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A patient is being admitted to the psychiatric unit. While explaining his reason for seeking admission, he describes how his 32-year-old son recently died of a heart attack. Which response by the nurse would enhance the effectiveness of this interview?
- A. How is your wife handling your son?s death?
- B. Do you have any other living children that can help you cope with this loss?
- C. This must be a very difficult time for you.
- D. I know exactly how you?re feeling; my 23-year-old son died unexpectedly last year.
Correct Answer: C
Rationale: A therapeutic response acknowledges the patient?s emotions and fosters rapport. 'This must be a very difficult time for you' reflects empathy and encourages further sharing. Options A and B shift focus to others, and option D involves inappropriate self-disclosure, which may detract from the patient?s needs.
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A patient is engaged in bibliotherapy and begins to express his feelings because he closely associates his experience with that provided by the reading material. The nurse interprets this as which of the following?
- A. Insight
- B. Catharsis
- C. Anxiety reduction
- D. Problem solving
Correct Answer: B
Rationale: Bibliotherapy involves emotional release through relating to reading material. The patient?s expression of feelings indicates catharsis, the release of pent-up emotions. Insight involves understanding, anxiety reduction is a secondary effect, and problem-solving involves action planning.
A home health nurse is making a home visit to a psychiatric patient who was recently discharged from a mental health unit. During the visit, the nurse plans on clarifying when she will return for the next home visit. During which stage would the nurse discuss the next home visit with the patient?
- A. Closure stage
- B. Service implementation
- C. Greeting stage
- D. Focus establishment
Correct Answer: A
Rationale: Discussing the next visit occurs during the closure stage, as it involves wrapping up the current interaction and planning future contact. Service implementation involves care delivery, greeting establishes rapport, and focus establishment sets the session?s purpose.
A nurse is performing a biopsychosocial assessment of a patient with depression. Which of the following would the nurse assess as part of the psychological domain? Select all that apply.
- A. Abstract reasoning
- B. Medication use
- C. Mood
- D. Orientation
- E. Self-care
Correct Answer: A,C,D
Rationale: The psychological domain includes cognitive and emotional functions such as abstract reasoning (A), mood (C), and orientation (D). Medication use (B) is part of the biological domain, and self-care (E) relates to the social or functional domain.
Which of the following questions would be most helpful in beginning an initial assessment interview for a patient who has just been admitted to a psychiatric inpatient unit?
- A. Have you had any previous psychiatric admissions?
- B. What brings you into the hospital today?
- C. Have you had any thoughts about trying to harm yourself?
- D. How would you describe your relationship with your spouse?
Correct Answer: B
Rationale: The initial assessment interview aims to establish rapport and understand the patient?s primary reason for admission. Asking 'What brings you into the hospital today?' is open-ended, patient-centered, and elicits the patient?s perception of their problem, setting the stage for further assessment. Previous admissions, suicidal thoughts, and relationships are important but secondary to understanding the current reason for admission.
The nurse is assessing a patient?s immediate and short-term memory. Which of the following would be most appropriate?
- A. Questioning the patient about an event that has occurred within the past several months
- B. Giving the patient a simple scenario and having him identify what would be the best response
- C. Giving the patient three words and asking him to recite them now and then in 5 minutes
- D. Asking the patient to tell the nurse the date, time, and current location
Correct Answer: C
Rationale: Testing immediate and short-term memory involves recalling information after a brief delay. Giving three words to recite now and in 5 minutes assesses both immediate recall and short-term memory. Past events test long-term memory, scenarios test judgment, and orientation tests cognitive status.