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Flashcards in Psych Deck (9):
1

A pt with severe depression & suicidal threats is at greater risk of committing suicide during what period of time?

When the pt's mood improves w/an increase in energy level.

2

A young adult seeks treatment in an outpatient mental health center. The client tells the nurse: “I am a government official being followed by spies.” On further questioning, the client reveals: “My warnings must be heeded to prevent nuclear war.” Which of the following actions should the nurse take?

A: Listen quietly w/o comment

B: Confront the pt's delusion

C: Ask for info about the spies

D: Contact the government agency

A: Listen quietly w/o comment

The client's comments demonstrate grandiose ideas. The most therapeutic response is to listen but to also avoid being pulled into the client’s delusional system. At some point validation of the present situation will need to be done. Confrontation at this time would be an inappropriate action and is not therapeutic.

3

A client who lives in an assisted living facility tells the nurse, “I am so depressed. Life isn't worth living anymore.” What is the best response by the nurse to this statement?

A: Come on, it's not that bad

B: Have you thought about hurting yourself

C: Think of the many positive things in life today

D: Did you tell any of this to your family?

B: Have you thought about hurting yourself?

It's important to determine if someone, who has voiced thoughts about death, is considering a suicidal act. This response is most therapeutic under the circumstances

4

Parents of a 4 year-old boy have just been informed that their son has a congenital neurologic demyelinating disorder that is terminal. The nurse anticipates their reaction to be in which phase of the crisis process?

A: Impact phase

B: Pre-crisis phase

C: Crisis phases

D: Resolution phase

A: Impact phase

There is no data to determine their response phase except the time frame of recent bad news. The impact of crisis is indicative of high levels of stress, sense of helplessness, confusion, disorganization, and the inability to apply problem-solving behavior.

5

The nurse observes a client with a diagnosis of obsessive-compulsive disorder on an inpatient unit. Which behavior is consistent with this medical diagnosis?

A: Preference for consistent caregivers

B: Repeatedly checking that a door is locked

C: Repetitive, involuntary movements

D: Verbalized suspicions about thefts on the unit

B: Repeatedly checking that a door is locked


Behaviors that are repeated are consistent with the diagnosis of obsessive-compulsive disorders. These behaviors, performed to reduce feelings of anxiety, often interfere with normal function and attendance at the place of employment. Verbalized suspicions reflect a paranoid thought process. Repetitive, involuntary movements are characteristic of some antipsychotic medication side effects. They are termed extrapyramidal effects such as tardive dyskinesia.

6

A nurse, who is assigned for five days to a client who has exhibited manipulative behaviors, becomes aware of feeling reluctance to interact with the client. The nurse should take what action next?

A: Talk with the client about the negative effects of manipulative behaviors on other clients and staff within the next few days

B: Limit contacts with the client to avoid reinforcement of the manipulative behavior during the work times

C: Develop a behavior modification plan for the client that will promote more functional behavior within the next week

D: Discuss the feelings of reluctance with an objective peer or supervisor within the next 24 hours

D: Discuss the feelings of reluctance with an objective peer or supervisor within the next 24 hours

The nurse who experiences stress in a therapeutic relationship can gain objectivity through discussion with other professionals. The nurse may wish to have a peer observe the nurse-client interactions with this client for a shift and then have a debriefing of positive and negative actions. The nurse must attempt to discover attitudes and feelings in the self that influence the nurse-client relationship in positive and negative ways.

7

A client was admitted to the psychiatric unit after refusal to get out of the bed. Once admitted, the client is observed talking to unseen people and voiding on the floor. The nurse should handle the problem of voiding on the floor by which of these approaches?

A: Toilet the client more frequently with supervision
B: Require the client to mop the floor after each incident
C: Restrict the client’s fluids throughout the day
D: Withhold privileges each time the voiding occurs

A: Toilet the client more frequently with supervision

With a client that has altered thought processes, the appropriate nursing approach to change behaviors is to take an active role in attending to the physical needs of the client. The other options are incorrect approaches.

8

A nurse and a client are talking about the client’s progress towards understanding the client’s behaviors during stressful situations. This is typical of which phase in a therapeutic relationship?

Orientation

Termination

Pre-interaction

Working

Working

During the working phase, alternative behaviors and techniques are explored mutually with a nurse and a client. A discussion of the meaning behind behaviors is one of many approaches during the working phase.

9

A client who is a victim of domestic violence states, “If I were better, I would not have been beaten.” Which feeling best describes what the client may be experiencing at this time?

A: Fear
B: Helplessness
C: Self-blame
D: Rejection

C: Self-blame

Victims of domestic violence may be immobilized by a variety of affective responses with one being self-blame. These clients often believe that a change in their behavior will cause the abuser to become nonviolent. They may even have been told this by their abuser. This is an untrue but not uncommon myth.