Saunders NCLEX 7th Edition ch 61-65: Mental Health with complete questions and answers.

Saunders NCLEX 7th Edition ch 61-65: Mental Health with complete questions and answers. Ch 61: Foundations of Psychiatric Mental Health Nursing - correct answers. The nurse is assigned to care for a client experiencing disturbed thought processes. The nurse is told that the client believes that their food is being poisoned. Which communication technique should the nurse plan to use to encourage the client to eat? A. Open-ended questions and silence B. Focusing on self-disclosure regarding food preferences C. Stating the reasons that the client may not want to wat D. Offering opinions about the necessity of adequate nutrition - correct answers.Open-ended questions and silence *Open-ended questions and silence are strategies used to encourage clients to discuss their problem. Options C and D do not encourage the client to express feelings. The nurse should not offer opinions and should not state the reasons, but should encourage the client to identify the reasons for their behavior. Option B is not a client-centered intervention The nurse is assigned to care for a client admitted to the hospital after sustaining an injury from a house fire. The client attempted to save a neighbor involved in the fire, but despite the client's efforts, the neighbor died. Which action should the nurse take to enable the client to work through the meaning of the crisis? A. Identifying the client's ability to function B. Identifying the client's potential for self-harm C. Inquiring about the client's feelings that may affect coping D. Inquiring about the client's perception of the cause of the neighbor's death - correct answers.Inquiring about the client's feelings that may affect coping *The client must first deal with feelings and negative responses before the client is able to walk through the meaning of the crisis. Option C pertains directly to the client's feelings. Options A, B, and D do not directly address the client's feelings The nurse is assisting with the data collection on a client admitted to the psychiatric unit. After review of the obtained data, the nurse should identify which as a priority concern? A. The client's report of not eating or sleeping B. The presence of bruises on the client's body C. The client's report of self-destructive thoughts D. The family member is disapproving of the treatment - correct answers.The client's report of self-destructive thoughts *The client's thoughts are extremely important when verbalized. Self-destructive thoughts are the highest priority. Options A, B, and D will all affect the treatment of the client but are not of greatest importance at this time Laboratory work is prescribed for a client who has been experiencing delusions. When the laboratory technician approaches the client to obtain a specimen of the client's blood, the client begins to shout, "You're all vampires. Let me out of here!" The nurse who is present at the time should respond by stating which of the following? A. "The technician at the time is not going to hurt you but is going to help." B. "Are you fearful and think that others may want to hurt you?" C. "What makes you think that the technician wants to hurt you?" D. "The technician will leave and come back later for your blood." - correct answers."Are you fearful and think that others may want to hurt you?" *Option B is the only option that recognizes the client's need. This response helps the client focus on the emotion underlying the delusion but does not argue with it. If the nurse attempts to chage the client's mind, the delusion may, in fact, be even more strongly held. Options A, C, and D do not focus on the client's feelings An intoxicated client is brought to the emergency department by local police. The client is told that the oprimary health care provider (PHCP) will be in to see the client in about 30 minutes. The client becomes very loud and offensive and wants to be seen y the PHCP immediately. The nurse assising to care for the client should take which appropriate nursing intervention? A. Watch the behavior escalate before intervening B. Attempt to talk with the client to de-escalate the behavior C. Offer to take the client to an examination room until he or she can be treated D. Inform the client that he or she will be asked to leave if the behavior continues - correct answers.Offer to take the client to an examination room until he or she can be treated *Safety of the client, other clients, and staff is of prime concern. Options C is in effect an isolation technique that allows for separation from others and provides for a less stimulating environment when the client can maintain dignity. When dealing with an impaired individual, trying to talk may be out of the question. Waiting to intervene could cause the client to become even more agitated and a threat to others. Option D would only further aggravate an already agitated individual A client is admitted to a psychiatric unit for treatment of a psychotic disorder. The client is at the locked exit door and is shouting. "Let me out! There's nothing wrong with me! I don't belong here!" The nurse identifies this behavior as which defense mechanis,? A. Denial B. Projection C. Regression D. Rationalization - correct answers.Denial *Denial is the refusal to admit to a painful reality and is treated as if it does not exist. In projection, a person unconsciously rejects emotionally unacceptable features and attributes them to other people, objects, or situations. In regression, the client returns to an earlier, more comforting, although less mature, way of behaving. Rationalization is justifying the unacceptable attributes about oneself A client says to the nurse, "I'm going to 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 therapeutic response should the nurse make to the client? 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. "Well, it sounds like you're being pretty pessimistic. After all, years ago people died of pneumonia." - correct answers."You're feeling angry that your family continues to hope for you to be 'cured'?" *Reflection is the therapeutic communication technique that redirects the client's feelings back to validate what the client is saying. In option B, the nurse attempts to use focusing, but the attempt to discuss central issues is premature. In option D, the nurse makes a judgment and in nontherapeutic in the one-on-one relationship. In option A, the nurse is attempting to assess the client's ability to openly discuss feelings with family members. Although this may be appropriate, the timing is somewhat premature and closes off facilitation of the client's feelings