Psychiatric Nursing 8th Edition Keltner Test Bank

MULTIPLE CHOICE 1. A patient is hospitalized for severe depression. Knowing that the patient will be discharged after a short stay, what is the nurse’s first priority? a. Maximize the benefits of milieu management. b. Immediately begin to explore acute patient issues. c. Develop a goal-directed, problem-centered relationship. d. Choose a specific theoretical model as the basis for care. ANS: C Therapeutic relationships are planned, patient-centered, and goal-directed. This is of particular importance if progress is to be made when the duration of the relationship will be brief. The other options are not the priority. Exploration of patient issues requires trust development before it can proceed. DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation MSC: Client Needs: Safe, Effective Care Environment 2. A nurse tells a patient, “I know how you feel. My spouse can be very insensitive too. I am also considering divorce.” What behavior is the nurse demonstrating? a. Inappropriate self-disclosing b. Countertransference c. Establishment of trust with the patient d. Encouraging the patient to express negative feelings ANS: A Brief self-disclosure is used to help the patient clarify specific issues, to feel less vulnerable, or to feel more “normal.” When used appropriately, self-disclosure benefits the patient. When used inappropriately, it benefits the nurse. In this case, the self-disclosure burdens the patient with the nurse’s problems. Empathy focuses on the patient. Countertransference would result in different behaviors. Encouraging expression of negative feelings would be more direct. DIF: Cognitive level: Understanding TOP: Nursing process: Evaluation MSC: Client Needs: Safe, Effective Care Environment 3. A patient diagnosed with schizophrenia says to the nurse, “I feel really close to you. You’re the only true friend I have.” What is the nurse’s most therapeutic response? a. “We are not friends. Our relationship is a professional one.” b. “I feel sure there are other friends in your life. Can you name some?” c. “I am glad you trust me. Trust is important for the work we are doing together.” d. “Our relationship is professional, but let’s explore ways to strengthen personal friendships.” ANS: D The patient’s remarks call for the nurse to remind the patient of the parameters of their relationship and take the opportunity to discuss the issue of friends. Only this option incorporates both desired elements.