Essentials of Psychiatric Nursing 1st Edition Boyd Test Bank
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Below you will find some free nursing test bank questions from this test bank:
|Origin: Chapter 7, 1|
|1.||When engaged in therapeutic communication with a client who has a mental disorder, which of the following is the most important for a nurse to keep in mind?|
|A)||The nurse should self-disclose when indicated.|
|B)||The client is the primary focus of the interaction.|
|C)||The nurse should have an empathetic relationship with the client.|
|D)||The client’s conversations should be recorded.|
|A fundamental principle of therapeutic communication is that the client must be the focus of the interaction. Self-disclosure should be avoided. Empathy is important and develops over time as the nurse receives information from the client with open, nonjudgmental acceptance. The nurse communicates this understanding of the experience so that the client feels understood. Conversations with clients should be kept confidential.|
|Origin: Chapter 7, 2|
|2.||A hospitalized client diagnosed with depression asks a nurse, “Should I go home this weekend?” Which response by the nurse uses the technique of reflection?|
|A)||“Should you go home for the weekend?”|
|B)||“Home means what to you?”|
|C)||“It sounds as if you don’t want to go home this weekend.”|
|D)||“I doubt that you really should go home this weekend.”|
|Reflection is used when a client wants a nurse’s approval or judgment. The statement by the nurse that uses reflection is, “Should you go home for the weekend?” This allows the client the opportunity to discuss the matter further. The question, “Home means what to you?” seeks clarification. The statement, “It sounds as if you don’t want to go home this weekend” reflects the technique of interpretation. The statement, “I doubt that you really should go home” offers the nurse’s opinion and is judgmental.|
|Origin: Chapter 7, 3|
|3.||A client who is hospitalized with depression tells a nurse, “I don’t want to take the medication because I’m afraid I’ll become suicidal.” Which response by the nurse would be most appropriate?|
|A)||“Have you ever thought about hurting yourself?”|
|B)||“It’s important that you take this medication.”|
|C)||“I agree with you. I wouldn’t want to take this medication either.”|
|D)||“Another client took that medication, and he really felt better.”|
|The nurse’s best response is, “Have you ever thought about hurting yourself?” This response seeks to clarify the client’s statement about hurting himself and opens the door to allow a therapeutic discussion, since clients with depression may have suicidal thoughts. Telling the client to take the medication, agreeing with the client, or giving advice will block therapeutic communication.|
|Origin: Chapter 7, 4|
|4.||A female psychiatric client is talking to a nurse about her reasons for being hospitalized. The client begins to discuss her relationship with her female significant other. She is describing the things in her relationship that are making her uncomfortable, and she asks the nurse, “Should I break up with my partner?” Which response by the nurse would be most effective in building rapport between the client and nurse?|
|A)||“Of course you should; being a lesbian is just not natural.”|
|B)||“Yes, I think you should pursue building a relationship with a man.”|
|C)||“It sounds like you’re beginning to be uncomfortable in this relationship.”|
|D)||“You need to focus on yourself rather than the relationship right now.”|
|Nurses establish rapport through interpersonal warmth, a nonjudgmental attitude, and a demonstration of understanding. The response about the relationship becoming uncomfortable reflects both a nonjudgmental attitude and understanding. Telling the client that being a lesbian is unnatural, or that she should pursue a relationship with a man, reflects the nurse’s beliefs, gives advice, and is judgmental. Telling the client she needs to focus on herself ignores the client’s concern.|
|Origin: Chapter 7, 5|
|5.||A nurse engaged in an interaction with a client recognizes body space zones. Which of the following would the nurse identify as the individual’s personal zone?|
|A)||Beginning at the boundary of the intimate zone and ending at the social zone|
|B)||Extending outward from the border to the public zone|
|C)||Surrounding and protecting an individual from others, especially outsiders|
|D)||The most distant boundary that can be used for recognizing intruders|
|The four zones are intimate, personal, social, and public. The personal zone begins at the boundary of the intimate zone and ends at the social zone. The intimate zone varies widely in different cultures. The social zone begins at the end of the personal zone and ends at the public zone. The public zone begins at the end of the social zone and extends outward.|
|Origin: Chapter 7, 6|
|6.||While providing care to a client with a mental disorder, the client asks the nurse, “Does mental illness run in your family?” Which response by the nurse would be most inappropriate?|
|A)||“Mental illnesses do run in families, and I’ve had a lot of experience caring for people with mental illness.”|
|B)||“It sounds like you are concerned that there may be a family connection to your current problem?”|
|C)||“Yes, it does. I have a sister who was diagnosed several years ago with severe major depression.”|
|D)||“Mental illness can be family related. Let’s focus the discussion on you and how you’re doing today.”|
|The statement about the nurse’s sister suffering from depression is inappropriate because it involves self-disclosure that serves no therapeutic purpose. In addition, it ignores the underlying concern of the client’s statement: mental illnesses and family. The statements about having experience dealing with mental illnesses, sounding concerned about a family connection, and focusing the discussion on the client serve to redirect the interaction back to the client.|
|Origin: Chapter 7, 7|
|7.||A nursing instructor is describing the nurse–client relationship to a group of nursing students. Which of the following would the instructor emphasize as crucial for establishing and maintaining the relationship?|
|Self-awareness is crucial in a nurse–client relationship. Without it, nurses will find it impossible to establish and maintain therapeutic relationships with clients. Although rapport and empathy are important considerations for a nurse–client relationship, self-awareness is key. Values are inherent in nurses, and a nurse must be self-aware of his or her own values.|
|Origin: Chapter 7, 8|
|8.||A group of students is reviewing the process of verbal communication. The students demonstrate understanding of the information when they identify which of the following as the first component of the process?|
|A)||Formulation of an idea|
|With verbal communication, typically the person formulates an idea, encodes a message, and then transmits the message with emotion. The message is then received and decoded, and a response is made.|
|Origin: Chapter 7, 9|
|9.||A nurse responds to a client’s statement with silence based on the rationale that this technique is used primarily to do which of the following?|
|A)||Allow the nurse to determine an appropriate response|
|B)||Permit the client to gather his or her thoughts|
|C)||Encourage self-reflection by the nurse|
|D)||Demonstrate passive listening|
|By maintaining silence, the nurse allows the client to gather his or her thoughts and to proceed at his or her own pace. Silence may help the nurse determine an appropriate response or engage in self-reflection, but it is more directed toward allowing the client to focus. Silence does not reflect passive listening. Passive listening involves sitting quietly and letting the client talk, rambling without focusing, or guiding the thought process.|
|Origin: Chapter 7, 10|
|10.||A group of nursing students is preparing a class presentation on therapeutic and nontherapeutic techniques of communication. The students demonstrate understanding of the information when they select which techniques to demonstrate as therapeutic? Select all that apply.|
|Ans:||A, B, C|
|Therapeutic communication techniques include confrontation, open-ended statements, and reflection. Reassurance, agreement, and challenges are techniques that inhibit communication.|
|Origin: Chapter 7, 11|
|11.||When communicating with a client, which of the following would a nurse use to convey positive body language?|
|A)||Sitting erect with back against the chair|
|B)||Crossing the arms over the chest|
|C)||Sitting at the client’s eye level|
|D)||Keeping the feet flat on the floor with the legs crossed|
|Positive body language includes sitting at the same eye level as the client with a relaxed posture, leaning slightly forward, with the arms and legs uncrossed.|
|Origin: Chapter 7, 12|
|12.||During an interview, a client tells the nurse that he was recently let go from his job. As the interaction continues, the client states, “I was really overqualified for that position anyway. It was definitely below my area of expertise.” The nurse interprets this information as reflecting which of the following?|
|The client is attempting to use abstract thinking or make generalizations to control or minimize his feelings associated with the loss of his job. Refusing to acknowledge the painful aspect—for example, “I really didn’t want that job”—would reflect denial. With projection, an individual falsely attributes to another person his own acceptable feelings, thoughts, or impulses. Passive aggression reflects a façade of overt compliance that masks covert resistance, resentment, or hostility.|
|Origin: Chapter 7, 13|
|13.||A nurse is engaged in active listening. Which of the following would the nurse use? Select all that apply.|
|A)||Changing the subject to gather more information|
|B)||Responding indirectly to statements|
|C)||Using open-ended statements|
|D)||Concentrating on what the client says|
|E)||Allowing the client to talk as he wishes|
|Ans:||B, C, D|
|Through active listening, the nurse focuses on what the client is saying to interpret and respond objectively to the message. While listening, the nurse concentrates only on what the client is saying and on the underlying meaning. The nurse usually responds indirectly, using techniques such as open-ended statements, reflection, and questions that elicit additional responses from the client. Changing the subject is avoided. Allowing the client to talk as he wishes reflects passive listening, which does not foster a therapeutic relationship.|
|Origin: Chapter 7, 14|
|14.||An instructor is educating a group of nursing students on defense mechanisms. The instructor determines that the education was successful when the group states which of the following?|
|A)||Most defense mechanisms are considered to be maladaptive, regardless of the situation.|
|B)||Defense mechanisms help mediate a person’s response to emotional conflicts and external stressors.|
|C)||Use of defense mechanisms indicates that a person’s mental state is dysfunctional.|
|D)||Persistent use of defense mechanisms commonly enhances a person’s quality of life.|
|Defense mechanisms (also known as coping styles) are defined in the Diagnostic and Statistical Manual of Mental Disorders-5 as “mechanisms that mediate the [client’s] reaction to emotional conflicts and to external stressors.” Some defense mechanisms (e.g., projection, splitting, acting out) are almost invariably maladaptive. Others (e.g., suppression, denial) may be either maladaptive or adaptive, depending on their severity, their inflexibility, and the context in which they occur. While defense mechanisms might seem to indicate the existence of a problematic mental state, this is not true. Healthy individuals in many different contexts use defense mechanisms. As with some other mental illnesses, the use of defense mechanisms becomes maladaptive when their persistent use reduces the client’s quality of life. The degree to which a particular defense mechanism is maladaptive varies.|
|Origin: Chapter 7, 15|
|15.||A group of nursing students is role-playing situations to practice using therapeutic communication techniques. Which of the following would the students identify as verbal communication?|
|A)||Emotion underlying the words|
|Verbal communication, which is principally achieved by spoken words, includes the underlying emotion, context, and connotation of what is actually said. Nonverbal communication includes gestures, expressions, and body language.|