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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.
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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.
The nurse asks the client what that experience was like. Which communication skill is the nurse using?
- A. Encouraging expression
- B. Encouraging description of perceptions
- C. Exploring
- D. Requesting an explanation
Correct Answer: A
Rationale: Encouraging expression involves asking the client to describe the quality of their experience, as seen in the nurse's question about what the experience was like.
Patient says to the nurse, 'I wonder what's playing at the movie tonight.' The most therapeutic response would be,
- A. Are you telling me you would like to go to the movies?
- B. Why don't you look in the newspaper.
- C. There's nothing worth watching.
- D. Do you like to go to the movies?
Correct Answer: A
Rationale: Verbalizing the implied clarifies the client's hint about wanting to go to the movies, making the conversation more direct and therapeutic.
Which of the following are nontherapeutic techniques?
- A. Silence
- B. Voicing doubt
- C. Agreeing
- D. Challenging
- E. Giving approval
- F. Accepting
Correct Answer: C,D,E
Rationale: Agreeing, challenging, and giving approval are nontherapeutic as they can imply judgment or reinforce misconceptions, unlike silence, voicing doubt, or accepting, which support therapeutic dialogue.
The nurse asks the patient what he would like to talk about. This is an example of
- A. Broad opening
- B. Encouraging expression
- C. Focusing
- D. Offering self
Correct Answer: A
Rationale: Broad openings allow the client to initiate and direct the conversation, encouraging them to choose the topic, unlike focusing or offering self, which have different purposes.