice provides a relaxation technique but lacks the empowering and affirming aspect of positive self-talk.
A client has made multiple visits to the clinic. The nurse suspects that the client may be experiencing complex somatic symptom disorder based on which of the following?
- A. Expressions of concern about psychological problems
- B. Indications that parents were always in 'good health'
- C. Reports of the same symptoms repeatedly
- D. Evidence of a need for social support from her friends
Correct Answer: C
Rationale: The correct answer is C: Reports of the same symptoms repeatedly. In complex somatic symptom disorder, individuals often report persistent physical symptoms with no clear medical explanation. By repeatedly reporting the same symptoms, the client demonstrates a key characteristic of this disorder. Choices A, B, and D do not directly align with the diagnostic criteria for complex somatic symptom disorder. Expressions of concern about psychological problems (A) could indicate other mental health conditions. Indications that parents were always in 'good health' (B) and evidence of a need for social support from friends (D) are not specific to complex somatic symptom disorder.
A person who has been unable to leave home for more than a week because of severe anxiety says, "I know it does not make sense, but I just can't bring myself to leave my apartment alone." Which nursing intervention is appropriate?
- A. Help the person use online video calls to provide interaction with others.
- B. Advise the person to accept the situation and use a companion.
- C. Ask the person to explain why the fear is so disabling.
- D. Teach the person to use positive self-talk techniques.
Correct Answer: D
Rationale: The correct answer is D, teaching the person to use positive self-talk techniques. This intervention is appropriate because it addresses the cognitive aspect of anxiety. By teaching the person to challenge negative thoughts and replace them with positive affirmations, they can gradually overcome their fear and build confidence in leaving the apartment. Online video calls (A) may provide temporary relief but do not address the root cause of the anxiety. Advising the person to use a companion (B) may enable avoidance of the problem rather than actively working on overcoming it. Asking the person to explain their fear (C) may not be helpful if they are already aware that it is irrational. Positive self-talk techniques empower the individual to change their mindset and behavior effectively.
Taylor, a psychiatric registered nurse, orients Regina, a patient with anorexia nervosa, to the room where she will be assigned during her stay. After getting Regina settled, the nurse informs Regina:
- A. I need to go through the belongings you have brought with you.
- B. You can use the scale in the back room when you need to.
- C. You will be eating five times a day here.
- D. The daily structure is based around your desire to eat.
Correct Answer: A
Rationale: The correct answer is A because as a psychiatric nurse, it is important to ensure the safety of the patient, especially those with anorexia nervosa who may have harmful items in their belongings. Going through the patient's belongings allows the nurse to assess and remove any potential risks. This action aligns with the duty of care and ensures the patient's well-being.
Choice B is incorrect because using a scale can trigger anxiety and reinforce unhealthy behaviors related to weight monitoring in patients with anorexia nervosa. Choice C is incorrect as stating a specific number of meals may not be suitable for every individual and could create unnecessary pressure on the patient. Choice D is incorrect because the structure of care should be based on evidence-based practices and clinical guidelines, not solely on the patient’s desire to eat.