EXAM1 PSYCHIATRIC\MENTAL HEALTH
NURSING PRACTICE QUESTIONS(LASTEST
UPDATE).
Documentation in a patient's chart shows, "Throughout a 5-minute
interaction, patient 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 patient is giving positive feedback about the nurse's communication
techniques.
b. The nurse is viewing the patient's behavior through a cultural filter.
c. The patient's verbal and nonverbal messages are incongruent.
d. The patient is demonstrating psychotic behaviors. - CORRECT ANSWER -
ANS: C
When a verbal message is not reinforced with nonverbal behavior, the
message is confusing and incongruent. Some clinicians call it a "mixed
message." It is inaccurate to say that the patient is giving positive feedback
about the nurse's communication techniques. The concept of a cultural
filter is not relevant to the situation because a cultural filter determines
what we will pay attention to and what we will ignore. Data are insufficient
to draw the conclusion that the patient is demonstrating psychotic
behaviors.
While talking with a patient diagnosed with major depression, a nurse
notices the patient is unable to maintain eye contact. The patient's chin
lowers to the chest, while the patient 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 - CORRECT ANSWER -ANS: A
Eye contact and body movements are considered nonverbal
communication. There are insufficient data to determine the level of the
patient's social skills or whether a cultural barrier exists.
During the first interview with a parent whose child died in a car accident,
the nurse feels empathic and reaches out to take the patient's hand. Select
the correct analysis of the nurse's behavior.
a. It shows empathy and compassion. It will encourage the patient to
continue to express feelings.
b. The gesture is premature. The patient's cultural and individual
interpretation of touch is unknown.
c. The patient will perceive the gesture as intrusive and overstepping
boundaries.
d. The action is inappropriate. Psychiatric patients should not be touched. -
CORRECT ANSWER -ANS: B
Touch has various cultural and individual interpretations. Nurses should
refrain from using touch until an assessment can be made regarding the
way in which the patient will perceive touch. The other options present
prematurely drawn conclusions.
During a one-on-one interaction with the nurse, a patient frequently looks
nervously at the door. Select 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." -
CORRECT ANSWER -ANS: A
Making observations and encouraging the patient to describe perceptions
are useful therapeutic communication techniques for this situation. The
other responses are assumptions made by the nurse.
A black patient says to a white nurse, "There's no sense talking. You
wouldn't understand because you live in a white world." The nurse's best
action would be to:
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 patient that nurses interact with people from all cultures.
d. change the subject to one that is less emotionally disturbing. - CORRECT
ANSWER -ANS: B
Having the patient speak in specifics rather than globally will help the
nurse understand the patient's perspective. This approach will help the
nurse engage the patient. Reassurance and changing the subject are not
therapeutic techniques.
A Filipino American patient had a nursing diagnosis of situational low self-
esteem related to poor social skills as evidenced by lack of eye contact.
Interventions were used to raise the patient's self-esteem, but after 3 weeks,
the patient's eye contact did not improve. What is the most accurate
analysis of this scenario?
a. The patient'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 patient.
, c. The patient's poor eye contact is indicative of anger and hostility that
were unaddressed.
d. The nurse should have assessed the patient's culture before making this
diagnosis and plan. - CORRECT ANSWER -ANS: D
The amount of eye contact a person engages in is often culturally
determined. In some cultures, eye contact is considered insolent, whereas
in others eye contact is expected. Asian Americans, including persons from
the Philippines, often prefer not to engage in direct eye contact.
When a female Mexican American patient and a female nurse sit together,
the patient often holds the nurse's hand. The patient also links arms with
the nurse when they walk. The nurse is uncomfortable with this behavior.
Which analysis is most accurate?
a. The patient is accustomed to touch during conversation, as are members
of many Hispanic subcultures.
b. The patient understands that touch makes the nurse uncomfortable and
controls the relationship based on that factor.
c. The patient is afraid of being alone. When touching the nurse, the patient
is reassured and comforted.
d. The patient is trying to manipulate the nurse using nonverbal techniques.
- CORRECT ANSWER -ANS: A
The most likely answer is that the patient's behavior is culturally
influenced. Hispanic women frequently touch women they consider to be
their friends. Although the other options are possible, they are less likely.
A Puerto Rican American patient uses dramatic body language when
describing emotional discomfort. Which analysis most likely explains the
patient's behavior? The patient:
a. has a histrionic personality disorder.
NURSING PRACTICE QUESTIONS(LASTEST
UPDATE).
Documentation in a patient's chart shows, "Throughout a 5-minute
interaction, patient 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 patient is giving positive feedback about the nurse's communication
techniques.
b. The nurse is viewing the patient's behavior through a cultural filter.
c. The patient's verbal and nonverbal messages are incongruent.
d. The patient is demonstrating psychotic behaviors. - CORRECT ANSWER -
ANS: C
When a verbal message is not reinforced with nonverbal behavior, the
message is confusing and incongruent. Some clinicians call it a "mixed
message." It is inaccurate to say that the patient is giving positive feedback
about the nurse's communication techniques. The concept of a cultural
filter is not relevant to the situation because a cultural filter determines
what we will pay attention to and what we will ignore. Data are insufficient
to draw the conclusion that the patient is demonstrating psychotic
behaviors.
While talking with a patient diagnosed with major depression, a nurse
notices the patient is unable to maintain eye contact. The patient's chin
lowers to the chest, while the patient 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 - CORRECT ANSWER -ANS: A
Eye contact and body movements are considered nonverbal
communication. There are insufficient data to determine the level of the
patient's social skills or whether a cultural barrier exists.
During the first interview with a parent whose child died in a car accident,
the nurse feels empathic and reaches out to take the patient's hand. Select
the correct analysis of the nurse's behavior.
a. It shows empathy and compassion. It will encourage the patient to
continue to express feelings.
b. The gesture is premature. The patient's cultural and individual
interpretation of touch is unknown.
c. The patient will perceive the gesture as intrusive and overstepping
boundaries.
d. The action is inappropriate. Psychiatric patients should not be touched. -
CORRECT ANSWER -ANS: B
Touch has various cultural and individual interpretations. Nurses should
refrain from using touch until an assessment can be made regarding the
way in which the patient will perceive touch. The other options present
prematurely drawn conclusions.
During a one-on-one interaction with the nurse, a patient frequently looks
nervously at the door. Select 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." -
CORRECT ANSWER -ANS: A
Making observations and encouraging the patient to describe perceptions
are useful therapeutic communication techniques for this situation. The
other responses are assumptions made by the nurse.
A black patient says to a white nurse, "There's no sense talking. You
wouldn't understand because you live in a white world." The nurse's best
action would be to:
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 patient that nurses interact with people from all cultures.
d. change the subject to one that is less emotionally disturbing. - CORRECT
ANSWER -ANS: B
Having the patient speak in specifics rather than globally will help the
nurse understand the patient's perspective. This approach will help the
nurse engage the patient. Reassurance and changing the subject are not
therapeutic techniques.
A Filipino American patient had a nursing diagnosis of situational low self-
esteem related to poor social skills as evidenced by lack of eye contact.
Interventions were used to raise the patient's self-esteem, but after 3 weeks,
the patient's eye contact did not improve. What is the most accurate
analysis of this scenario?
a. The patient'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 patient.
, c. The patient's poor eye contact is indicative of anger and hostility that
were unaddressed.
d. The nurse should have assessed the patient's culture before making this
diagnosis and plan. - CORRECT ANSWER -ANS: D
The amount of eye contact a person engages in is often culturally
determined. In some cultures, eye contact is considered insolent, whereas
in others eye contact is expected. Asian Americans, including persons from
the Philippines, often prefer not to engage in direct eye contact.
When a female Mexican American patient and a female nurse sit together,
the patient often holds the nurse's hand. The patient also links arms with
the nurse when they walk. The nurse is uncomfortable with this behavior.
Which analysis is most accurate?
a. The patient is accustomed to touch during conversation, as are members
of many Hispanic subcultures.
b. The patient understands that touch makes the nurse uncomfortable and
controls the relationship based on that factor.
c. The patient is afraid of being alone. When touching the nurse, the patient
is reassured and comforted.
d. The patient is trying to manipulate the nurse using nonverbal techniques.
- CORRECT ANSWER -ANS: A
The most likely answer is that the patient's behavior is culturally
influenced. Hispanic women frequently touch women they consider to be
their friends. Although the other options are possible, they are less likely.
A Puerto Rican American patient uses dramatic body language when
describing emotional discomfort. Which analysis most likely explains the
patient's behavior? The patient:
a. has a histrionic personality disorder.
