Therapeutic communication is the foundation of a patient-centered interview. Which of the following techniques is not considered therapeutic?
- A. Restating
- B. Encouraging description of perception
- C. Summarizing
- D. Asking 'why' questions
Correct Answer: D
Rationale: Asking 'why' questions is not considered a therapeutic technique in patient-centered communication as it can make patients feel defensive or judged. 'Why' questions may imply criticism or put the patient on the spot, potentially hindering open and honest communication. Instead, focusing on open-ended questions that encourage patients to express their feelings and thoughts without feeling judged or interrogated is more conducive to therapeutic communication.
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Which response demonstrates accurate information that should be discussed with the female patient diagnosed with bipolar disorder and her support system? Select the incorrect one.
- A. Remember that alcohol and caffeine can trigger a relapse of your symptoms.
- B. Due to the risk of a manic episode, antidepressant therapy is never used with bipolar disorder.
- C. It's critical to inform your healthcare provider immediately if you are experiencing sleep disturbances.
- D. Is your family prepared to be actively involved in helping manage this disorder?
Correct Answer: B
Rationale: In managing bipolar disorder, it is vital to educate the patient and their support system about triggers like alcohol and caffeine, the significance of good sleep, and the need for family involvement. However, the statement in choice B is incorrect. While antidepressants need to be carefully monitored in bipolar disorder, they can be used in conjunction with mood stabilizers to manage depression in some cases.
Which assessment question asked by the nurse demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder? Select one that doesn't apply.
- A. Do rules apply to you?
- B. What do you do to manage anxiety?
- C. Do you have a history of disordered eating?
- D. Do you think that you drink too much?
Correct Answer: A
Rationale: Questions about anxiety management, disordered eating, and alcohol use are relevant to identifying comorbid conditions with major depressive disorder, but the question 'Do rules apply to you?' does not directly address common comorbid mental health conditions associated with major depressive disorder.
During cognitive-behavioral therapy, a 12-year-old patient reports to the nurse practitioner:
- A. I was so mad I wanted to hit my mother.
- B. I thought that everyone at school hated me. That's not true. Most people like me and I have a friend named Todd.
- C. I forgot that you told me to breathe when I become angry.
- D. I scream as loud as I can when the train goes by the house.
Correct Answer: B
Rationale: In cognitive-behavioral therapy, recognizing and challenging negative thoughts is crucial for progress. Choice B demonstrates the patient's ability to identify and correct distorted thoughts, indicating positive advancement in therapy. This cognitive restructuring is a key component of cognitive-behavioral therapy, helping individuals develop healthier thinking patterns and coping strategies.
When explaining one of the main differences between narcolepsy and obstructive sleep apnea syndrome, what should the nurse mention?
- A. Symptoms of the two diagnoses are essentially the same, making it difficult to differentiate between them.
- B. People with narcolepsy awaken from a nap feeling rested and replenished.
- C. People with obstructive sleep apnea syndrome can experience temporary paralysis during naps.
- D. Naps are contraindicated for clients with narcolepsy due to their association with catatonia.
Correct Answer: B
Rationale: Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and sudden attacks of sleep, while obstructive sleep apnea syndrome involves the obstruction of the upper airway during sleep. One of the main differences is that people with narcolepsy often experience refreshing naps, feeling rested and replenished upon waking, which is not the case for obstructive sleep apnea syndrome. This distinction is important for healthcare providers to understand as it helps differentiate between these two sleep disorders.
In a client's history, a significant indicator suggesting marginal coping skills and the need for careful risk assessment for violence is a history of
- A. childhood trauma.
- B. family involvement.
- C. academic problems.
- D. chemical dependence.
Correct Answer: D
Rationale: A history of chemical dependence is a critical factor indicating marginal coping skills and the need for assessing the risk of violence. Substance abuse can impair judgment, increase impulsivity, and escalate the likelihood of violent behavior. It is essential to thoroughly evaluate and address substance abuse issues in clients to enhance treatment outcomes and ensure safety.