Therapeutic

Question 1

Pre-interaction phase?

Answer 1

Before meeting the pt
Finding everything about the patient
Explore self-perceptions
(check own emotions at the door)

Question 2

Orientation phase?

Answer 2

Establish trust
Establish contract/agreement
Establish roles
Establish Boundaries
(establish acceptable behavior)
David = the patient
Yuko = nurse

Question 3

Working phase?

Answer 3

Promote client change

Question 4

Termination phase?

Answer 4

Evaluate goal attainment
Ensure therapeutic closure

Transference and Countertransference occur

Question 5

What are the characteristics that enhance the
achievement of a therapeutic relationship? 5

Answer 5

Rapport
Trust
Respect
Genuineness
Empathy

Question 6

What are a) Transference b) Countertransference?

Answer 6

a) Client unconsciously displaces to the nurse feelings formed toward a person from the past
Pt to the nurse (mom, sister, friend, etc)

b) Nurse to the pt

Question 7

How would you manage a) transference? b) Countertransference?

Question 8

A client threatens to kill himself, his wife, and their
children if the wife follows through with divorce
proceedings. During the interaction phase of the
nurse-client relationship, which interaction should the
nurse employ?

a) Acknowledging the client’s actions and encouraging
alternative behaviors
b) Establishing rapport and developing treatment goals
c) Providing community resources on aggression
management
d) Exploring personal thoughts and feelings that may
adversely impact the provision of care

Answer 8

D

Question 9

What should the nurse be aware of during the pre-interaction phase of the nurse-client relationship?

Answer 9

Awareness of self
Their own feelings, fears, and anxieties about working with a particular client

Question 10

What the priority nursing focus is during the orientation phase of the nurse-client relationship?

Answer 10

Create an environment for trust and rapport, respect
Identify strengths and weakness

Question 11

What the priority nursing focus is during the working phase?

Answer 11

Continue to maintain trust and rapport, promote pt
Use problem-solving to work toward achieving established goals
Overcome resistance

Question 12

What the priority nursing focus is during the Termination phase?

Question 13

What is the priority nursing action during the orientation (introductory) phase of the nurse-client relationship?

A. Acknowledge the client’s actions and generate alternative behaviors.
B. Establish rapport and develop treatment goals.
C. Attempt to find an alternative placement.
D. Explore how thoughts and feelings about this client may adversely impact care.

Answer 13

B

Question 14

What should be the nurse’s primary goal during the pre-interaction phase of the nurse-client relationship?

A. To evaluate goal attainment and ensure therapeutic closure
B. To establish trust and formulate a contract for intervention
C. To explore self-perceptions
D. To promote client change

Answer 14

C

Question 15

Which client statement should a nurse identify as a typical response to stress most often experienced in the working phase of the nurse-client relationship?

A. “I can’t bear the thought of leaving here and failing.”
B. “I might have a hard time working with you. You remind me of my mother.”
C. “I can’t tell my husband how I feel; he wouldn’t listen anyway.”
D. “I’m not sure that I can count on you to protect my confidentiality.”

Answer 15

C

Question 16

Which client response should a nurse expect during the working phase of the nurse-client relationship?

A. The client gains insight and incorporates alternative behaviors.
B. The client and nurse establish rapport and mutually develop treatment goals.
C. The client explores feelings related to reentering the community.
D. The client explores personal strengths and weaknesses that impact behaviors.

Answer 16

A
insight 洞察
incorporates 盛り込む

Question 17

Why did the implementation of the Community Health Centers Act of 1963 fail?

Answer 17

Only 50% of the proposed centers were ever built

Shut down institutions to use drugs to tx pt. There were no community resources, but some started to be funded. In the 80s they found it didn’t work so they put the money to states since the govt could not achieve their goals.

Question 18

Primary Prevention?

Answer 18

Occurs before illness occurs

Teaching parenting skills and child development to prospective new parents
Teaching physical and psychosocial effects of alcohol/drugs to elementary school students
Providing education and support to unemployed or homeless individuals

Question 19

Secondary Prevention?

Question 20

Tertiary Prevention?
improving quality of life

Answer 20

Preventing complications of illness
Rehabilitation to reach maximum level of functioning

Question 21

Based on the public health model of primary level of prevention, which services would the community nurse provide?

A) Teaching recovering clients daily living skills and encouraging independence
B) Monitoring effectiveness of aftercare services through home health visits
C) Care of a client hospitalized for suicidal attempt
D) Teaching parenting skills and child development to prospective new parents

Answer 21

D

Question 22

A nurse is planning care for several clients who are attending community-based mental health programs. Which of the following clients should the nurse visit first?

A client who received a burn on the arm while using a hot iron at home
B lient who requests a change in antipsychotic medication due to some new adverse effects
C client who reports hearing a voice saying that life is not worth living anymore
D client who tells the nurse about experiencing manifestations of severe anxiety before and during a job interview

Answer 22

C

Question 23

A nurse is working in a community health facility. Which of the following services does this type of program provide? (Select all that apply)

A Educational groups
B Medication dispensing programs
C Individual counseling programs
D Detoxification programs
E Family therapy

Answer 23

A, B, C, E

Question 24

1. As the move-out date to leave the shelter gets closer, a battered wife states, “I’m afraid to leave here. I’m afraid for my safety and the safety of my children.” Which nursing statement is most supportive?

A. “This is a difficult transition. Let’s formulate a plan to keep you all safe in the community.”
B. “It’s the policy that clients can only live here for 30 days. Maybe we can ask for more time.”
C. “You’ve had a month to come up with a plan for keeping you and your family safe.”
D. “Hopefully, your husband has been in counseling. I’m sure this will work out fine.”

Answer 24

A

– uses reflection therapeutic communication

Question 25

Based on the public health model of primary level of prevention, which services would the community nurse provide?

A. Teaching recovering clients daily living skills and encouraging independence
B. Monitoring effectiveness of aftercare services through home health visits
C. Care of a client hospitalized for a suicidal attempt
D. Teaching parenting skills and child development to prospective new parents

Answer 25

D

Question 26

3. Which of the following represents a nursing intervention at the primary level of prevention?

Answer 26

A. Teaching a class in parent effectiveness training
B. Leading a group of adolescents in drug rehabilitation
C. Referring a married couple for sex therapy
D. Leading a support group for battered women

Question 27

4. Which of the following represents a nursing intervention at the secondary level of prevention?

A. Teaching a class about menopause to middle-aged women
B. Providing support in the emergency room to a rape victim
C. Leading a support group for women in transition
D. Making monthly visits to the home of a client with schizophrenia to ensure medication compliance

Answer 27

B

Question 28

5. Which of the following represents a nursing intervention at the tertiary level of prevention?

A. Serving as case manager for a mentally ill homeless client
B. Leading a support group for newly retired men
C. Teaching prepared childbirth classes
D. Caring for a depressed widow in the hospital

Answer 28

A

Question 29

6. John, a homeless person, has just come to live in the shelter. The shelter nurse is assigned to his care. Which of the following is a priority intervention on the part of the nurse?

A. Referring John to a social worker
B. Developing a plan of care for John
C. Conducting a behavioral and needs assessment on John
D. Helping John apply for Social Security benefits

Answer 29

C

Question 30

7. Mrs. W (a 78-year-old depressed widow) says to her home health nurse, “What’s the use? I don’t have anything to live for anymore.” Which is the best response on the part of the nurse?

A. “Of course you do, Mrs. W. Why would you say such a thing?”
B. “You seem so sad. I’m going to do my best to cheer you up.”
C. “Let’s talk about why you are feeling this way.”
D. “Have you been thinking about harming yourself in any way?”

Answer 30

D

Question 31

8. Which of the following behaviors are associated with the phenomenon of transference? (Select all that apply.)

A. The client attributes toward the nurse feelings associated with a person from the client’s past.
B. The nurse attributes toward the client feelings associated with a person from the nurse’s past.
C. The client forms an overwhelming affection for the nurse.
D. The client becomes excessively dependent on the nurse and forms unrealistic expectations of him or her.

Answer 31

A,C

Question 32

9. A client states: “I refuse to shower in this room. I must be very cautious. The FBI has placed a camera in here to monitor my every move.” Which of the following is the therapeutic response?

A. “That’s not true.”
B. “I have a hard time believing that is true.”
C. “Surely you don’t really believe that.”
D. “I will help you search this room so that you can see there is no camera.”

Answer 32

b

Question 33

10. Nancy, a depressed client who has been unkept and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most appropriate?

A. “Nancy, I see you have put on a clean dress and combed your hair.”
B. “Nancy, you look wonderful today!”
C. “Nancy, I’m sure everyone will appreciate that you have cleaned up for the group today.”
D. “Now that you see how important it is, I hope you will do this every day.”

Answer 33

A

Question 34

Dorothy was involved in an automobile accident while under the influence of alcohol. She swerved her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following
statements by the nurse is most appropriate?

A. “Now that you know what can happen when you drink and drive, I’m sure you won’t let it happen again.”
B. “You know that was a terrible thing you did. That child could have been killed.”
C. “I’m sure everything is going to be okay now that you understand the possible consequences of such behavior.”
D. “How are you feeling about what happened?”

Answer 34

D

Question 35

Mrs. S. asks the nurse, “Do you think I should tell my husband about my affair with my boss?” Which is the most appropriate response by the nurse?

A. “What do you think would be best for you to do?”
B. “Of course you should. Marriage has to be based on truth.”
C. “Of course not. That would only make things worse.”
D. “I can’t tell you what to do. You have to decide for yourself.”

Answer 35

A

Question 36

Carol, an adolescent, just returned from group therapy and is crying. She says to the nurse, “All the other kids laughed at me! I try to fit in, but I always seem to say the wrong thing. I’ve never had a close friend. I guess I never will.” Which is the most appropriate response by the nurse?

A. “What makes you think you will never have any friends?”
B. “You’re feeling pretty down on yourself right now.”
C. “I’m sure they didn’t mean to hurt your feelings.”
D. “Why do you feel this way about yourself?”

Answer 36

B

Question 37

What are the case management?

Answer 37

Assessment
Planning
Implementation
Coordination
Monitoring
Evaluation

Question 38

Case management

Assessment

Answer 38

Assessing below
Physical assessment if needed
Psychosocial history
Substance use
Coping strategies
Support systems
Cultural beliefs
MSE/The mental state examination

Question 39

When diagnose pt what tool to use?

Answer 39

DSM5(doctor)
NANDA dx- For NURSES

Question 40

What are counseling includes?

Answer 40

Milieu (environment/group) therapy
Promotion of self-care activities
Psychosocial interventions
Cognitive and behavioral therapies
Health Teaching
Health Promotion/Maintenance

Question 41

A nurse helps a newly admitted pt who has a psychotic disorder feel safe in the environment of the facility.

Beneficence, Autonomy, Justice,
Fidelity or Veracity?

Answer 41

Beneficence
The quality of doing good

Question 42

A pt says “You and that other staff were talking about me, weren’t you?
The nurse truly replay “ We were discussing wats to help you out”

Beneficence, Autonomy, Justice,
Fidelity or Veracity?

Answer 42

Veracity
Honesty when dealing with pt

Question 43

Rather than giving advice to pt who has difficulty making decisions, a nurse helps the pt explore all alternatives choices.
Beneficence, Autonomy, Justice,
Fidelity or Veracity?

Answer 43

Autonomy
The pt right to make their own decisions.

Question 44

During a treatment team meeting, a nurse leads a discussion regarding whether or not two pt who broke the same rule were treated equally

Beneficence, Autonomy, Justice,
Fidelity or Veracity?

Answer 44

Justice

Question 45

A pt asks nurse to be present when they talk to their guardian and the nurse remans with the client during the interaction

Beneficence, Autonomy, Justice,
Fidelity or Veracity?

Answer 45

Fidelity
Loyalty and faithfulness

Question 46

What is the involuntary commitment

Answer 46

pt enters against their will
Emergency commitments – danger to self, danger to others
Limited to 60 days, then another review of admission is required