Test Bank For Primary Care Psychiatry 2nd Edition by Robert McCarron, Glen Xiong Chapter 1 - 26

Chapter 1: The Primary Care Psychiatric Interview Primary Care Psychiatry 2nd Edition McCarron Xiong Test Bank MULTIPLE CHOICE 1. A patient says to the nurse, I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadnt rested well. Which response should the nurse use to clarify the patients comment? a. It sounds as though you were uncomfortable with the content of your dream. b. I understand what youre saying. Bad dreams leave me feeling tired, too. c. So you feel as though you did not get enough quality sleep last night? d. Can you give me an example of what you mean by stoned? ANSWER: D The technique of clarification is therapeutic and helps the nurse examine the meaning of the patients statement. Asking for a definition of stoned directly asks for clarification. Restating that the patient is uncomfortable with the dreams content is parroting, a non-therapeutic technique. The other responses fail to clarify the meaning of the patients comment. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: mcs 154 (dm 9-2) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 2. A patient diagnosed with schizophrenia tells the nurse, The CIA is monitoring us through the fluorescent lights in this room. Be careful what you say. Which response by the nurse would be most therapeutic? a. Lets talk about something other than the CIA. b. It sounds like youre concerned about your privacy. S - The Marketplace to Buy and Sell your Study Material c. The CIA is prohibited from operating in health care facilities. d. You have lost touch with reality, which is a symptom of your illness. ANSWER: B It is important not to challenge the patients beliefs, even if they are unrealistic. Challenging undermines the patients trust in the nurse. The nurse should try to understand the underlying feelings or thoughts the patients message conveys. The correct response uses the therapeutic technique of reflection. The other comments are non-therapeutic. Asking to talk about something other than the concern at hand is changing the subject. Saying that the CIA is prohibited from operating in health care facilities gives false reassurance. Stating that the patient has lost touch with reality is truthful, but uncompassionate. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: mcs 154 (dm 9-2) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 3. The patient says, My marriage is just great. My spouse and I always agree. The nurse observes the patients foot moving continuously as the patient twirls a shirt button. The conclusion the nurse can draw is that the patients communication is: a. clear. c. precise. b. mixed. d. inadequate. ANSWER: B Mixed messages involve the transmission of conflicting or incongruent messages by the speaker. The patients verbal message that all was well in the relationship was modified by the nonverbal behaviors denoting anxiety. Data are not present to support the choice of the verbal message being clear, explicit, or inadequate. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: mcs 150-151 TOP: Nursing Process: Assessment S - The Marketplace to Buy and Sell your Study Material MSC: Client Needs: Psychosocial Integrity 4. A nurse interacts with a newly hospitalized patient. Select the nurses comment that applies the communication technique of offering self. a. Ive also had traumatic life experiences. Maybe it would help if I told you about them. b. Why do you think you had so much difficulty adjusting to this change in your life? c. I hope you will feel better after getting accustomed to how this unit operates. d. Id like to sit with you for a while to help you get comfortable talking to me. ANSWER: D Offering self is a technique that should be used in the orientation phase of the nurse-patient relationship. Sitting with the patient, an example of offering self, helps to build trust and convey that the nurse cares about the patient. Two incorrect responses are ineffective and non￾therapeutic. The other incorrect response is therapeutic but is an example of offering hope. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: mcs 154 (dm 9-2) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 5. Which technique will best communicate to a patient that the nurse is interested in listening? a. Restating a feeling or thought the patient has expressed. b. Asking a direct question, such as Did you feel angry? c. Making a judgment about the patients problem. d. Saying, I understand what youre saying. ANSWER: A Restating allows the patient to validate the nurses understanding of what has been communicated. Restating is an active listening technique. Judgments should be suspended in a S - The Marketplace to Buy and Sell your Study Material nurse-patient relationship. Close-ended questions such as Did you feel angry? ask for specific information rather than showing understanding. When the nurse simply states that he or she understands the patients words, the patient has no way of measuring the understanding. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: mcs 154 (dm 9-2) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 6. A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate? a. What are the common elements here? b. Tell me again about your experiences. c. Am I correct in understanding that . . . d. Tell me everything from the beginning. ANSWER: C Asking, Am I correct in understanding that permits clarification to ensure that both the nurse and patient share mutual understanding of the communication. Asking about common elements encourages comparison rather than clarification. The remaining responses are implied questions that suggest the nurse was not listening. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: mcs 154 (dm 9-2) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity