Psychiatric Mental Health Nursing 5th Ed By Fortinash – Test Bank

Fortinash: Psychiatric Mental Health Nursing, 5th Edition

Chapter 04: Therapeutic Communication

Test Bank

MULTIPLE CHOICE

1. An example of an environmental factor that would cause a nurse to modify a planned critical interaction occurs when the:

a.	Patient expresses a personal dislike for the nurse
b.	Patient is in total denial about her condition
c.	Nurse lacks the degree of knowledge required for the interaction
d.	Nurse learns that the patient’s mother has been hospitalized with a stroke

ANS: D

Environmental factors include timing. Timing of critical interventions is important. It should occur when the individual can give full attention to the topic. It would be inappropriate to continue with the plan in the face of the patient’s distress related to her mother’s illness. The remaining options reflect other types of factors that influence communication such as attitudes, knowledge, and relationships.

DIF:Cognitive Level: ApplicationREF:Page 63

TOP:Nursing Process: Planning (Communication and Documentation)

MSC: NCLEX: Psychosocial Integrity

2. The nurse suspects that the patient’s communication is being negatively influenced by personal attitude when he is heard stating:

a.	“They think I’m mentally ill but I’m not; I just get a little depressed at times.”
b.	“I can’t concentrate on anything besides getting out of here and back to my kids.”
c.	“Obviously my therapist can’t understand where I’m coming from because our lives are so different.”
d.	“There isn’t anyone here in this hospital I can trust enough to talk to about why I abuse alcohol and drugs.”

ANS: C

Attitude determines how one person responds to another. It includes one’s biases, past experiences, and openness. People of different socioeconomic backgrounds may have difficulty surmounting this barrier. The remaining options reflect factors that can negatively influence communication but they are environmental, knowledge, and relationship-oriented.

DIF:Cognitive Level: ApplicationREF:Page 64

TOP: Nursing Process: Assessment (Communication and Documentation)

MSC: NCLEX: Psychosocial Integrity

3. The nature of the communication characterized in this exchange between a nurse and a chronically depressed patient is:

Nurse: Is it true that you enjoy knitting?

Patient: Yes, I’ve done it for years and am pretty good at it.

Nurse: I’m just a beginner. Do you think you could give me some tips?

Patient: I guess so. What would you like to know?

a.	Therapeutic
b.	Collegial
c.	Social
d.	Intrapersonal

ANS: C

Although the conversation takes place between the nurse and a patient, it is of a social nature. It is superficial and benefits both parties mutually by encouraging a relationship based on mutual interest. No expectation of help exists. Therapeutic communication promotes patient growth and is patient-focused. Collegial conversation occurs for the purpose of professional collaboration. Intrapersonal communication takes place within the individual.

DIF:Cognitive Level: ComprehensionREF:Page 66

TOP: Nursing Process: Implementation (Communication and Documentation)

MSC: NCLEX: Psychosocial Integrity

4. A patient expresses a sense of genuineness in the nurse providing care when sharing with family members that:

a.	“I believe the nurse can feel what I’m feeling.”
b.	“I always know what the nurse expects of me; the explanations are always clear.”
c.	“I can tell the nurse is sincere because the face supports what the mouth is saying.”
d.	“I may not always like what the nurse has to say but I can always depend on what I’m told.”

ANS: C

Genuineness is demonstrated by congruence between verbal and nonverbal behavior. Empathy is seeing things from the patient’s viewpoint. Clearly stating expectations is a characteristic of clarity. Trustworthiness can be described as dependability.

DIF:Cognitive Level: ApplicationREF:Page 69

TOP: Nursing Process: Implementation (Communication and Documentation)

MSC: NCLEX: Psychosocial Integrity

5. When providing discharge teaching to a patient for whom English is a second language, what technique will the nurse use to assess the patient’s understanding of the information being shared verbally?

a.	Continuously evaluating the patient’s nonverbal cues
b.	Periodically asking the patient if they have any questions
c.	Asking the patient to repeat the information they are given
d.	Providing the information in concise, written form

ANS: A

Individuals from different cultures or even different generations often misunderstand and misinterpret an unfamiliar language. Being aware of and critically examining cues that result from nonverbal responses is an excellent technique for checking their interpretations. Asking if they have questions is an ineffective technique in light of the language barrier. Repeating the information is no guarantee that the patient understands the information. Providing the information in written form reinforces the material but does not ensure understanding especially if the patient has deficiencies related to reading the language.

DIF: Cognitive Level: ApplicationREF: Page 64

TOP: Nursing Process: Planning (Communication and Documentation)

MSC: NCLEX: Psychosocial Integrity

MAECENAS IACULIS

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ADIPISCING CONVALLIS BULUM

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