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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 group of nursing students are reviewing information about counseling interventions. The students demonstrate a need for additional review when they identify counseling interventions as involving which of the following?
- A. Specific, time-limited intervention
- B. Focus on coping improvement
- C. Goal of regaining functional abilities
- D. Prevention of disability
Correct Answer: A
Rationale: Counseling interventions focus on improving coping (B), regaining function (C), and preventing disability (D), but they are not always specific or time-limited (A), as they may be ongoing or flexible. Identifying A as a key feature indicates misunderstanding.
The nurse is determining the success of a patient?s plan of care by evaluating outcome indicators. The nurse understands that these indicators are usually determined initially at which time?
- A. On the day of discharge
- B. During the assessment process
- C. At the initial interview
- D. With goal-setting process
Correct Answer: D
Rationale: Outcome indicators are specific, measurable criteria established during the goal-setting process in the nursing plan of care. This occurs after assessment and diagnosis, aligning interventions with desired outcomes. Discharge, assessment, and initial interviews precede or inform goal-setting.
After teaching a group of nursing students about milieu therapy, the instructor determines that additional teaching is needed when the students identify which of the following as a key concept of milieu therapy?
- A. Structure interaction
- B. Open communication
- C. Validation
- D. De-escalation
Correct Answer: D
Rationale: Milieu therapy emphasizes a therapeutic environment with structured interaction (A), open communication (B), and validation (C) to promote healing. De-escalation (D) is a specific intervention, not a core concept of milieu therapy, indicating a need for further review.
A nurse is assisting a patient in using simple relaxation techniques. Which of the following would the nurse do first?
- A. Have the patient assume a relaxed position.
- B. Advise the patient to let the sensations happen.
- C. Ensure a quiet, nondisrupting environment.
- D. Instruct the patient to take an initial slow, deep breath.
Correct Answer: C
Rationale: Ensuring a quiet, nondisrupting environment is the first step in relaxation techniques, as it creates optimal conditions for relaxation. Positioning, allowing sensations, and deep breathing follow to facilitate the process.
During assessment, the nurse asks a patient to explain what the following means: 'A penny saved is a penny earned.' The nurse is assessing which of the following?
- A. Affect
- B. Attention
- C. Concentration
- D. Abstract reasoning
Correct Answer: D
Rationale: Interpreting proverbs like 'A penny saved is a penny earned' requires abstract reasoning, the ability to understand and analyze abstract concepts. Affect involves emotional expression, attention is focus, and concentration is sustained mental effort.