psychiatric chapter 9 well Answered

Which statement made by the nurse best demonstrates a core concept of patient- and family-centered care? - ANSWERS"Let me see if I understood your concerns about your medications." The nurse is conducting an admission interview with a client newly admitted voluntarily to the mental health unit for acute depression. Which statement made by the nurse best addresses the initial goal of a therapeutic nurse-patient relationship? - ANSWERS"My aim is to provide you with a safe, consistent environment to deal with your issues." Which statement by the nurse best confirms the relationship being maintained with the client is a therapeutic one? - ANSWERS"Can you give me some examples of how your coping skills have improved?" Which statement by the nurse demonstrates a blurring of boundaries with a client diagnosed with depression? - ANSWERS"The client is just too depressed to shower and dress today." Which intervention should the nurse implement to reinforce value education for an adolescent client with a history of being both physically and emotionally abused? - ANSWERSModeling to demonstrate the difference between assertive and aggressive behavior A nurse assesses a confused older adult. The nurse experiences sadness and reflects, "The patient is like one of my grandparents...so helpless." Which response is the nurse demonstrating? - ANSWERSCountertransference Which statement shows a nurse has empathy for a patient who made a suicide attempt? - ANSWERS"You must have been very upset when you tried to hurt yourself." After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference? - ANSWERSThe nurse feels unusually happy when the patient's mood begins to lift. A patient says, "Please don't share information about me with the other people." How should the nurse respond? - ANSWERS"I will not share information with your family or friends without your permission, but I share information about you with other staff." A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent most of the session. Another patient comes to the door of the room, interrupts, and says to the nurse, "I really need to talk to you." The nurse should: - ANSWERStell the interrupting patient, "This session is 5 more minutes; then I will talk with you." Termination of a therapeutic nurse-patient relationship has been successful when the nurse: - ANSWERSdiscusses with the patient changes that happened during the relationship and evaluates outcomes. What is the desirable outcome for the orientation stage of a nurse-patient relationship? The patient will demonstrate behaviors that indicate: - ANSWERSrapport and trust with the nurse. During which phase of the nurse-patient relationship can the nurse anticipate that identified patient issues will be explored and resolved? - ANSWERSWorking At what point in the nurse-patient relationship should a nurse plan to first address termination? - ANSWERSDuring the orientation phase A nurse introduces the matter of a contract during the first session with a new patient because contracts: - ANSWERSspell out the participation and responsibilities of each party. As a nurse escorts a patient being discharged after treatment for major depression, the patient gives the nurse a necklace with a heart pendant and says, "Thank you for helping mend my broken heart." Which is the nurse's best response? - ANSWERS"I'm glad I could help you, but I can't accept the gift. My reward is seeing you with a renewed sense of hope." Which remark by a patient indicates passage from orientation to the working phase of a nurse-patient relationship? - ANSWERS"I want to find a way to deal with my anger without becoming violent." A nurse explains to the family of a mentally ill patient how a nurse-patient relationship differs from social relationships. Which is the best explanation? - ANSWERS"The focus is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient." A nurse wants to demonstrate genuineness with a patient diagnosed with schizophrenia. The nurse should: - ANSWERSuse congruent communication strategies. A nurse caring for a withdrawn, suspicious patient recognizes development of feelings of anger toward the patient. The nurse should: - ANSWERSdiscuss the anger with a clinician during a supervisory session. A nurse wants to enhance growth of a patient by showing positive regard. The nurse's action most likely to achieve this goal is: - ANSWERSstaying with a tearful patient. A patient says, "I've done a lot of cheating and manipulating in my relationships." Select a nonjudgmental response by the nurse. - ANSWERS"How do you feel about that?" A patient says, "People should be allowed to commit suicide without interference from others." A nurse replies, "You're wrong. Nothing is bad enough to justify death." What is the best analysis of this interchange? - ANSWERSDiffering values are reflected in the two statements. Which issues should a nurse address during the first interview with a patient with a psychiatric disorder? - ANSWERSRelationship parameters, the contract, confidentiality, and termination An advanced practice nurse observes a novice nurse expressing irritability regarding a patient with a long history of alcoholism and suspects the new nurse is experiencing countertransference. Which comment by the new nurse confirms this suspicion? - ANSWERS"My parents were alcoholics and often neglected our family." Which behavior shows that a nurse values autonomy? The nurse: - ANSWERSdiscusses options and helps the patient weigh the consequences. As a nurse discharges a patient, the patient gives the nurse a card of appreciation made in an arts and crafts group. What is the nurse's best action? - ANSWERSRecognize the effectiveness of the relationship and patient's thoughtfulness. Accept the card. A patient says, "I'm still on restriction, but I want to attend some off-unit activities. Would you ask the doctor to change my privileges?" What is the nurse's best response? - ANSWERS"That's a good topic for you to discuss with your doctor." A community mental health nurse has worked with a patient for 3 years but is moving out of the city and terminates the relationship. When a novice nurse begins work with this patient, what is the starting point for the relationship? - ANSWERSBegin at the orientation phase. As a patient diagnosed with a mental illness is being discharged from a facility, a nurse invites the patient to the annual staff picnic. What is the best analysis of this scenario? - ANSWERSThe nurse's action blurs the boundaries of the therapeutic relationship. A nurse says, "I am the only one who truly understands this patient. Other staff members are too critical." The nurse's statement indicates: - ANSWERSboundary blurring. Which descriptors exemplify consistency regarding nurse-patient relationships? Select all that apply. - ANSWERSb. Having the same nurse care for a patient on a daily basis c. Providing a schedule of daily activities to a patient d. Setting a time for regular sessions with a patient A nurse ends a relationship with a patient. Which actions by the nurse should be included in the termination phase? Select all that apply. - ANSWERSa. Focus dialogues with the patient on problems that may occur in the future. b. Help the patient express feelings about the relationship with the nurse. A novice psychiatric nurse has a parent with bipolar disorder. This nurse angrily recalls feelings of embarrassment about the parent's behavior in the community. Select the best ways for this nurse to cope with these feelings.Select all that apply. - ANSWERSa. Seek ways to use the understanding gained from childhood to help patients cope with their own illnesses. e. Recognize that the feelings may add sensitivity to the nurse's practice, but supervision is important.