While sitting in the day room of the mental health unit, a male adolescent avoids eye contact, looks at the floor, and talks softly when interacting verbally with the RN. The two trade places, and the RN demonstrates the client’s behaviors. What is the main goal of this therapeutic technique?
- A. Initiate a non-threatening conversation with the client.
- B. Dialog about the ineffectiveness of his interactions.
- C. Allow the client to identify the way he interacts.
- D. Discuss the client’s feelings when he responds.
Correct Answer: C
Rationale: The main goal of the therapeutic technique demonstrated by the RN is to allow the client to identify the way he interacts (Choice C). By mirroring the client's behaviors, the RN provides a reflection of the client's own actions, which can help the client become more self-aware of how he presents himself. This can lead to insight into his own behavior and communication style, facilitating personal growth and potential behavior change.
Choice A is incorrect because the main goal is not just to initiate conversation, but to promote self-awareness. Choice B is incorrect as the focus is not on discussing the ineffectiveness of interactions but rather on self-identification. Choice D is incorrect as the main focus is not on discussing the client's feelings but on allowing the client to recognize his own behavior patterns.
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Which nursing statement is an example of reflection?
- A. I think this feeling will pass.
- B. So you are saying that life has no meaning.
- C. I’m not sure I understand what you mean.
- D. You look sad.
Correct Answer: B
Rationale: The correct answer is B because it demonstrates reflective listening by paraphrasing and summarizing the patient's statement. This shows active listening and understanding of the patient's perspective. Choice A is about personal feelings, not reflecting the patient's emotions. Choice C is a statement of uncertainty, not reflective listening. Choice D is an observation, not reflection.
Which statement made by the nurse demonstrates the best understanding of nonverbal communication?
- A. The patient’s verbal and nonverbal communication is often different.
- B. When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.
- C. If a patient is slumped in the chair, I can be sure he’s angry or depressed.
- D. It’s easier to understand verbal communication than nonverbal communication.
Correct Answer: B
Rationale: The correct answer is B because it demonstrates an understanding of the importance of checking for congruence between verbal and nonverbal communication to validate responses. Nonverbal cues can provide additional context and insight into a patient's true feelings or intentions. Choice A is too general and does not emphasize the significance of congruence. Choice C makes an assumption based solely on nonverbal cues, which can be misleading. Choice D is incorrect as understanding nonverbal communication is equally important as verbal communication.
A middle-aged adult with major depressive disorder suffers from psychomotor retardation, hypersomnia, and amotivation. Which intervention is likely to be most effective in returning this client to a normal level of functioning?
- A. Encourage the client to exercise.
- B. Suggest that the client develop a list of pleasurable activities.
- C. Provide education on methods to enhance sleep.
- D. Teach the client to develop a plan for daily structured activities.
Correct Answer: D
Rationale: The correct answer is D: Teach the client to develop a plan for daily structured activities. This intervention is most effective because it addresses the symptoms presented by the client - psychomotor retardation, hypersomnia, and amotivation. Structured activities can help regulate the client's daily routine, combat inertia, and provide a sense of purpose and accomplishment. By setting specific tasks and goals, the client can gradually increase their level of activity and engagement, which can improve mood and motivation. Encouraging exercise (choice A) may be beneficial, but developing a structured plan encompasses a broader approach to address all symptoms. Creating a list of pleasurable activities (choice B) may not address the lack of motivation or structure. Providing education on sleep enhancement methods (choice C) may not directly address psychomotor retardation and amotivation.
Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient’s nursing diagnosis is altered thought processes?
- A. I know you say you hear voices, but I cannot hear them.
- B. Stop listening to the voices, they are NOT real.
- C. You say you hear voices, what are they telling you?
- D. Please tell the voices to leave you alone for now.
Correct Answer: C
Rationale: The correct answer is C because it demonstrates active listening and encourages the patient to express their experiences. By asking "You say you hear voices, what are they telling you?" the nurse shows empathy, validation, and a non-judgmental attitude towards the patient's altered thought processes. This statement helps the patient feel heard and understood, fostering a therapeutic nurse-patient relationship.
Choice A is incorrect because it dismisses the patient's experience and does not acknowledge their reality. Choice B is incorrect as it commands the patient to stop listening to the voices without addressing the underlying issues. Choice D is incorrect because it suggests the patient has control over the voices, which may not be the case.
The nurse administers each of the following drugs to various patients. The patient who should be most carefully assessed for fluid and electrolyte imbalance is the one receiving:
- A. Lithium (Eskalith)
- B. Clozapine (Clozaril)
- C. Diazepam (Valium)
- D. Amitriptyline
Correct Answer: A
Rationale: The correct answer is A: Lithium (Eskalith). Lithium is known to cause nephrogenic diabetes insipidus, leading to excessive urination and potential dehydration. Therefore, the patient receiving lithium should be carefully assessed for fluid and electrolyte imbalances. Clozapine (B), Diazepam (C), and Amitriptyline (D) do not have a significant impact on fluid and electrolyte balance compared to lithium.