practice questions from the kc Flashcards
A client with diagnosed borderline personality disorder tells the nurse, “You’re the best nurse here. I can talk to you and you listen. You’re the only one here that can help me.” Which response by the nurse is most therapeutic?
A. “Thank you; you’re a good person.”
B. “All of the nurses here provide good care.”
C. “Other clients have told me that too.”
D. “Mary and Sam are good nurses too
B. “All of the nurses here provide good care.”
The most therapeutic response is “All of the nurses here provide good care.” This statement corrects the client’s unrealistic and exaggerated perception. The other statements promote the client’s idealistic view and do nothing to help correct the client’s distortion.
Is the following statement true or false? Self-awareness is achieved primarily from feedback from others.
False
A 31-year-old client with acute stress disorder states to the nurse, “I keep having horrible nightmares about the car accident that killed my child. I should not have taken them with me to the store.” Which response by the nurse is most therapeutic?
A. “Don’t keep torturing yourself with such horrible thoughts.”
B. “Stop blaming yourself. It’s only hurting you.”
C. “Let’s talk about something that’s a bit more pleasant.”
D.“The accident just happened and couldn’t have been predicted.”
D.“The accident just happened and couldn’t have been predicted.”
Saying “The accident just happened and couldn’t have been predicted” provides the client with an objective perception of the event instead of the client’s perceived role. This type of statement reflects active listening and helps reduce feelings of blame and guilt. Saying “Don’t keep torturing yourself” or “Stop blaming yourself” is inappropriate because it tells the client what to do, subsequently delaying the therapeutic process. The statement “Let’s talk about something that’s a bit more pleasant” ignores the client’s feelings and changes the subject. The client needs to verbalize feelings and decrease feelings of isolation.
The nurse is caring for a severely depressed client. Which statement by the nurse is most therapeutic when talking to the client on the patient care unit?
A. “Everybody feels down once in a while.”
B. “Things will get better.”
C. “You’re wearing a new shirt today.”
D. “I like the shoes you wore yesterday.”
C. “You’re wearing a new shirt today.”
Pointing out facts of the present day draws the client into reality. Offering inane platitudes such as “everybody feels down once in a while” or “things will get better” minimizes the client’s feelings and may increase their feelings of worthlessness. Informing the client that the nurse liked something the client wore yesterday could make the client feel the nurse did not like other things they wore and requires the client to remember what that item was—often difficult with severe depression.
Which area should the nurse prioritize during the mental status examination?
A.Body Image
B.Stress level
C. Coping patterns
D. Insight
D. insight
Which activity occurs during the orientation phase of the nurse-patient relationship?
A. Testing the relationship
B. Resolving the problem
C. Engaging in problem-solving
D. Identifying problems
A. Testing the relationship
is the following statement true or false? Body language is important when engaging in therapeutic communication
true
Which technique would be least effective in promoting therapeutic communication?
A. Reassurance
B. Silence
C. Confrontation
D. observation
A. Reassurance
Is the following statement true or false? The first step of the patient interview is to use open-ended statements to gather data
False
During a group session, a client who is depressed tells the group, “I just lost my job.” Which response by the nurse is best?
A.”You were probably too depressed to work.”
B. “Would you tell us about your job?”
C. “You’ll find another job when you’re better.”
D. “It must have been very upsetting for you.”
D. “It must have been very upsetting for you.”
By stating “It must have been very upsetting for you,” the nurse conveys empathy to the client by recognizing the underlying meaning of a painful occurrence. The nurse’s statement invites the client to verbalize feelings and thoughts and lets the client know that the nurse is listening to and respects the client. Telling the client to talk about the job disregards the client’s feelings and is nontherapeutic for the depressed client because of underlying feelings of worthlessness and guilt that are commonly present. Telling the client that they will find another job when they are better or that they were probably too depressed to work is inappropriate because it disregards the client’s feelings and may promote additional feelings of failure and inadequacy in the client.
A client who is hospitalized with depression tells the nurse, “I don’t want to take the medication because I’m afraid I’ll become suicidal. I read a lot about these medications on Google.” 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. Google is not a reliable source.”
C. “I agree with you. I wouldn’t want to take this medication either because of my religion.”
D.“I don’t see any problem. Another client took that medication, and he really felt better.”
A. “Have you ever thought about hurting yourself?”
The PMH-RN is preparing to meet with a new patient. Which action should the nurse prioritize when developing a therapeutic relationship with this patient?
A.Sympathy
B.Compassion
C.Empathy
D.Kindness
C. Empathy
A 49-year-old client who is a veteran with posttraumatic stress disorder tells the nurse about the horror and mass destruction of war that he has witnessed. The client states, “I killed all of those people for nothing.” Which response by the nurse is most appropriate?
A. “You did what you had to do at that time.”
B.“Maybe you didn’t kill as many people as you think.”
C. “How many people did you kill?”
D. War is a terrible thing.”
A. “You did what you had to do at that time.”
The nurse states “You did what you had to do at that time” to help the client evaluate past behavior in the context of the trauma. Clients commonly feel guilty about past behaviors when viewing them in the context of current values. The other statements are inappropriate because they do not help the client evaluate past behavior in the context of the trauma.
Which intervention addresses the biologic domain?
A. Bibilotherpay
B. Psychoeducation
C. Pain management
D. Conflict resolution
C. pain management
A 27-year-old patient with bipolar disorder, manic phase, states to the nurse, “You’re looking good today. I’m taking you out to dinner.” What reply by the nurse is most therapeutic?
A. “Thank you for the compliment but I don’t want to go out to dinner.”
B.”Thank you for the compliment but I can’t go out to dinner with you.”
C. “It doesn’t matter how I look; the answer is no.”
D. “I’m Beth Smith, a nurse working on this unit.”
D. “I’m Beth Smith, a nurse working on this unit.”
The nurse should state her name and purpose on the unit to clarify her identity and to counteract other beliefs the patient may have. Stating that the nurse does not want to or cannot go out to dinner is not therapeutic because it fails to clarify the patient’s misperceptions or erroneous beliefs, as is the statement “It doesn’t matter how I look; the answer is no.”
