Chapter 9 Flashcards
A client says to the nurse, “I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn’t rested well.” Which response should the nurse use to clarify the client’s comment?
a. “It sounds as though you were uncomfortable with the content of your dream.”
b. “I understand what you’re saying. Bad dreams leave me feeling tired, too.”
c. “So you feel as though you did not get enough quality sleep last night?”
d. “Can you give me an example of what you mean by ‘stoned’?”
d. “Can you give me an example of what you mean by ‘stoned’?”
A client diagnosed with schizophrenia tells the nurse, “The Central Intelligence Agency is monitoring us through the fluorescent lights in this room. The CIA is everywhere, so be careful what you say.” Which response by the nurse is most therapeutic?
a. “Let’s talk about something other than the CIA.”
b. “It sounds like you’re concerned about your privacy.”
c. “The CIA is prohibited from operating in health care facilities.”
d. “You have lost touch with reality, which is a symptom of your illness.”
b. “It sounds like you’re concerned about your privacy.”
The client says, “My marriage is just great. My spouse and I always agree.” The nurse observes the client’s foot moving
continuously as the client twirls a shirt button. What conclusion can the nurse draw about the client’s statement?
a. It is clear.
b. It may be distorted.
c. It is incongruous.
d. It is inadequate.
c. It is incongruous.
A nurse interacts with a newly hospitalized client. Which of the nurse’s comments applies the communication technique of “offering self?”
a. “I’ve also had traumatic life experiences. Maybe it would help if I told you about them.”
b. “Why do you think you had so much difficulty adjusting to this change in your life?”
c. “I hope you will feel better after getting accustomed to how this unit operates.”
d. “I’d like to sit with you for a while to help you get comfortable talking to me.”
d. “I’d like to sit with you for a while to help you get comfortable talking to me.”
Which technique will best communicate to a client that the nurse is interested in listening?
a. Restating a feeling or thought the client has expressed.
b. Asking a direct question, such as “Did you feel angry?”
c. Making a judgment about the client’s problem.
d. Saying, “I understand what you’re saying.”
a. Restating a feeling or thought the client has expressed.
A client discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?
a. “What are the common elements here?”
b. “Tell me again about your experiences.”
c. “Am I correct in my understanding of that?”
d. “Tell me everything from the beginning.”
c. “Am I correct in my understanding of that?”
A client tells the nurse, “I don’t think I’ll ever get out of here.” What is the nurse’s most therapeutic response?
a. “Don’t talk that way. Of course, you will leave here!”
b. “Keep up the good work, and you certainly will.”
c. “You don’t think you’re making progress?”
d. “Everyone feels that way sometimes.”
c. “You don’t think you’re making progress?”
Documentation in a client’s chart states, “Throughout a 5-minute interaction, client fidgeted and tapped left foot, periodically covered face with hands, and looked under chair while stating, ‘I enjoy spending time with you.’” Which analysis is most accurate?
a. The client is giving positive feedback about the nurse’s communicationtechniques.
b. The nurse is viewing the client’s behavior through a cultural filter.
c. The client’s verbal and nonverbal messages are incongruent.
d. The client is demonstrating psychotic behaviors.
c. The client’s verbal and nonverbal messages are incongruent.
While talking with a client diagnosed with major depressive disorder, a nurse notices the client is unable to maintain eye contact. The client’s chin lowers to the chest. The client looks at the floor. Which aspect of communication has the nurse assessed?
a. Nonverbal communication
b. A message filter
c. A cultural barrier
d. Social skills
a. Nonverbal communication
During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the client’s hand. Select the correct analysis of the nurse’s behavior.
a. It shows empathy and compassion. It will encourage the client to continue to express feelings.
b. The gesture is premature. The client’s cultural and individual interpretation of touch is unknown.
c. The client will perceive the gesture as intrusive and overstepping boundaries.
d. The action is inappropriate. Psychiatric clients should not be touched.
b. The gesture is premature. The client’s cultural and individual interpretation of touch is unknown.
During a one-on-one interaction with the nurse, a client frequently looks nervously at the door. What is the best comment by the nurse regarding this nonverbal communication?
a. “I notice you keep looking toward the door.”
b. “This is our time together. No one is going to interrupt us.”
c. “It looks as if you are eager to end our discussion for today.”
d. “If you are uncomfortable in this room, we can move someplace else.”
a. “I notice you keep looking toward the door.”
A client of color says to a Caucasian nurse, “There’s no sense talking about how I feel. You wouldn’t understand because you live in a white world.” What is the nurse’s best action?
a. Explain, “Yes, I do understand. Everyone goes through the same experiences.”
b. Say, “Please give an example of something you think I wouldn’t understand.”
c. Reassure the client that nurses interact with people from all cultures.
d. Change the subject to one that is less emotionally disturbing.
b. Say, “Please give an example of something you think I wouldn’t understand.”
A newly immigrated client had a nursing diagnosis of situational low self-esteem related to poor social skills as evidenced by lack of eye contact. Interventions were applied to increase the client’s self-esteem but after 3 weeks, the client’s eye contact did not improve. What is the most accurate analysis of this scenario?
a. The client’s eye contact should have been directly addressed by role playing to increase comfort with eye contact.
b. The nurse should not have independently embarked on assessment, diagnosis, and planning for this client.
c. The client’s poor eye contact is indicative of anger and hostility that were unaddressed.
d. The nurse should have assessed the client’s culture before making this diagnosis and plan.
d. The nurse should have assessed the client’s culture before making this diagnosis and plan.
When a specific client and the nurse sit together, the client often holds the nurse’s hand. The client also links arms with the nurse when they walk. The nurse is uncomfortable with this behavior. Which analysis is most accurate?
a. The client is accustomed to touch during conversation, as are members of many ethnic subcultures.
b. The client understands that touch makes the nurse uncomfortable and controls the relationship based on that factor.
c. The client is afraid of being alone. When touching the nurse, the client is reassured and comforted.
d. The client is trying to manipulate the nurse using nonverbal techniques.
a. The client is accustomed to touch during conversation, as are members of many ethnic subcultures.
A ethnic client uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the client’s behavior?
a. This is a characteristic of a histrionic personality disorder.
b. The client believes dramatic body language is sexually appealing.
c. The client wishes to impress upon staff the degree of emotional pain they are experiencing.
d. This may be a characteristic of a culture where dramatic body language is the norm.
d. This may be a characteristic of a culture where dramatic body language is the norm.
