Psych (NUR 204) Exam 1 Questions
With Rationale Solutions
During which phase of the nurse-patient relationship can the nurse anticipate that
identified patient issues will be explored and resolved?
Answers:
-Pre-orientation
-Orientation
-Working
-Termination - SOLVED ANSWER-Working
Rationale: During the working phase, the nurse strives to assist the patient in making
connections among dysfunctional behaviors, thinking, and emotions and offers support
while alternative coping behaviors are tried.
A nurse wants to demonstrate genuineness with a patient diagnosed with
schizophrenia. The nurse should:
Answers:
-restate what the patient says.
-use congruent communication strategies.
-use self-revelation in patient interactions.
-consistently interpret the patient's behaviors. - SOLVED ANSWER-Use congruent
communication strategies.
Rationale: Genuineness is a desirable characteristic involving awareness of one's own
feelings as they arise and the ability to communicate them when appropriate. The
incorrect options are undesirable in a therapeutic relationship.
,A nurse introduces the matter of a contract during the first session with a new patient
because contracts:
Answers:
-specify what the nurse will do for the patient.
-spell out the participation and responsibilities of each party.
-indicate the feeling tone established between the participants.
-are binding and prevent either party from prematurely ending the relationship. -
SOLVED ANSWER-Spell out the participation and responsibilities of each party.
Rationale: A contract emphasizes that the nurse works with the patient rather than
doing something for the patient. "Working with" is a process that suggests each party is
expected to participate and share responsibility for outcomes. Contracts do not,
however, stipulate roles or feeling tone, and premature termination is forbidden.
A nurse wants to enhance growth of a patient by showing positive regard. The nurse's
action most likely to achieve this goal is:
Answers:
-making rounds daily.
-staying with a tearful patient.
-administering medication as prescribed.
-examining personal feelings about a patient. - SOLVED ANSWER-Staying with a
tearful patient.
Rationale: Staying with a crying patient offers support and shows positive regard.
Administering daily medication and making rounds are tasks that could be part of an
assignment and do not necessarily reflect positive regard. Examining feelings regarding
a patient addresses the nurse's ability to be therapeutic.
,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?
Answers:
-Recognize the effectiveness of the relationship and patient's thoughtfulness. Accept the
card.
-Inform the patient that accepting gifts violates policies of the facility. Decline the card.
-Acknowledge the patient's transition through the termination phase but decline the
card.
-Accept the card and invite the patient to return to participate in other arts and crafts
groups. - SOLVED ANSWER-Recognize the effectiveness of the relationship and
patient's thoughtfulness. Accept the card.
Rationale: The nurse must consider the meaning, timing, and value of the gift. In this
instance, the nurse should accept the patient's expression of gratitude. See relationship
to audience response question.
A patient is having difficulty making a decision. The nurse has mixed feelings about
whether to provide advice. Which principle usually applies? Giving advice:
Answers:
-is rarely helpful.
-fosters independence.
-lifts the burden of personal decision making.
-helps the patient develop feelings of personal adequacy. - SOLVED ANSWER-Is rarely
helpful
Rationale: Giving advice fosters dependence on the nurse and interferes with the
patient's right to make personal decisions. It robs patients of the opportunity to weigh
alternatives and develop problem-solving skills. Furthermore, it contributes to patient
feelings of personal inadequacy. It also keeps the nurse in control and feeling powerful.
, A patient with acute depression states, "God is punishing me for my past sins." What is
the nurse's most therapeutic response?
Answers:
-"You sound very upset about this."
-"God always forgives us for our sins."
-"Why do you think you are being punished?"
-"If you feel this way, you should talk to your minister." - SOLVED ANSWER-"Why do
you think you are being punished?"
Rationale: The nurse reflects the patient's comment, a therapeutic technique to
encourage sharing for perceptions and feelings. The incorrect responses reflect
probing, closed-ended comments, and giving advice, all of which are non-therapeutic.
A nurse interacts with a newly hospitalized patient. Select the nurse's comment that
applies the communication technique of "offering self."
Answers:
-"I've also had traumatic life experiences. Maybe it would help if I told you about them."
-"Why do you think you had so much difficulty adjusting to this change in your life?"
-"I hope you will feel better after getting accustomed to how this unit operates."
-"I'd like to sit with you for a while to help you get comfortable talking to me." - SOLVED
ANSWER-"I'd like to sit with you for a while to help you get comfortable talking to me."
Rationale: "Offering self" is a technique that should be used in the orientation phase of
the nurse-patient relationship. Sitting with the patient, an example of "offering self,"
helps to build trust and convey that the nurse cares about the patient. Two incorrect
responses are ineffective and non-therapeutic. The other incorrect response is
therapeutic but is an example of "offering hope."
With Rationale Solutions
During which phase of the nurse-patient relationship can the nurse anticipate that
identified patient issues will be explored and resolved?
Answers:
-Pre-orientation
-Orientation
-Working
-Termination - SOLVED ANSWER-Working
Rationale: During the working phase, the nurse strives to assist the patient in making
connections among dysfunctional behaviors, thinking, and emotions and offers support
while alternative coping behaviors are tried.
A nurse wants to demonstrate genuineness with a patient diagnosed with
schizophrenia. The nurse should:
Answers:
-restate what the patient says.
-use congruent communication strategies.
-use self-revelation in patient interactions.
-consistently interpret the patient's behaviors. - SOLVED ANSWER-Use congruent
communication strategies.
Rationale: Genuineness is a desirable characteristic involving awareness of one's own
feelings as they arise and the ability to communicate them when appropriate. The
incorrect options are undesirable in a therapeutic relationship.
,A nurse introduces the matter of a contract during the first session with a new patient
because contracts:
Answers:
-specify what the nurse will do for the patient.
-spell out the participation and responsibilities of each party.
-indicate the feeling tone established between the participants.
-are binding and prevent either party from prematurely ending the relationship. -
SOLVED ANSWER-Spell out the participation and responsibilities of each party.
Rationale: A contract emphasizes that the nurse works with the patient rather than
doing something for the patient. "Working with" is a process that suggests each party is
expected to participate and share responsibility for outcomes. Contracts do not,
however, stipulate roles or feeling tone, and premature termination is forbidden.
A nurse wants to enhance growth of a patient by showing positive regard. The nurse's
action most likely to achieve this goal is:
Answers:
-making rounds daily.
-staying with a tearful patient.
-administering medication as prescribed.
-examining personal feelings about a patient. - SOLVED ANSWER-Staying with a
tearful patient.
Rationale: Staying with a crying patient offers support and shows positive regard.
Administering daily medication and making rounds are tasks that could be part of an
assignment and do not necessarily reflect positive regard. Examining feelings regarding
a patient addresses the nurse's ability to be therapeutic.
,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?
Answers:
-Recognize the effectiveness of the relationship and patient's thoughtfulness. Accept the
card.
-Inform the patient that accepting gifts violates policies of the facility. Decline the card.
-Acknowledge the patient's transition through the termination phase but decline the
card.
-Accept the card and invite the patient to return to participate in other arts and crafts
groups. - SOLVED ANSWER-Recognize the effectiveness of the relationship and
patient's thoughtfulness. Accept the card.
Rationale: The nurse must consider the meaning, timing, and value of the gift. In this
instance, the nurse should accept the patient's expression of gratitude. See relationship
to audience response question.
A patient is having difficulty making a decision. The nurse has mixed feelings about
whether to provide advice. Which principle usually applies? Giving advice:
Answers:
-is rarely helpful.
-fosters independence.
-lifts the burden of personal decision making.
-helps the patient develop feelings of personal adequacy. - SOLVED ANSWER-Is rarely
helpful
Rationale: Giving advice fosters dependence on the nurse and interferes with the
patient's right to make personal decisions. It robs patients of the opportunity to weigh
alternatives and develop problem-solving skills. Furthermore, it contributes to patient
feelings of personal inadequacy. It also keeps the nurse in control and feeling powerful.
, A patient with acute depression states, "God is punishing me for my past sins." What is
the nurse's most therapeutic response?
Answers:
-"You sound very upset about this."
-"God always forgives us for our sins."
-"Why do you think you are being punished?"
-"If you feel this way, you should talk to your minister." - SOLVED ANSWER-"Why do
you think you are being punished?"
Rationale: The nurse reflects the patient's comment, a therapeutic technique to
encourage sharing for perceptions and feelings. The incorrect responses reflect
probing, closed-ended comments, and giving advice, all of which are non-therapeutic.
A nurse interacts with a newly hospitalized patient. Select the nurse's comment that
applies the communication technique of "offering self."
Answers:
-"I've also had traumatic life experiences. Maybe it would help if I told you about them."
-"Why do you think you had so much difficulty adjusting to this change in your life?"
-"I hope you will feel better after getting accustomed to how this unit operates."
-"I'd like to sit with you for a while to help you get comfortable talking to me." - SOLVED
ANSWER-"I'd like to sit with you for a while to help you get comfortable talking to me."
Rationale: "Offering self" is a technique that should be used in the orientation phase of
the nurse-patient relationship. Sitting with the patient, an example of "offering self,"
helps to build trust and convey that the nurse cares about the patient. Two incorrect
responses are ineffective and non-therapeutic. The other incorrect response is
therapeutic but is an example of "offering hope."
