Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice Quiz #3: 75 Questions

Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice Quiz #3: 75 Questions 1. 1. Question A psychotic client reports to the evening nurse that the day nurse put something suspicious in his water with his medication. The nurse replies, “You’re worried about your medication?” The nurse’s communication is: o A. An example of presenting reality o B. Reinforcing the client’s delusions o C. Focusing on emotional content o D. A non-therapeutic technique called mind-reading Incorrect Correct Answer: C. Focusing on emotional content The nurse should help the client focus on the emotional content rather than delusional material. Sometimes during a conversation, patients mention something particularly important. When this happens, nurses can focus on their statement, prompting patients to discuss it further. Patients don’t always have an objective perspective on what is relevant to their case; as impartial observers, nurses can more easily pick out the topics to focus on. • Option A: Presenting reality isn’t helpful because it can lead to confrontation and disengagement. It’s frequently useful for nurses to summarize what patients have said after the fact. This demonstrates to patients that the nurse was listening and allows the nurse to document conversations. Ending a summary with a phrase like “Does that sound correct?” gives patients explicit permission to make corrections if they’re necessary. • Option B: Agreeing with the client and supporting his beliefs are reinforcing delusions. Patients often ask nurses for advice about what they should do about particular problems or in specific situations. Nurses can ask patients what they think they should do, which encourages patients to be accountable for their own actions and helps them come up with solutions themselves. • Option D: Mind reading isn’t therapeutic. Similar to active listening, asking patients for clarification when they say something confusing or ambiguous is important. Saying something like “I’m not sure I understand. Can you explain it to me?” helps nurses ensure they understand what’s actually being said and can help patients process their ideas more thoroughly 2. 2. Question A client is admitted to the inpatient unit of the mental health center with a diagnosis of paranoid schizophrenia. He’s shouting that the government of France is trying to assassinate him. Which of the following responses is most appropriate? • A. “I think you’re wrong. France is a friendly country and an ally of the United States. Their government wouldn’t try to kill you.” • B. “I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel frightened by this.” • C. “You’re wrong. Nobody is trying to kill you.” • D. “A foreign government is trying to kill you? Please tell me more about it.” Incorrect Correct Answer: B. “I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel frightened by this.” Responses should focus on reality while acknowledging the client’s feelings. Sometimes during a conversation, patients mention something particularly important. When this happens, nurses can focus on their statement, prompting patients to discuss it further. Patients don’t always have an objective perspective on what is relevant to their case; as impartial observers, nurses can more easily pick out the topics to focus on. • Option A: Arguing with the client or denying his belief isn’t therapeutic. By using nonverbal and verbal cues such as nodding and saying “I see,” nurses can encourage patients to continue talking. Active listening involves showing interest in what patients have to say, acknowledging that you’re listening and understanding, and engaging with them throughout the conversation. Nurses can offer general leads such as “What happened next?” to guide the conversation or propel it forward. • Option C: Arguing can also inhibit development of a trusting relationship. Continuing to talk about delusions may aggravate the psychosis. It’s frequently useful for nurses to summarize what patients have said after the fact. This demonstrates to patients that the nurse was listening and allows the nurse to document conversations. Ending a summary with a phrase like “Does that sound correct?” gives patients explicit permission to make corrections if they’re necessary. • Option D: Asking the client if a foreign government is trying to kill him may increase his anxiety level and can reinforce his delusions. Voicing doubt can be a gentler way to call attention to the incorrect or delusional