Chapters 7, 8, 9, and 16 P.Q.'s Flashcards Preview

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Flashcards in Chapters 7, 8, 9, and 16 P.Q.'s Deck (19):
1

You are assessing a 6-year-old patient. When assessing a child’s perception of a difficult issue, which methods of assessment are appropriate? Select all that apply.

a.) Engage the child in a specific therapeutic game.

b.) Ask the child to draw a picture.

c.) Provide the child with an anatomically correct doll to act out a story.

d.) Allow the child to tell a story. 

a.) Engage the child in a specific therapeutic game.

b.) Ask the child to draw a picture.

c.) Provide the child with an anatomically correct doll to act out a story.

d.) Allow the child to tell a story. 

2

Which are the purposes of a thorough mental health nursing assessment? Select all that apply.

a.) Establish a rapport between the nurse and patient. 

b.) Assess for risk factors affecting the safety of the patient or others.

c.) Allow the nurse the chance to provide counseling to the patient.

d.) Identify the nurse’s goals for treatment.

e.) Formulate a plan of care.

a, b, d, e

a.) Establish a rapport between the nurse and patient. 

b.) Assess for risk factors affecting the safety of the patient or others.

d.) Identify the nurse’s goals for treatment.

e.) Formulate a plan of care.

3

You are performing a spiritual assessment on a patient. Which patient statement would indicate that there is an experiential concern in the patient’s spiritual life?

a.) “I really believe that my spouse loves me.”

b.) “My sister will never forgive me for what I did.”

c.) “I try to find time every day to pray, even though it’s not easy.”

d.) “I am happy with my life choices, even if my mother is not.” 

b.) “My sister will never forgive me for what I did.”

4

A patient states he has “given up on life.” His wife left him, he was fired from his job, and he is four payments behind on his mortgage, meaning he will soon lose his house. Which nursing diagnosis is appropriate?

a.) Anxiety related to multiple losses

b.) Defensive coping related to multiple losses

c. Ineffective denial related to multiple losses

d. Hopelessness related to multiple losses 

d. Hopelessness related to multiple losses

5

A 43-year-old female patient is brought to the emergency department with complaints of bizarre speech, visual hallucinations, and changes in behavior. She has no psychiatric history. Before ordering a psychiatric consultation, the emergency room physician orders a battery of blood tests as well as an MRI of the brain. The rationale for this is:

a.) To avoid a lawsuit.

b.) Medical conditions and physical illnesses may mimic psychiatric illnesses; therefore, physical causes of symptoms must be ruled out. 

c.) Emergency room physicians are required to order a certain number of tests for the emergency room visit to be reimbursed.

d.) To comply with hospital standards of care. 

b.) Medical conditions and physical illnesses may mimic psychiatric illnesses; therefore, physical causes of symptoms must be ruled out. 

6

Which of the following actions best represents the basis or foundation of all other psychiatric nursing care?

a.) The nurse assesses the patient at regular intervals.

b.) The nurse administers psychotropic medications.

c.) The nurse spends time sitting with a withdrawn patient.

d.) The nurse participates in team meetings with other professionals. 

a.) The nurse assesses the patient at regular intervals.

7

A male patient frequently inquires about the female student nurse’s boyfriend, social activities, and school experiences. Which of the following initial responses by the student best addresses the issue raised by this behavior?

a.) The student requests assignment to a patient of the same gender as the student.

b.) She limits sharing personal information and stresses the patient-centered focus of the conversation.

c.) She tells him that she will not talk about her personal life.

d.) She explains that if he persists in focusing on her, she cannot work with him. 

b.) She limits sharing personal information and stresses the patient-centered focus of the conversation.

8

A student nurse exhibits the following behaviors or actions while interacting with her patient. Which of these are appropriate as part of a therapeutic relationship?

a.) Sitting attentively in silence with a withdrawn patient until the patient chooses to speak.

b.) Offering the patient advice on how he could cope more effectively with stress.

c.) Controlling the pace of the relationship by selecting topics for each interaction.

d.) Limiting the discussion of termination issues so as not to sadden the patient unduly.

a.) Sitting attentively in silence with a withdrawn patient until the patient chooses to speak.

9

Emily is a 28-year-old nurse on the psychiatric unit. She has been working with Jenna, a 27-year-old who was admitted with depression. Emily and Jenna find they have much in common, including each having a 2-year-old daughter and each having graduated from the same high school. Emily and Jenna discuss getting together for lunch with their daughters after Jenna is discharged. This situation reflects:

a.) Successful termination

b.) Promoting interdependence

c. Boundary blurring

d. A strong therapeutic relationship 

c. Boundary blurring

10

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?” 

b.) “You say you look forward to the meeting, but you appear anxious or unhappy.”

11

Which student behavior is consistent with therapeutic communication?

a.) Offering your opinion when asked in order to convey support.

b.) Summarizing the essence of the patient’s comments in your own words.

c.) Interrupting periods of silence before they become awkward for the patient.

d.) Telling the patient he did well when you approve of his statements or actions. 

b.) Summarizing the essence of the patient’s comments in your own words.

12

Which statement about nonverbal behavior is accurate?

a.) A calm expression means that the patient is experiencing low levels of anxiety.

b.) Patients respond more consistently to therapeutic touch than to verbal interventions.

c.) The meaning of nonverbal behaviors varies with cultural and individual differences.

d.) Eye contact is a reliable measure of the patient’s degree of attentiveness and engagement. 

c.) The meaning of nonverbal behaviors varies with cultural and individual differences.

13

A nurse stops in to interview a patient on a medical unit and finds the patient lying supine in her bed with the head elevated at 10 degrees. Which initial response(s) would most enhance the chances of achieving a therapeutic interaction? Select all that apply.

a.) Apologize for the differential in height and proceed while standing to avoid delay.

b.) If permitted, raise the head of the bed and, with the patient’s permission, sit on the bed.

c.) If permitted, raise the head of the bed to approximate the nurse’s height while standing.

d.) Sit in whatever chair is available in the room to convey informality and increase comfort.

e.) Locate a chair or stool that would place the nurse at approximately the level of the patient.

f.) Remain standing and proceed so as not to create distraction by altering the arrangements.

e.) Locate a chair or stool that would place the nurse at approximately the level of the patient.

14

James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for day shift and anxiously reports, “Last night demons came to my room and tried to rape me.” Which response would be most therapeutic?

a.) “There are no such things as demons; what you saw were hallucinations.”

b.) “It is not possible for anyone to enter your room at night; you are safe here.”

c.) “You seem very upset; please tell me more about what you experienced last night.”

d.) “That must have been very frightening, but we’ll check on you at night and you’ll be safe.” 

c.) “You seem very upset; please tell me more about what you experienced last night.”

15

Nick, a construction worker, is on duty when a nearly completed wall suddenly falls, crushing a number of co-workers. Although badly shaken initially, he seemed to be coping well. About two weeks after the tragedy he begins to experience tremors, nightmares, and periods during which he feels numb or detached from his environment. He finds himself frequently thinking about the tragedy and feeling guilty that he was spared while many others died. Which statement about this situation is most accurate?

a.) Nick has acute stress disorder and will benefit from antianxiety medications.

b.) Nick is experiencing posttraumatic stress disorder (PTSD) and should be referred for outpatient treatment.

c.) Nick is experiencing anxiety and grief and should be monitored for PTSD symptoms.

d.) Nick is experiencing mild anxiety and a normal grief reaction; no intervention is needed. 

a.) Nick has acute stress disorder and will benefit from antianxiety medications.

16

You are caring for Susannah, a 29-year-old who has been diagnosed with dissociative identity disorder. She was recently hospitalized after coming to the emergency room with deep cuts on her arms with no memory of how this occurred. The priority nursing intervention for Susannah is:

a.) Assist in recovering memories of abuse.

b.) Maintain 1:1 observation.

c.) Teach coping skills and stress-management strategies.

d.) Refer for integrative therapy. 

b.) Maintain 1:1 observation.

17

You are caring for Connor, an 8-year-old boy who has been diagnosed with reactive attachment disorder. Which of the following nursing outcomes would be the most appropriate to achieve?

a.) Increases ability to self-control and decreases impulsive behaviors.

b. Avoids situations that trigger conflicts. 

c.) Expresses complex thoughts.

d.) Writes or draws feelings in a journal.

d.) Writes or draws feelings in a journal.

18

Ashley is a 21-year-old college student who was sexually assaulted at a party. She was seen in the local emergency department and referred for counseling after being diagnosed by the provider on call as having acute stress disorder. Which of the following treatment modalities would you expect to see used in therapy with Ashley?

a.) Aversion therapy

b.) Stress-reduction therapy

c.) Cognitive-behavioral therapy

d.) Short-term classical analysis therapy 

c.) Cognitive-behavioral therapy

19

Jamie, age 24, has been diagnosed with a dissociative disorder fol- lowing a traumatic event. Jamie’s mother asks you, “Does this mean my daughter is now crazy?” Your best response would be:

a.) “People with dissociative disorders are out of touch with reality, so in that way, your daughter is now mentally ill. Don’t worry.  Treatment is available.”

b.) “Jamie will most likely need long-term intensive in patient treatment to deal with her traumatic memories as well as to work through her delusions.”

c.) “Most mental health providers are skeptical about dissociative disorders and aren’t sure they truly exist. Jamie may be making up her symptoms as a cry for help.”

d.) “Jamie is dealing with the anxiety associated with the trauma by separating herself from it. With treatment she can get back to her previous level of functioning.” 

d.) “Jamie is dealing with the anxiety associated with the trauma by separating herself from it. With treatment she can get back to her previous level of functioning.”