NCLEX questions therapeutic communication

NCLEX questions therapeutic communication Social SciencesPsychologyClinical Psychology Sal13148Top creator on Quizlet Save NCLEX Style Questions - Therapeuti...34 terms Creola733Preview Psychiatric Nursing - Therapeutic C...30 terms caroline_lyons8 Preview FINAL - Chapter 24 - Personality Dis...34 terms jhess214Preview Anxiety 30 terms gra A patient with a diagnosis of major depression who has attempted suicide says to the nurse, "I should have died! I've always been a failure.Nothing ever goes right for me." Which response demonstrates therapeutic communication?A "You have everything to live for." B "Why do you see yourself as a failure?" C "Feeling like this is all part of being depressed."

• "You've been feeling like a failure for a while?"

D Responding to the feelings expressed by a patient is an effective therapeutic communication technique. The correct option is an example of the use of restating. The remaining options block communication because they minimize the patient's experience and do not facilitate exploration of the patient's expressed feelings. In addition, use of the word "why" is nontherapeutic.When the community health nurse visits a patient at home, the patient states, "I haven't slept the last couple of nights." Which response by the nurse illustrates a therapeutic communication response to this patient.A "I see." B "Really?"

• "You're having difficulty sleeping?"

D "Sometimes, I have trouble sleeping too."

• "You're having difficulty sleeping?"

The correct option uses the therapeutic communication technique of restatement. Although restatement is a technique that has a prompting component to it, it repeats the patients major theme, which assists the nurse to obtain a more specific perception of the problem from the patient. The remaining options are not therapeutic responses since none encourage the patient to expand on the problem. Offering personal experiences moves the focus away from the patient and onto the nurse.

A patient experiencing disturbed thought processes believes that his food is being poisoned. Which communication technique should the use to encourage the patient to eat?A Using open-ended questions and silence B Sharing personal preference regarding food choices C Documenting reasons why the patient does not want to eat D Offering opinions about the necessity of adequate nutrition A A patient admitted to a mental health unit for treatment of psychotic behavior spends hours at the locked exit door shouting. "Let me out. There's nothing wrong with me. I don't belong here." What defense mechanism is the patient implementing?A Denial B Projection C Regression D Rationalization A Denial is refusal to admit to a painful reality, which is treated as if it does not exist. In projection, a person unconsciously rejects emotionally unacceptable features and attributes them to other persons, objects, or situations. Regression allows the patient to return to an earlier, more comforting, although less mature, way of behaving. Rationalization is justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller and the listener.A patient diagnosed with terminal cancer says to the nurse "I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." Which response by the nurse is therapeutic?A "Have you shared your feelings with your family?" B "I think we should talk more about your anger with your family." C "You're feeling angry that your family continues to hope for you to be cured?" D "You are probably very depressed, which is understandable with such a diagnosis." C Restating is a therapeutic communication technique in which the nurse repeats what the patient says to show understanding and to review what was said. While it is appropriate for the nurse to attempt to assess the patient's ability to discuss feelings openly with family members, it does not help the patient discuss the feelings causing the anger. The nurse's attempt to focus on the central issue of anger is premature. The nurse would never make a judgment regarding the reason for the patient's feeling, this is non-therapeutic in the one-to-one relationship.On review of the patient's record, the nurse notes the admission was voluntary. Based on this information, the nurse anticipates which patient behavior?A Fearfulness regarding treatment measures.B Anger and aggressiveness directed toward others.C An understanding of the pathology and symptoms of the diagnosis.D A willingness to participate in the planning of the care and treatment plan.D In general, patients seek voluntary admission. If a patient seeks voluntary admission, the most likely expectations is the patient will participate in the treatment program since they are actively seeking help. The remaining options are not characteristics of this type of admission. Fearfulness, anger, and aggressiveness are more characteristic of an involuntary admission. Voluntary admission does not guarantee a patient's understanding of their illness, only of their desire for help.

A patient admitted voluntarily for treatment of an anxiety disorder demands to be released from the hospital. Which action should the nurse take

INITIALLY?

A Contact the patient's health care provider (HCP).B Call the patient's family to arrange for transportations.C Attempt to persuade the patient to stay for only a few more days.D Tell the patient that leaving would likely result in an involuntary commitment.A In general, patients seek, voluntary admission. Voluntary patients have the right to demand and obtain release. The nurse needs to be familiar with the state and facility policies and procedures. The best nursing action is to contact the HCP, who has the authority to discuss discharge with the patient. While arranging for safe transportation is appropriate it is premature in this situation and should be done only with the patient's' permission. While it is appropriate to discuss why the patient feels the need to leave and the possible outcomes of leaving against medical advice, attempting to get the patient to agree to staying "a few more days" has little value and will not likely be successful. Many states require that the patient submit a written release notice to the facility staff members, who reevaluate the patient's condition for possible conversion to involuntary status if necessary, according to criteria established by law. While this is a possibility, it should not be used as a threat to the patient.When reviewing the admission assessment, the nurse notes that a patient was admitted to the mental health unity involuntarily. Based on this type of admission, the nurse should provide which intervention for this patient?A Monitor closely for harm to self or others.B Assist in completing an application for admission.C Supply the patient with written information about their mental illness.D Provide an opportunity for the family to discuss why they felt the admission was needed.A Involuntary admission is necessary when a person is a danger to self or others or is in need of psychiatric treatment regardless of the patient's willingness to consent to the hospitalization. A written request is a component of a voluntary admission. Providing written information regarding the illness is likely premature initially. The family may have had no role to play in the patient's' admission.The nurse is preparing a patient for the termination phase of the nurse-patient relationship. The nurse prepares to implement which nursing task that is MOST APPROPRIATE for this phase?A Planning short-term goals B Making appropriate referrals C Developing realistic solutions D Identifying expected outcomes B Tasks of the termination phase include evaluating patient performance, evaluating achievement of expected outcomes, evaluating future needs, making appropriate referrals and dealing with the common behaviors associated with termination. The remaining options identify tasks appropriate for the working phase of the relationship.The nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbors says to the nurse, "How is Mary doing? She is my best friend and is seen at your clinic every week." Which is the MOST APPROPRIATE nursing response?A "I can not discuss any patient situation with you." B "If you want to know about Mary, you need t ask her yourself." C "Only because you're worried about a friend, I'll tell you that she is improving." D "Being her friend, you know she is having a difficult time and deserves her privacy." A The nurse is required to maintain confidentiality regarding the patient and the patient's care. Confidentiality is basic to the therapeutic relationship and is a patient's right. The most appropriate response to the neighbor is the statement of that responsibility in a direct, but polite manner. A blunt statement that does not acknowledge why the nurse cannot reveal patient information may be taken as disrespectful and uncaring. The remaining options identify statements that do not maintain patient confidentiality.

The nurse calls security and has physical restraints applied when a client who was admitted voluntarily becomes both physically and verbally abusive while demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions? Select all that apply.A Libel B Battery C Assault D Slander E False Imprisonment BCE False imprisonment is an act with the intent to confine a person to a specific area. The nurse can be charged with false imprisonment if the nurse prohibits a patient from leaving the hospital if the patient has been admitted voluntarily and if no agency or legal policies exist for detaining the patient. Assault and battery are related to the act of restraining the patient in a situation that did not meet criteria for such an intervention. Libel and slander are not applicable here since the nurse did not write or verbally make untrue statements about the patient Libel A written defamation of a person's character, reputation, business, or property rights.Slander Spoken defamation battery Illegal touching of another person assault A threatened or attempted physical attack by someone who appears to be able to cause bodily harm if not stopped The nurse in the mental health unit recognizes which of the following as therapeutic communication techniques? Select all that apply.A Restating B Listening C Asking the patient "Why?" D Maintaining neutral responses E Providing acknowledgment and feedback F Giving advice and approval or disapproval ABDE Therapeutic communication techniques include listening, maintaining silence, maintaining neutral responses, using broad openings and open- ended questions, focusing and refocusing, restating, clarifying and validating, sharing perceptions, reflecting, providing acknowledgment and feedback, giving information, presenting reality, encouraging formulation of a plan of action, providing nonverbal encouragement, and summarizing Asking why is often interpreted as being accusatory by the patient and should also be avoided. Providing advice or giving approval or disapproval are barriers to communication.