7/19/2021 Module i4 iExam: iHESI iVN iTXGRP i1912COHORT(VNE
i39)
Question 1 i
pts
i i i
A iclient iwith ischizophrenia isays, i“I’m iaway ifor ithe iday i... ibut idon’t
ithink iwe ishould iplay i… ior ido iwe ihave ifeet iof iclay?” iWhich
ialteration iin ithe iclient’s ispeech idoes ithe inurse idocument?
Neologism
Word isalad
Co
orrrec
ct! Clang iassociation
Associative ilooseness
Rationale: iClang iassociation iis ithe imeaningless irhyming iof
iwords iin iwhich ithe irhyming iis imore iimportant ithan ithe
icontext iof ithe iwords. iA ineologism iis ia imade-up iword ithat
ihas imeaning ionly ito ithe iclient. iWord isalad iis ithe iterm ifor ia
imixture iof imeaningless iphrases, ieither ito ithe iclient ior itoithe
ilistener. iAssociative ilooseness iis ia iterm iused ito idescribe
ischizophrenic ispeech iin iwhich iconnections iand ithreads
iare iinterrupted ior imissing.
Test-Taking iStrategy: iKnowledge iof ithe ispeech ipatterns
iexhibited iby ithe iclient iwith ischizophrenia iis ineeded ito
ianswer ithis iquestion. iFocus ion ithe idata iin ithe iquestion iand
inote ithe imeaningless irhyming iof iwords. iReview ithese
ispeech ipatterns iwith ischizophrenia iif iyou ihad idifficulty iwith
ithis iquestion.
Cognitive iAbility: iApplying
Client iNeeds: iPsychosocial iIntegrity
Integrated iProcess: iCommunication iand iDocumentation
Content iArea: iMental iHealth
Question 2 i
pts
i i i
https://concorde.instructure.com/courses/18612/quizzes/83901?module_item_id=1519720 1/116
,7/19/2021 Module i4 iExam: iHESI iVN iTXGRP i1912COHORT(VNE
i39)
A iclient iwith ischizophrenia iand ihis iparents iare imeeting iwith ithe
inurse. iOne iof ithe iyoung iman’s iparents isays ito ithe inurse, i“We
iwere istunned iwhen iwe ilearned ithat iour ison ihad ischizophrenia.
iHe iwas ino idifferent ithan ifrom ihis iolder ibrother iwhen ithey iwere
igrowing iup. iNow ihe’s ihad ianother irelapse, iand iwe ican’t
iunderstand iwhy ihe istopped ihis imedication.” iWhich iresponse iby
ithe inurse iis iappropriate?
Telling ithe iparents, i“Medication inoncompliance iis ithe imost
if requent ireason ithat ipeople iwith ithis idiagnosis irelapse.”
Telling ithe iparents, i“Well, iit’s ihis idecision ito itake ihis imedicine,
ibut iit’s iyours ito ihave ihim ilive iwith iyou iif ihe istops ithe
imedication.”
Co
orrrec
ct!
Asking ithe iclient, i“How ican iwe ihelp iyou ito itake iyour imedicine ior
ito itell ius iwhen iyou’re ihaving iproblems iso ithat iyour imedication
ican ibe iadjusted?”
Saying ito ithe iparents, i“Your iconcerns iare iappropriate, ibut iI
iwonder iwhether iyour ison iwas ihaving itrouble itelling isomeone
ithat ihe ihad iconcerns iabout ihis imedication.”
https://concorde.instructure.com/courses/18612/quizzes/83901?module_item_id=1519720 2/116
,7/19/2021 Module i4 iExam: iHESI iVN iTXGRP i1912COHORT(VNE
i39)
Rationale: iThe itherapeutic iresponse iis ithe ione iin iwhich ithe
inurse imodels ispeaking idirectly ito ithe iclient. iThis ifacilitates
ifurther iassessment iof ithe isituation iand ihelps ielicit ithe
icauses iof iand imotivations ifor ithe iclient’s ibehavior ifor iboth
ithe inurse iand ithe ifamily. iIn ithe icorrect ioption, ithe inurse
ialso iseeks iclarification iof ithe idegree iof iopenness iand
imutuality ifelt iby ithe iclient iand ihis ifamily itoward ieach iother.
iThe inurse iprovides iinformation ito ithe ifamily iwhen istating
ithat inoncompliance iis ithe imost ifrequent ireason ifor irelapse
iin ipeople iwith ithis idiagnosis. iHowever, ithe istatement iis
inontherapeutic iat ithis itime ibecause iit idoes inot ifacilitate ithe
iexpression iof ifeelings. iThe inurse iuses ia isuperego istyle iof
icommunication iwhen istating, i“Well, iit’s ihis idecision ito itake
ihis imedicine, ibut iit’siyours ito ihave ihim ilive iwith iyou iif ihe
istops ithe imedication.”iThe icontent iof ithis istatement i may ibe
itrue, ibut iit iis inontherapeutic iin ithat iit icarries i a ithreatening
i message iand imay iprevent ithe ifamily ifrom itrusting ithe
inurse. iBy istating i“Your iconcerns iare iappropriate, ibut iI
iwonder iwhether iyour ison iwas ihaving itrouble itelling
isomeone ithat ihe ihad iconcerns iabout ihis imedication,” ithe
inurse igives iapproval iand iprematurely ianalyzes ithe iclient’s
imotivation iwithout isufficient iassessment.
Test-Taking iStrategy: iUse iyour iknowledge iof itherapeutic
icommunication itechniques iand iremember ito ifocus ion ithe
iclient’s ifeelings. iAlso inote ithat ithe icorrect ioption iis ithe
ionly ioption iin iwhich ithe inurse idirectly iaddresses ithe
iclient. iReview itherapeutic icommunication itechniques iif
iyou ihad idifficulty iwith ithis iquestion.
Cognitive iAbility: iApplying
Client iNeeds: iPsychosocial iIntegrity
Integrated iProcess: iCommunication iand iDocumentation
Content iArea: iMental iHealth
Question 3 i
pts
i i i
An iacutely iill iclient iwith ischizophrenia isays ito ithe inurse, i“He
ikeeps isaying ithat ihe ilikes iyou, iand iI ikeep itelling ihim iyou’re
imarried, ibut ihe iwon’t ilisten, iand iI ithink ihe’s igoing ito iget ifresh
iwith iyou.” iOnce ithe inurse ihas idetermined ithat ithe iclient iis
https://concorde.instructure.com/courses/18612/quizzes/83901?module_item_id=1519720 3/116
, 7/19/2021 Module i4 iExam: iHESI iVN iTXGRP i1912COHORT(VNE
i39)
hallucinating, iwhich iresponse ito ithe iclient iwould ibe imost
iappropriate istatement?
Co
orrrec
ct!
“Try inot ito ilisten ito ithe ivoices iright inow iso ithat iI ican italk iwith
iyou.”
“I ithink ithat iyou ican ihelp ihim istop ihis ibehavior iif iyou
iconcentrate.”
“Tell ihim iI isaid ito imind ihis ip’s iand iq’s ior iI’ll icall ithe ipolice ion
ihim.”
“I ithink ithat iyou’re itrying ito ishare iyour iown ifeelings itoward ime,
ibut iyou’re ishy.”
Rationale: iThe iappropriate istatement iby ithe inurse iis ithe
ione ithat idoes inot iacknowledge ithe iclient’s ihallucinations.
iBy iresponding i“I ithink ithat iyou ican ihelp ihim istop ihis
ibehavior iif iyou iconcentrate” ior i“Tell ihim iI isaid ito imind ihis
ip’s iand iq’s ior iI’ll icall ithe ipolice ion ihim,” ithe inurse
iacknowledges ithe ihallucinations. iThe inurse iattempts ito
iinterpret ithe iclient’s ithinking iwith ia istatement isuch ias i“I
ithink ithat iyou’re itrying ito ishare iyour iown ifeelings itoward
ime, ibut iyou’re ishy.”
Test-Taking iStrategy: iUse iyour iknowledge iof itherapeutic
icommunication itechniques iand iremember ithat ithe inurse
ishould inot iacknowledge ithe iclient’s ihallucinations. iAlso
inote ithat ithe icorrect ioption iis ithe ionly ione ithat iencourages
irealistic iverbalization ifrom ithe iclient. iReview itherapeutic
icommunication itechniques iwith ia iclient iwho iisihallucinating
iif iyou ihad idifficulty iwith ithis iquestion.
Cognitive iAbility: iApplying
Client iNeeds: iPsychosocial iIntegrity
Integrated iProcess: iCommunication iand iDocumentation
Content iArea: iMental iHealth
https://concorde.instructure.com/courses/18612/quizzes/83901?module_item_id=1519720 4/116
i39)
Question 1 i
pts
i i i
A iclient iwith ischizophrenia isays, i“I’m iaway ifor ithe iday i... ibut idon’t
ithink iwe ishould iplay i… ior ido iwe ihave ifeet iof iclay?” iWhich
ialteration iin ithe iclient’s ispeech idoes ithe inurse idocument?
Neologism
Word isalad
Co
orrrec
ct! Clang iassociation
Associative ilooseness
Rationale: iClang iassociation iis ithe imeaningless irhyming iof
iwords iin iwhich ithe irhyming iis imore iimportant ithan ithe
icontext iof ithe iwords. iA ineologism iis ia imade-up iword ithat
ihas imeaning ionly ito ithe iclient. iWord isalad iis ithe iterm ifor ia
imixture iof imeaningless iphrases, ieither ito ithe iclient ior itoithe
ilistener. iAssociative ilooseness iis ia iterm iused ito idescribe
ischizophrenic ispeech iin iwhich iconnections iand ithreads
iare iinterrupted ior imissing.
Test-Taking iStrategy: iKnowledge iof ithe ispeech ipatterns
iexhibited iby ithe iclient iwith ischizophrenia iis ineeded ito
ianswer ithis iquestion. iFocus ion ithe idata iin ithe iquestion iand
inote ithe imeaningless irhyming iof iwords. iReview ithese
ispeech ipatterns iwith ischizophrenia iif iyou ihad idifficulty iwith
ithis iquestion.
Cognitive iAbility: iApplying
Client iNeeds: iPsychosocial iIntegrity
Integrated iProcess: iCommunication iand iDocumentation
Content iArea: iMental iHealth
Question 2 i
pts
i i i
https://concorde.instructure.com/courses/18612/quizzes/83901?module_item_id=1519720 1/116
,7/19/2021 Module i4 iExam: iHESI iVN iTXGRP i1912COHORT(VNE
i39)
A iclient iwith ischizophrenia iand ihis iparents iare imeeting iwith ithe
inurse. iOne iof ithe iyoung iman’s iparents isays ito ithe inurse, i“We
iwere istunned iwhen iwe ilearned ithat iour ison ihad ischizophrenia.
iHe iwas ino idifferent ithan ifrom ihis iolder ibrother iwhen ithey iwere
igrowing iup. iNow ihe’s ihad ianother irelapse, iand iwe ican’t
iunderstand iwhy ihe istopped ihis imedication.” iWhich iresponse iby
ithe inurse iis iappropriate?
Telling ithe iparents, i“Medication inoncompliance iis ithe imost
if requent ireason ithat ipeople iwith ithis idiagnosis irelapse.”
Telling ithe iparents, i“Well, iit’s ihis idecision ito itake ihis imedicine,
ibut iit’s iyours ito ihave ihim ilive iwith iyou iif ihe istops ithe
imedication.”
Co
orrrec
ct!
Asking ithe iclient, i“How ican iwe ihelp iyou ito itake iyour imedicine ior
ito itell ius iwhen iyou’re ihaving iproblems iso ithat iyour imedication
ican ibe iadjusted?”
Saying ito ithe iparents, i“Your iconcerns iare iappropriate, ibut iI
iwonder iwhether iyour ison iwas ihaving itrouble itelling isomeone
ithat ihe ihad iconcerns iabout ihis imedication.”
https://concorde.instructure.com/courses/18612/quizzes/83901?module_item_id=1519720 2/116
,7/19/2021 Module i4 iExam: iHESI iVN iTXGRP i1912COHORT(VNE
i39)
Rationale: iThe itherapeutic iresponse iis ithe ione iin iwhich ithe
inurse imodels ispeaking idirectly ito ithe iclient. iThis ifacilitates
ifurther iassessment iof ithe isituation iand ihelps ielicit ithe
icauses iof iand imotivations ifor ithe iclient’s ibehavior ifor iboth
ithe inurse iand ithe ifamily. iIn ithe icorrect ioption, ithe inurse
ialso iseeks iclarification iof ithe idegree iof iopenness iand
imutuality ifelt iby ithe iclient iand ihis ifamily itoward ieach iother.
iThe inurse iprovides iinformation ito ithe ifamily iwhen istating
ithat inoncompliance iis ithe imost ifrequent ireason ifor irelapse
iin ipeople iwith ithis idiagnosis. iHowever, ithe istatement iis
inontherapeutic iat ithis itime ibecause iit idoes inot ifacilitate ithe
iexpression iof ifeelings. iThe inurse iuses ia isuperego istyle iof
icommunication iwhen istating, i“Well, iit’s ihis idecision ito itake
ihis imedicine, ibut iit’siyours ito ihave ihim ilive iwith iyou iif ihe
istops ithe imedication.”iThe icontent iof ithis istatement i may ibe
itrue, ibut iit iis inontherapeutic iin ithat iit icarries i a ithreatening
i message iand imay iprevent ithe ifamily ifrom itrusting ithe
inurse. iBy istating i“Your iconcerns iare iappropriate, ibut iI
iwonder iwhether iyour ison iwas ihaving itrouble itelling
isomeone ithat ihe ihad iconcerns iabout ihis imedication,” ithe
inurse igives iapproval iand iprematurely ianalyzes ithe iclient’s
imotivation iwithout isufficient iassessment.
Test-Taking iStrategy: iUse iyour iknowledge iof itherapeutic
icommunication itechniques iand iremember ito ifocus ion ithe
iclient’s ifeelings. iAlso inote ithat ithe icorrect ioption iis ithe
ionly ioption iin iwhich ithe inurse idirectly iaddresses ithe
iclient. iReview itherapeutic icommunication itechniques iif
iyou ihad idifficulty iwith ithis iquestion.
Cognitive iAbility: iApplying
Client iNeeds: iPsychosocial iIntegrity
Integrated iProcess: iCommunication iand iDocumentation
Content iArea: iMental iHealth
Question 3 i
pts
i i i
An iacutely iill iclient iwith ischizophrenia isays ito ithe inurse, i“He
ikeeps isaying ithat ihe ilikes iyou, iand iI ikeep itelling ihim iyou’re
imarried, ibut ihe iwon’t ilisten, iand iI ithink ihe’s igoing ito iget ifresh
iwith iyou.” iOnce ithe inurse ihas idetermined ithat ithe iclient iis
https://concorde.instructure.com/courses/18612/quizzes/83901?module_item_id=1519720 3/116
, 7/19/2021 Module i4 iExam: iHESI iVN iTXGRP i1912COHORT(VNE
i39)
hallucinating, iwhich iresponse ito ithe iclient iwould ibe imost
iappropriate istatement?
Co
orrrec
ct!
“Try inot ito ilisten ito ithe ivoices iright inow iso ithat iI ican italk iwith
iyou.”
“I ithink ithat iyou ican ihelp ihim istop ihis ibehavior iif iyou
iconcentrate.”
“Tell ihim iI isaid ito imind ihis ip’s iand iq’s ior iI’ll icall ithe ipolice ion
ihim.”
“I ithink ithat iyou’re itrying ito ishare iyour iown ifeelings itoward ime,
ibut iyou’re ishy.”
Rationale: iThe iappropriate istatement iby ithe inurse iis ithe
ione ithat idoes inot iacknowledge ithe iclient’s ihallucinations.
iBy iresponding i“I ithink ithat iyou ican ihelp ihim istop ihis
ibehavior iif iyou iconcentrate” ior i“Tell ihim iI isaid ito imind ihis
ip’s iand iq’s ior iI’ll icall ithe ipolice ion ihim,” ithe inurse
iacknowledges ithe ihallucinations. iThe inurse iattempts ito
iinterpret ithe iclient’s ithinking iwith ia istatement isuch ias i“I
ithink ithat iyou’re itrying ito ishare iyour iown ifeelings itoward
ime, ibut iyou’re ishy.”
Test-Taking iStrategy: iUse iyour iknowledge iof itherapeutic
icommunication itechniques iand iremember ithat ithe inurse
ishould inot iacknowledge ithe iclient’s ihallucinations. iAlso
inote ithat ithe icorrect ioption iis ithe ionly ione ithat iencourages
irealistic iverbalization ifrom ithe iclient. iReview itherapeutic
icommunication itechniques iwith ia iclient iwho iisihallucinating
iif iyou ihad idifficulty iwith ithis iquestion.
Cognitive iAbility: iApplying
Client iNeeds: iPsychosocial iIntegrity
Integrated iProcess: iCommunication iand iDocumentation
Content iArea: iMental iHealth
https://concorde.instructure.com/courses/18612/quizzes/83901?module_item_id=1519720 4/116
