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A psychotherapist works with an anxious, dependent patient. Which strategy is most consistent with psychoanalytic psychotherapy?
- A. Identifying the patient's strengths and assets
- B. Praising the patient for describing feelings of isolation
- C. Focusing on feelings developed by the patient toward the therapist
- D. Providing psychoeducation and emphasizing medication adherence
Correct Answer: C
Rationale: The correct answer is C because focusing on the patient's feelings developed towards the therapist is consistent with psychoanalytic therapy. This approach allows the therapist to explore transference and countertransference dynamics, which are central in understanding the patient's inner conflicts and relational patterns. By addressing these feelings, the therapist can help the patient gain insight into unresolved issues from their past that are influencing their current behavior.
Choice A is incorrect because while it can be beneficial in therapy, it is more aligned with a strengths-based or humanistic approach rather than psychoanalytic therapy. Choice B is also incorrect because praising the patient for describing feelings of isolation does not directly address the deeper unconscious processes that psychoanalytic therapy aims to explore. Choice D is incorrect because providing psychoeducation and emphasizing medication adherence are more commonly associated with cognitive-behavioral or medication-focused therapies, rather than psychoanalytic therapy.
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In the emergency department, the nurse assesses a client who is aggressive and experiencing auditory hallucinations. The client states,"The CIA is plotting to kill me." To which mental health setting would the nurse expect this client to be admitted?
- A. Long-term, inpatient facility.
- B. Day treatment.
- C. Short-term, inpatient, locked unit.
- D. Psychiatric case management.
Correct Answer: C
Rationale: The correct answer is C: Short-term, inpatient, locked unit. This setting is appropriate because the client is exhibiting acute symptoms of aggression and auditory hallucinations, indicating a need for close monitoring and safety precautions in a secure environment. Long-term inpatient facility (choice A) is not suitable for acute episodes. Day treatment (choice B) may not provide the level of supervision needed. Psychiatric case management (choice D) focuses on community-based care, not acute inpatient care. Therefore, choice C is the most appropriate for managing the client's current symptoms.
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.
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.
While leading a group, a nurse leader says to a patient, 'This is the fourth time that you've changed the subject when we have talked about child abuse. Is something going on?' The nurse is using which technique?
- A. Support
- B. Confrontation
- C. Summarizing
- D. Clarification
Correct Answer: B
Rationale: The correct answer is B: Confrontation. In this scenario, the nurse leader directly addresses the patient's behavior of changing the subject, which is a key aspect of confrontation technique. Confrontation is used to address discrepancies or inconsistencies in a nonjudgmental manner to promote self-awareness and insight. This technique encourages the patient to explore their thoughts and behaviors.
Incorrect Choices:
A: Support - Support involves providing empathy, understanding, and validation to the patient. The nurse in the scenario is not offering support, but rather challenging the patient's behavior.
C: Summarizing - Summarizing involves restating key points to ensure understanding and facilitate communication. The nurse's statement does not summarize but rather confronts the patient's behavior.
D: Clarification - Clarification is used to ensure mutual understanding by seeking clarification on unclear statements. The nurse's statement is not seeking clarification but rather addressing a specific behavior pattern.
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.