Nursing Elites

1. In an acute mental health facility, a nurse is communicating with a client. The client states, “I can’t sleep. I stay up all night.” The nurse responds, “You are having difficulty sleeping?” Which of the following therapeutic communication techniques is the nurse demonstrating?

• A. Offering general leads
• B. Summarizing
• C. Focusing
• D. Restating

Correct answer: D

Rationale: The nurse is using the restating technique, where the nurse paraphrases or repeats the main idea expressed by the client to show understanding and encourage further communication. Restating helps clarify the client's message and fosters a therapeutic relationship. Choice A, offering general leads, involves encouraging the client to continue talking with nonverbal or minimal verbal prompts. Summarizing (Choice B) involves condensing and organizing the client's message. Focusing (Choice C) involves centering the conversation on a key element or topic.

2. What intervention should the nurse implement when caring for a patient demonstrating manic behavior?

• A. Monitor the patient’s vital signs frequently.
• B. Engage the patient in calming activities.
• C. Offer the patient a quiet environment for relaxation.
• D. Reduce environmental stimuli and create a calm atmosphere.

Correct answer: D

Rationale: When caring for a patient demonstrating manic behavior, the nurse should implement the intervention of reducing environmental stimuli and creating a calm atmosphere. This approach is crucial in managing manic behavior as it helps decrease triggers that may worsen the patient's symptoms. Engaging the patient in calming activities (Choice B) may not be effective during a manic episode as the patient may have difficulty focusing. While offering a quiet environment for relaxation (Choice C) is beneficial, it may not be sufficient to address the heightened stimulation experienced during mania. Monitoring the patient’s vital signs frequently (Choice A) is important in general patient care but may not directly address the specific needs of a patient exhibiting manic behavior.

3. Which patient behavior is consistent with therapeutic communication?

• A. Offering your opinion when asked to provide support.
• B. Summarizing the essence of the patient’s comments in your own words.
• C. Avoiding interrupting periods of silence to allow the patient space to think.
• D. Providing positive reinforcement when the patient expresses themselves.

Correct answer: B

Rationale: Summarizing the essence of the patient’s comments in your own words is a key component of therapeutic communication. This behavior demonstrates active listening, ensures understanding of the patient's message, and encourages further discussion. By summarizing, you show the patient that you are engaged and interested, which helps them feel heard and valued. Offering your opinion (choice A) may bias the patient's thoughts and feelings, interrupting periods of silence (choice C) may prevent the patient from processing their thoughts, and providing positive reinforcement (choice D) may not always be appropriate or necessary in therapeutic communication.

4. What assessment question will provide insight into the effects of a woman’s circadian rhythms on her quality of life?

• A. How much sleep do you usually get each night?
• B. Does your heart ever seem to skip a beat?
• C. When was the last time you had a fever?
• D. Do you have problems urinating?

Correct answer: A

Rationale: Inquiring about the amount of sleep a woman gets each night is crucial in understanding how her circadian rhythms may be affecting her quality of life. Circadian rhythms play a significant role in regulating sleep-wake cycles, and disruptions in these rhythms can impact overall well-being and quality of life.

5. In treating PTSD, which type of therapy is most commonly recommended?

• A. Cognitive-behavioral therapy (CBT)
• B. Psychoanalytic therapy
• C. Humanistic therapy
• D. Gestalt therapy

Correct answer: A

Rationale: Cognitive-behavioral therapy (CBT) is the most commonly recommended therapy for PTSD due to its effectiveness in helping patients identify and change negative thoughts and behaviors associated with trauma. This therapy focuses on providing practical coping strategies to manage symptoms and process traumatic experiences. Psychoanalytic therapy, humanistic therapy, and gestalt therapy are less commonly used for PTSD as they may not target the specific symptoms and cognitive distortions associated with this disorder.

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