Application of concepts in psychiatric
mental health nursing- chapter 11
1. An angry client on an inpatient unit approaches a nurse, stating, "Someone took my
lunch! People need to respect others, and you need to do something about this now!"
The nurse's response should be guided by which basic assumption of milieu therapy?
1. Conflict should be avoided at all costs on inpatient psychiatric units.
2. Conflict should be resolved by the nursing staff.
3. Every interaction is an opportunity for therapeutic intervention.
4. Conflict resolution should be addressed only during group therapy. - ANS>>3. This is
correct. Every interaction is an opportunity for therapeutic intervention.
2. A client on an inpatient unit angrily states to a nurse, "Peter is not cleaning up after
himself in the community bathroom. You need to address this problem." Which
response by the nurse is appropriate?
1. "I'll talk to Peter and present your concerns."
2. "Why are you overreacting to this issue?"
3. "You should bring this to the attention of your treatment team."
4. "I can see that you are angry. Let's discuss ways to approach Peter with your
concerns." - ANS>>4. This is correct. This is a therapeutic statement to the client.
3. A newly admitted client asks, "Why do we need a unit schedule? I'm not going to
these groups. I'm here to get some rest." Which reply by the nurse is appropriate?
1. "Group therapy provides the opportunity to learn and practice new coping skills."
2. "Group therapy is mandatory. All clients must attend."
3. "Group therapy is optional. You can go if you find the topic helpful and interesting."
4. "Group therapy is an economical way of providing therapy to many clients
concurrently." - ANS>>1. This is correct. This statement is therapeutic to the client and
explains why group therapy is important.
4. A client diagnosed with schizophrenia functions well and is bright, spontaneous, and
interactive during hospitalization but then decompensates after discharge. Which
statement is true regarding what the milieu provides that may be missing in the home
environment?
1. Peer pressure
2. Structured programming
3. Visitor restrictions
4. Mandated activities - ANS>>2. This is correct. The therapeutic community provides a
structured schedule of
activities in which interpersonal interaction and communication with others are
emphasized. In the milieu, time is also devoted to personal problems and focus
groups. Structured programming is often missing in the home environment.
, 5. To promote self-reliance, how would a psychiatric-mental health nurse best conduct
medication administration?
1. Encourage clients to request their medications at the appropriate times.
2. Refuse to administer medications unless clients request them at the appropriate
times.
3. Allow the clients to determine appropriate medication times.
4. Take medications to the clients' bedsides at the appropriate times. - ANS>>1. This is
correct. This action promotes self-reliance in the client. Nurses are
responsible for the management of medication administration on inpatient
psychiatric units; however, nurses must work with clients to foster independence and
provide experiences that would foster increased self-esteem.
6. A nurse working on an inpatient psychiatric unit is assigned to conduct a 45-minute
education group. Which activity would the nurse identify as an appropriate group topic?
1. Dream analysis
2. Creative cooking
3. Paint by number
4. Stress management - ANS>>4. This is correct. The nurse should identify that
teaching clients about stress
management is an appropriate education group topic. Nurses should be able to
perform the role of client teacher in the psychiatric area. Nurses need to be able to
assess a client's learning readiness. Other topics for education groups include
medical diagnoses, side effects of medications, and the importance of medication
compliance
7. Which statement made by the nursing student indicates an understanding regarding
the role of the social worker?
1. "The social worker can encourage a client to express their feelings through the use of
music."
2. "My client has been eating drywall, so I have contacted the social worker to come
speak to them."
3. "I have asked the social worker to organize a game of volleyball this weekend."
4. "My client cannot afford medications when they are discharged, so the social worker
is arranging some assistance." - ANS>>4. This is correct. A social worker is concerned
with a client's social needs, such as
placement, financial support, and community requirements.
8. Which statement describes the development of trust between the nurse and client?
1. "You cannot draw a picture until you take your medication."
2. "I am sorry you are angry."
3. "I am going to teach you how to change your dressing."
4. "I will listen if you would like to tell me about your day." - ANS>>4. This is correct. The
nurse is telling the client they will listen to them, which, by
encouraging them to share their feelings, establishes trust.
mental health nursing- chapter 11
1. An angry client on an inpatient unit approaches a nurse, stating, "Someone took my
lunch! People need to respect others, and you need to do something about this now!"
The nurse's response should be guided by which basic assumption of milieu therapy?
1. Conflict should be avoided at all costs on inpatient psychiatric units.
2. Conflict should be resolved by the nursing staff.
3. Every interaction is an opportunity for therapeutic intervention.
4. Conflict resolution should be addressed only during group therapy. - ANS>>3. This is
correct. Every interaction is an opportunity for therapeutic intervention.
2. A client on an inpatient unit angrily states to a nurse, "Peter is not cleaning up after
himself in the community bathroom. You need to address this problem." Which
response by the nurse is appropriate?
1. "I'll talk to Peter and present your concerns."
2. "Why are you overreacting to this issue?"
3. "You should bring this to the attention of your treatment team."
4. "I can see that you are angry. Let's discuss ways to approach Peter with your
concerns." - ANS>>4. This is correct. This is a therapeutic statement to the client.
3. A newly admitted client asks, "Why do we need a unit schedule? I'm not going to
these groups. I'm here to get some rest." Which reply by the nurse is appropriate?
1. "Group therapy provides the opportunity to learn and practice new coping skills."
2. "Group therapy is mandatory. All clients must attend."
3. "Group therapy is optional. You can go if you find the topic helpful and interesting."
4. "Group therapy is an economical way of providing therapy to many clients
concurrently." - ANS>>1. This is correct. This statement is therapeutic to the client and
explains why group therapy is important.
4. A client diagnosed with schizophrenia functions well and is bright, spontaneous, and
interactive during hospitalization but then decompensates after discharge. Which
statement is true regarding what the milieu provides that may be missing in the home
environment?
1. Peer pressure
2. Structured programming
3. Visitor restrictions
4. Mandated activities - ANS>>2. This is correct. The therapeutic community provides a
structured schedule of
activities in which interpersonal interaction and communication with others are
emphasized. In the milieu, time is also devoted to personal problems and focus
groups. Structured programming is often missing in the home environment.
, 5. To promote self-reliance, how would a psychiatric-mental health nurse best conduct
medication administration?
1. Encourage clients to request their medications at the appropriate times.
2. Refuse to administer medications unless clients request them at the appropriate
times.
3. Allow the clients to determine appropriate medication times.
4. Take medications to the clients' bedsides at the appropriate times. - ANS>>1. This is
correct. This action promotes self-reliance in the client. Nurses are
responsible for the management of medication administration on inpatient
psychiatric units; however, nurses must work with clients to foster independence and
provide experiences that would foster increased self-esteem.
6. A nurse working on an inpatient psychiatric unit is assigned to conduct a 45-minute
education group. Which activity would the nurse identify as an appropriate group topic?
1. Dream analysis
2. Creative cooking
3. Paint by number
4. Stress management - ANS>>4. This is correct. The nurse should identify that
teaching clients about stress
management is an appropriate education group topic. Nurses should be able to
perform the role of client teacher in the psychiatric area. Nurses need to be able to
assess a client's learning readiness. Other topics for education groups include
medical diagnoses, side effects of medications, and the importance of medication
compliance
7. Which statement made by the nursing student indicates an understanding regarding
the role of the social worker?
1. "The social worker can encourage a client to express their feelings through the use of
music."
2. "My client has been eating drywall, so I have contacted the social worker to come
speak to them."
3. "I have asked the social worker to organize a game of volleyball this weekend."
4. "My client cannot afford medications when they are discharged, so the social worker
is arranging some assistance." - ANS>>4. This is correct. A social worker is concerned
with a client's social needs, such as
placement, financial support, and community requirements.
8. Which statement describes the development of trust between the nurse and client?
1. "You cannot draw a picture until you take your medication."
2. "I am sorry you are angry."
3. "I am going to teach you how to change your dressing."
4. "I will listen if you would like to tell me about your day." - ANS>>4. This is correct. The
nurse is telling the client they will listen to them, which, by
encouraging them to share their feelings, establishes trust.
