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NCLEX PRACTICE QUESTIONS FOR FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING (RN) WITH CORRECT ANSWERS #24

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NCLEX PRACTICE QUESTIONS FOR FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING (RN) WITH CORRECT ANSWERS #24

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NCLEX PRACTICE QUESTIONS FOR FOUNDATIONS OF PSYCHIATRIC MENTAL
HEALTH NURSING (RN) WITH CORRECT ANSWERS #24

1. A patient with a diagnosis of major depression who has attenpted 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 failiure?"
C. "Feeling like this is all part of being depressed."
D. "You've been feeling like a failure for a while?" - correct answer (D) "You've been
feeling like a failure for a while?"
RATIONALE: 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 additions, use of the word "why" is nontherapeutic.

2. When the community health nurse visits a patient at home, the patitent states, "I
haven't slept at all the last cople of nights. Which response by the nurse illustrates a
therapeutic communication response to this patient."
A. "I see."
B. "Really?"
C. "You're having difficulty sleeping?"
D. "Sometimes, I have trouble sleeping too." - correct answer (C) "You're having
difficulty sleeping?"
RATIONALE: 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.

3. 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 prefernce regarding food choices
C. Documenting reasons why the patient does not wat to eat
D. Offering opinions about the necessity of adequate nutrition - correct answer (A)
Using open-ended questions and silence
RATIONALE: Open-ended questions and silence are strategies use to encourage
patients to discuss their problems. Sharing personal food preferences is not a patient-
centered intervention. The remaining options are not helpful to the patient because they
do not encourage the patient to express feelings. The nurse should not offer opinions
and should encourage the patient to identify the reasons for the behavior.

, 4. A patient admitted to a nental health unit for treatment of psychotic behavior spends
hours at teh locked exit door shouting. "Let me out. Ther'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 - correct answer (A) Denial
RATIONALE: 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 ealier, 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.

5. A patient diagnosed with terminal cancer says to the nurse "I'm going ot 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 understanble with such a diagnosis" -
correct answer (C) "You're feeling angry that your family continues to hope for you to be
cured?"
RATIONALE: 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 feeing, this is non-therapeutic in the one-to-one relationship.

6. On review of the patients 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 agressiveness directed toward others.
C. An understanding of the pathology and syptoms of the diagnosis
D. A willingness to participte in the planning of the care and treatment plan - correct
answer (D) A willingness to participate in the planning of the care and treatment plan
RATIONALE: 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 patients understanding of their illness, only of their desire for help.

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