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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 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.
Cognitive-behavioral therapy is going well when a 12-year-old patient in therapy 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: The correct answer is B because it demonstrates cognitive restructuring in cognitive-behavioral therapy. The patient challenges their negative thought ("everyone hates me") with evidence to the contrary ("most people like me and I have a friend named Todd"). This shows progress in changing maladaptive thought patterns.
Choice A indicates potential aggression, choice C suggests poor retention of coping strategies, and choice D implies a maladaptive coping mechanism. Overall, B is the correct choice as it aligns with the goals of cognitive-behavioral therapy to challenge and reframe negative thoughts.
A client with an eating disorder tells the RN, "I’ve been eating only 400 calories per day and have been taking diuretics to lose weight.” What is the RN’s best response?
- A. “Your diet is very harmful and needs to be changed immediately.”
- B. “It’s important to monitor your calorie intake carefully.”
- C. “Have you noticed any physical effects from this low-calorie diet?”
- D. “The diuretics could be causing your body to lose essential nutrients.”
Correct Answer: D
Rationale: The correct response is D: “The diuretics could be causing your body to lose essential nutrients.” This response addresses both the client’s low-calorie diet and the use of diuretics, highlighting the potential harm caused by the diuretics in depleting essential nutrients from the body. By focusing on the specific issue of nutrient loss, the nurse can educate the client on the dangers of using diuretics for weight loss and encourage seeking professional help. Options A, B, and C do not address the potential harm of diuretics and may not adequately address the severity of the situation. Option C is more general and may not directly address the issue of nutrient loss.
Pablo is a homeless adult who has no family connection. Pablo passed out on the street and emergency medical services took him to the hospital where he expresses a wish to die. The physician recognizes evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo. What is the rationale for this treatment choice? Select all that apply.
- A. Intermittent supervision is available in inpatient settings.
- B. He requires stabilization of multiple symptoms.
- C. He has nutritional and self-care needs.
- D. Medication adherence will be mandated.
Correct Answer: A
Rationale: The correct answer is A: Intermittent supervision is available in inpatient settings. In an inpatient treatment setting, Pablo can receive continuous monitoring and supervision, ensuring his safety and well-being. This is crucial for someone like Pablo who is homeless, has substance use issues, and expressed a wish to die. Inpatient treatment can provide a controlled environment where his physical and mental health can be closely monitored, and immediate interventions can be implemented if needed.
Incorrect choices:
B: While stabilization of multiple symptoms is important, the key factor here is the need for constant supervision, which is better provided in an inpatient setting.
C: Although nutritional and self-care needs are important, the primary concern in this case is Pablo's mental health and safety, which can be better addressed in an inpatient setting.
D: While medication adherence is important, it is not the primary reason for recommending inpatient treatment for Pablo. The need for supervision and monitoring takes precedence.
You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic?
- A. A new psychiatrist is a chance to start fresh; I’m sure it will go well for you.
- B. You say you look forward to the meeting, but you appear anxious or unhappy.
- C. I notice that you frowned and avoided eye contact just now. Don’t you feel well?
- D. I get the impression you don’t really want to see your psychiatrist—can you tell me why?
Correct Answer: B
Rationale: The correct answer is B. This response acknowledges the patient's non-verbal cues and reflects back to the patient what you observed, showing empathy and understanding. It validates the patient's emotions and opens up the opportunity for the patient to further elaborate on their feelings. Choice A minimizes the patient's feelings and may come off as dismissive. Choice C puts the patient on the spot and may make them defensive. Choice D makes an assumption about the patient's feelings without giving them a chance to express themselves.