Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. Which skill is most important for a nurse preparing to work in the psychiatric setting?
a. Helpful transference
b. Sympathetic listening
c. Supportive confrontation
d. Therapeutic communication
ANS: D
Therapeutic communication provides the basis for effective use of each stage of the nursing
process, as explained by the authors. The other options are skills basic to effective use of the
nursing process.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
2. When observing and interpreting a patient‘s nonverbal communication, which nursing
consideration is important?
a. Knowing that patients are usually aware of their nonverbal cues
b. Accepting that verbal responses are more important than nonverbal cues
c. Recognizing that nonverbal cues have obvious meaning and are easily interpreted
d. Validating nonverbal cues to provide significant information
ANS: D
, Body language has meaning but meaning cannot be globally ascribed. Validation with the
individual is necessary to accurate interpretation. The other options are incorrect in the
information they provide.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
3. A patient diagnosed with schizophrenia, paranoid type, frequently gets up, and walks away
during interactions with a nurse. How can the nurse best increase the patient‘s comfort level and
so encourage communication?
a. Arranging the chairs side by side, about 2 feet apart
b. Sitting at eye level across the table from the patient
c. Standing a few feet away from where the patient sits
d. Talking in the patient‘s room with the door closed
ANS: B
Suspicious patients require increased personal space. Sitting across the table provides that space.
Being at the same eye level fosters communication. Side-by-side placement of chairs might not
give the suspicious patient the ability to watch the nurse closely enough for comfort. Being in a
closed room might be threatening to the patient.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. During a one-on-one interaction with the nurse, a patient frequently looks nervously at the door.
Select the best nursing response to this nonverbal cue.
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.‖
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.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation