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The nurse should use clear concrete messages when working with patients displaying which of the following conditions?
- A. Anxiety
- B. Anorexia
- C. Dementia
- D. Schizophrenia
- E. Hypochondriasis
Correct Answer: A,C,D
Rationale: Clear, concrete messages are essential for clients with anxiety, dementia, or schizophrenia, who may struggle with abstract thinking due to cognitive or emotional impairments.
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Which statements are true of concrete and abstract messages?
- A. Abstract messages include figures of speech that are difficult to interpret.
- B. Abstract messages are important for accurate information exchange.
- C. Concrete messages require the listener to interpret what the speaker says.
- D. Concrete messages are clear, direct, and easy to understand.
- E. Abstract messages are best used for persons who are anxious.
Correct Answer: A,D
Rationale: Abstract messages use figures of speech that are hard to interpret, while concrete messages are clear and direct, ideal for accurate communication, especially with anxious clients.
A patient remarks, 'You know, it's the same thing every time.' The nurse should respond by stating,
- A. I understand
- B. I'm sure everyone is doing their best.
- C. I'm not sure what you mean. Please explain.
- D. It's the same thing every time?
Correct Answer: C
Rationale: Consensual validation seeks mutual understanding by clarifying ambiguous statements, ensuring both nurse and client share the same meaning.
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.
During the mental status assessment, the client expresses the belief that the CIA is stalking him and plans to kidnap him. The best response by the nurse would be,
- A. That makes no sense at all.
- B. You can tell me about that after I finish asking these questions.
- C. What kinds of things have been happening?
- D. Why would the CIA be interested in you?
Correct Answer: C
Rationale: Seeking information encourages the client to elaborate on their belief, allowing the nurse to assess further without dismissing or reinforcing the delusion.
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.