NUR 318 Focus on Mental Health Exam Questions with Answers

NUR 318 Focus on Mental Health Exam Questions with Answers 1. A nurse overhears a hospitalized client with mania telling another client, “I’m actually a journalist writing an article for a magazine — I’m just posing as a person with mental illness.” How should the nurse respond? A. Ignoring the delusion B. Taking the client to a quiet room C. Supporting the client’s denial of illness D. Presenting the client with the actual situation Correct Rationale: When dealing with a delusional client, it is important for the nurse to state clearly that the nurse does not share the client’s perceptions. All three of the other options — ignoring the delusion, taking the client to a quiet room, and supporting the client’s denial of illness — do not focus on reality, and they ignore the issue. Presenting the client with the actual situation helps orient the client to reality. Test-Taking Strategy: Reality orientation is the priority. Eliminate the comparable or alike options that ignore the client, or the client’s symptoms. The correct option illustrates a means of helping orient the client to reality. Review: care of the client experiencing delusions. Level of Cognitive Ability: Applying Client Needs: Psychosocial integrity Integrated Process: Nursing Process/Implementation Content Area: Mental Health Giddens Concepts: Communication, Psychosis HESI Concepts: Cognition, Communication Reference: Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A communication approach to evidence-based care. (revised reprint)) (2nd ed. pp. 305, 318-320). St. Louis: Saunders. Awarded 99.0 points out of 99.0 possible points. 2. A client who is hallucinating fearfully says to the nurse, “Please tell that demon to get out.” How should the nurse respond to the client? A. “If you tell the demon to go away, it will.” B. “I’ll stay here with you until the demon leaves your room.” C. “If you return to bed, you will find that the demon will leave.” D. “I know you must be very upset by this, but I don’t see a demon.” Correct Rationale: If the client hallucinates, it is best to provide reality-based perceptions and not negate the client’s experience, because this may lead to a regressive struggle with the client. Giving advice or false reassurance is incorrect because such techniques indicate that demons actually are present, which feeds into the client’s hallucination and reinforces the client’s behavior. Test-Taking Strategy: Use your knowledge of therapeutic communication techniques, noting that the client is hallucinating. Remember that it is most important to maintain reality with the client. This will direct you to the correct option. Review: communication techniques for the client who is hallucinating Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Content Area: Mental Health Giddens Concepts: Communication, Psychosis HESI Concepts: Cognition, Communication References: Stuart, G. (2013). Principles & practice of psychiatric nursing (10th ed., pp. 25-29). St. Louis: Mosby. Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A communication approach to evidence-based care. (revised reprint)) (2nd ed. p. 320). St. Louis: Saunders. Awarded 99.0 points out of 99.0 possible points. 3. The mother of a 3-year-old says, “My child hit his teddy bear after being scolded for picking the neighbors’ flowers.” The nurse should explain the child is using which defense mechanism? A. Projection B. Sublimation C. Displacement Correct D. Identification Rationale: The defense mechanism of displacement involves the discharge of intense feelings for one person onto a less threatening substitute person or object to satisfy an impulse. Projection involves attributing an attitude, behavior, or impulse to someone else, such as that which occurs in blaming or scapegoating. Sublimation is rechanneling an impulse into a more socially acceptable object. Identification involves modeling behavior after someone else's. Test-Taking Strategy: Use knowledge of the subject, defense mechanisms, to assist with the process of elimination. Focusing on the child’s behavior will direct you to the correct option. Review: defense mechanisms. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Analysis Content Area: Mental Health Giddens Concepts: Development, Coping HESI Concepts: Developmental, Stress & Coping Reference: Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A communication approach to evidence-based care. (revised reprint)) (2nd ed. pp. 171, 173). St. Louis: Saunders. Awarded 99.0 points out of 99.0 possible points. 4. A client says to the nurse, “Even though my husband and I keep telling them we don’t want to have children, our parents are pressuring us to ‘start a family.’ What should we say to them?” Which response by the nurse is therapeutic? A. “This must be very difficult for both of you.” Correct B. “Maybe you should say you can’t have children.” C. “How do you usually cope with that kind of interference?” D. “Tell them to have more children if they want them so badly.” Rationale: Childless families may elect not to have children or to postpone having them until they have established themselves occupationally or financially. Telling the client to tell the parents that the couple can’t have children is incorrect because the client is being encouraged to lie about life decisions rather than helping the parents understand the couple’s choices. Asking how they usually cope with such interference is incorrect because it indicates that the nurse is judgmental and has decided that the parents are interfering with the client and spouse. Saying, “Tell them to have more children if they want them so badly,” is incorrect because it is sarcastic and ridicules the situation over which the client has expressed concerns. Test-Taking Strategy: Use your knowledge of therapeutic communication techniques and remember to focus on the client’s feelings. This will direct you to the correct option. Review: therapeutic communication techniques. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Content Area: Mental Health Giddens Concepts: Communication, Family Dynamics HESI Concepts: Communication, Developmental Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 5. A young adult client says, “I just can’t seem to stop snapping at my parents. I know they work hard to support me, but what do I do when they’re so overbearing?” Which responses by the nurse is therapeutic? A. “It’s important not to be rude to your parents.” B. “You need to be more patient with your parents.” C. “Snapping at your parents is childish. How could you?” D. “Have you talked to your parents about your frustrations?” Correct Rationale: The correct response is focused on the client’s concerns and encourages the therapeutic technique of formulating a plan of action. “It’s important not to be rude to your parents” and “You need to be more patient with your parents” are both nontherapeutic, judgmental responses that do not encourage the client to further explore her feelings and problem-solve. “Snapping at your parents is childish. How could you?” is incorrect because it is sarcastic and condescending, which is nontherapeutic. Test-Taking Strategy: Use your knowledge of therapeutic communication techniques and remember to focus on the client’s feelings. This will direct you to the correct option. Review: therapeutic communication techniques Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Content Area: Mental Health Giddens Concepts: Communication, Family Dynamics HESI Concepts: Communication, Developmental Reference: Stuart, G. (2013). Principles & practice of psychiatric nursing (10th ed., pp. 29, 31). St. Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 6. A client says, “I have so much trouble caring for my husband’s child from his first marriage. I resent the money we have to pay for child support because we have to deprive my own child of things. How can I stop feeling this way?” Which response by the nurse is therapeutic? A. “Your child benefits from having a sibling.” B. “Have you shared your feelings with your husband?” Correct C. “You need to take a second job to give your child what you think she deserves.” D. “I wonder why you married him, knowing that he wouldn’t desert his biological child.” bring into a marriage without prior discussion with the new partner. Bonding sometimes does not always occur when a child is not one’s biological offspring. The correct answer is focused on the client’s feelings. “Your child benefits from having a sibling” is not facilitative. “I wonder why you married him, knowing that he wouldn’t desert his biological child” is incorrect because it prejudges the client. “You need to take a second job to give your child what you think she deserves” is not open ended, does not facilitate feelings, and gives advice. Test-Taking Strategy: Use your knowledge of therapeutic communication techniques and remember to focus on the client’s feelings. This will direct you to the correct option. Review: therapeutic communication techniques if you had difficulty with this question. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Content Area: Mental Health Giddens Concepts: Communication, Family Dynamics HESI Concepts: Communication, Developmental Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 7. A client says to the nurse, “My wife retired last year from a lucrative law practice, and I’m really discouraged. I’ll be working until I die, even though I helped pay for her education.” Which response by the nurse is supportive? A. “That’s very unfair to you.” B. “You sound very troubled by this.” Correct C. “That’s such a tough break for you.” D. “Why not ask your wife for some help?” Rationale: Saying that the situation is unfair is judgmental and does not encourage the client to express his feelings; nor does “That’s such a tough break for you.” Suggesting that the husband approach the spouse for help is incorrect because it prematurely gives advice, a nontherapeutic communication technique. The correct option is focused on the client’s feelings. Test-Taking Strategy: Use your knowledge of therapeutic communication techniques and remember to focus on the client’s feelings. This will direct you to the correct option. Review: therapeutic communication techniques Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Content Area: Mental Health Giddens Concepts: Communication, Family Dynamics HESI Concepts: Communication, Developmental Reference: Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A communication approach to evidence-based care. (revised reprint)) (2nd ed. pp. 124-125). St. Louis: Saunders. Awarded 99.0 points out of 99.0 possible points. 8. A man who is homosexual is brought to the emergency department by the police. The client tells the nurse, “I was beaten up. I guess I just have to expect this kind of treatment for the rest of my life.” Which statement by the nurse is therapeutic? A. “I think you should take some self-defense classes.” B. “Maybe you should be more discreet when you’re in public.” C. “You feel that being beaten up goes along with being gay?” Correct D. “Why not try counseling to change your sexual orientation?” Rationale: Many lesbians and gays encounter harassment or violence in the course of their lives. “I think you should take some self-defense classes” is incorrect because it advises the client, and giving advice is not therapeutic. “Maybe you should be more discreet when you’re in public” also gives advice and presumes that the client has been indiscreet. “Why not try counseling to change your sexual orientation?” is incorrect because it assumes that sexual orientation can or should be changed. The correct option indicates reflection and is focused on the client’s feelings. Test-Taking Strategy: Use your knowledge of therapeutic communication techniques and remember to focus on the client’s feelings. This will direct you to the correct option. Review: therapeutic communication techniques Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Content Area: Mental Health Giddens Concepts: Communication, Interpersonal Violence HESI Concepts: Communication, Safety Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 9. A client whose spouse recently died is experiencing dysfunctional grieving. Which intervention has priority in the plan of care? A. Monitoring the client’s sleep pattern B. Assessing the client’s risk for violence toward self and others Correct C. Collaborating with the healthcare provider to prescribe an antidepressant D. Helping the client resolve the grief through emotional, cognitive, and behavioral means Rationale: The priority intervention for a client with dysfunctional grieving is assessment of the client’s risk for violence toward self and others. Although the nurse will assist the client in resolving the grief and monitor the client’s sleep pattern, these are not the priority interventions of the options given. Obtaining a prescription for an antidepressant is not a priority. Test-Taking Strategy: Use the process of elimination and the steps of the nursing process. Assessing the client’s risk for violence toward self and others and monitoring the client’s sleep pattern are both forms of assessment. To select from the remaining options, select assessing the client’s risk for violence toward self and others because it addresses the safety of the client. Review: interventions for a client experiencing dysfunctional grieving Level of Cognitive Ability: Analyzing Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Planning Content Area: Mental Health Giddens Concepts: Coping, Interpersonal Violence HESI Concepts: Grief & Loss, Safety Reference: Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A communication approach to evidence-based care. (revised reprint)) (2nd ed. pp. 488-489). St. Louis: Saunders. Awarded 99.0 points out of 99.0 possible points. 10. A nurse develops a plan of care for a client in whom Acquired Immunideficiency Syndrome (AIDS) was recently diagnosed. The client is experiencing difficulty adjusting to the illness. Which interventions are appropriate for this client? Select all that apply. A. B. C. D. Assisting the client with problem-solving and decision-making Correct E. Discouraging social networking to prevent the spread of infection Rationale: Assisting the client with problem-solving and decision-making, helping the client verbalize fears, helping the client identify sources of hope, and monitoring the client for signs of self-harm are all appropriate interventions. In planning care for a client having difficulty adjusting to an illness, the nurse develops interventions to promote social networking that will provide needed support and information to the client. Test-Taking Strategy: Use knowledge of the subject, adjusting to AIDS, to assist with the process of elimination. Note that the client is having difficulty adjusting to a serious illness. Recall that social support is important. Review: interventions for a client having difficulty adjusting to an illness. Level of Cognitive Ability: Analyzing Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Planning Content Area: Mental Health Giddens Concepts: Anxiety, Coping HESI Concepts: Mood & Affect, Stress & Coping Reference: Stuart, G. (2013). Principles & practice of psychiatric nursing (10th ed., pp. 235-236 ). St. Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 11. The parents of an 18-month-old arrive at the emergency department with their unconscious child. Physical examination reveals bruises on the child’s upper arms that resemble grip marks. Which nursing intervention is the priority? A. Stabilizing the child’s physical condition Correct B. Securing a safe environment for the child C. Confronting the parents with regard to suspected abuse D. Contacting the appropriate state officials to report the suspected abuse Rationale: In all child abuse cases, the primary concern is the physical condition of the child. Although contacting appropriate state officials to report suspected abuse and securing a safe environment for the child are both interventions that need to be performed, this child is unconscious, so the priority is to stabilize the child’s physical condition. Confronting the parents about the abuse at this time may cause resentment and conflict in the parents, and the parents might attempt to leave the emergency department with their child. Test-Taking Strategy: Note the strategic word “priority.” Use Maslow’s Hierarchy of Needs theory to answer this question. Recalling that physiological needs are the priority will direct you to the correct option. Review: care of the child who has been physically abused. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Implementation Content Area: Mental Health Giddens Concepts: Clinical Judgment, Interpersonal Violence HESI Concepts: Clinical Decision Making-Clinical Judgment-Critical Thinking, Safety pp. 262-263). St. Louis: Elsevier. Awarded 99.0 points out of 99.0 possible points. 12. A nurse in a women’s clinic develops a plan of care for survivors of intimate partner violence. Which tertiary prevention intervention should be included in the plan of care? A. Identifying families at risk for abuse B. Early case-finding and decisive intervention C. Changing societal views toward domestic abuse D. Assisting abused women in overcoming the physical and psychological effects of abuse Correct Rationale: Primary prevention intervention (here, identifying families at risk for abuse and changing societal views toward domestic abuse) is focused on risk identification and health promotion and prevention of disorders. Secondary prevention interventions (early case-finding and decisive intervention) are focused on early identification and treatment of a problem. Tertiary prevention intervention (helping survivors of intimate partner violence overcome the physical and psychological effects of abuse) is focused on reducing the residual effects of a disorder and rehabilitation. Test-Taking Strategy: Focus on the subject, a tertiary prevention intervention. Recalling the definitions of each prevention level will direct you to the correct option. Review: tertiary prevention for survivors of intimate partner violence. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Planning Content Area: Mental Health Giddens Concepts: Caregiving, Interpersonal Violence HESI Concepts: Safety, Stress & Coping 740). St. Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 13. A nurse is creating a written crisis plan for a worksite. The nurse should refer the reader to the section on which type of crisis, if an explosion occurs at the worksite? A. A situational crisis B. An individual crisis C. A maturational crisis D. An adventitious crisis Correct Rationale: Adventitious crises are unpredictable tragedies that occur without warning. An individual may experience crisis, but there is no formal type of crisis known as "individual crisis." A situational crisis occurs when a specific external event disturbs an individual’s psychological equilibrium. A maturational crisis involves the normal life transitions that produce changes in individuals and how they perceive themselves, their roles, and their status. Test-Taking Strategy: Use the process of elimination and knowledge of the definition of each type of crisis identified in the options. Focus on the data in the question to identify the correct option. Review: the different types of crises. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Planning Content Area: Mental Health Giddens Concepts: Caregiving, Clinical Judgment HESI Concepts: Clinical Decision Making-Clinical Judgment-Critical Thinking, Stress & Coping Reference: Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A communication approach to evidence-based care. (revised reprint)) (2nd ed. pp. 400-401). St. Louis: Saunders. Awarded 0.0 points out of 99.0 possible points. 14. A nurse prepares equipment in the electroconvulsive therapy (ECT) suite for a client who will be arriving shortly for therapy. Which items are essential? Select all that apply. A. Thermometer B. Bath blankets C. Pulse oximeter Correct D. Suction device Correct E. Ventilation equipment Correct Rationale: In the ECT suite, blood pressure, cardiac, and electroencephalographic monitors are placed on the client to assess vital functions. Whenever ECT is administered, emergency equipment, including oxygen, suction, and ventilation equipment, must also be available. Bath blankets and a thermometer are not essential equipment. Test-Taking Strategy: Use your knowledge of the ABCs (airway, breathing, and circulation) to identify the correct options. Also note that the correct options all involve the airway. Review: ECT therapy. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Planning Content Area: Mental Health Giddens Concepts: Clinical Judgment, Safety HESI Concepts: Clinical Decision Making-Clinical Judgment-Critical Thinking, Safety Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 15. A client with depression says, “I always make mistakes. I never do anything right.” Which response by the nurse is therapeutic? A. Saying, “Everyone makes mistakes.” B. Saying, “I know how you are feeling.” C. Saying, “That’s not true. Things will get better.” D. Identifying recent accomplishments that demonstrate the client’s abilities. Correct Rationale: Feelings of low self-esteem and worthlessness are common symptoms of the depressed client. Reminders of the client’s recent accomplishments or personal successes are ways to interrupt the client’s negative self-talk and distorted cognitive view of self. The incorrect options give advice and devalue the client’s feelings. Test-Taking Strategy: Use your knowledge of therapeutic communication techniques. Eliminate the incorrect comparable or alike options that give advice and devalue the client’s feelings. Focusing on the client’s diagnosis will direct you to the correct option. Review: care of the client with depression. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Communication and Documentation Content Area: Mental Health Giddens Concepts: Communication, Mood and Affect HESI Concepts: Communication, Mood & Affect 273). St. Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 16. A hospitalized client with a diagnosis of delirium often becomes disoriented and confused during the night. Which intervention does the nurse implement? A. Shutting all lights off at night B. Keeping the radio on during the night C. Keeping the television on during the night D. Ensuring a low-stimulation environment at night Correct Rationale: It is important to provide a consistent daily routine and a low-stimulation environment when a client is confused. Noise, including that from radios and televisions, may add to the client’s confusion and disorientation. Lighting is an environmental stimulus that helps maintain and improve orientation. Test-Taking Strategy: Eliminate the comparable or alike options (i.e., leaving the radio and television on) first. To select from the remaining options, note that the correct one is the umbrella option. Also note the closed-ended word “all” in the other option. Review: measures to be taken for the client who is disoriented and confused. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Implementation Content Area: Mental Health Giddens Concepts: Cognition, Psychosis HESI Concepts: Cognition, Stress & Coping Reference: Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A communication approach to evidence-based care. (revised reprint)) (2nd ed. p. 344). St. Louis: Saunders. Awarded 99.0 points out of 99.0 possible points. 17. A psychiatric nurse assists victims of a nightclub fire and their families. Which actions on the part of the nurse is the most important intervention in the immediate post disaster period? A. Making a list of people who may require mental health services B. Contacting sources of support that may be available for the victims C. Talking to people seeking assistance from the American Red Cross Correct D. Waiting for individuals to identify themselves publicly as being unable to cope places, such as morgues, hospitals, and shelters, where victims are likely to gather. Rather than wait for people to identify themselves publicly as being unable to cope with stress, it is suggested that nurses work with the American Red Cross, talk to people waiting in line to apply for assistance, go door to door, or visit a relocation site. The nurse should ask individuals how they are managing their affairs and explore their reactions to the stress. Test-Taking Strategy: Use knowledge of the subject, nursing care during a crisis, to assist the process of elimination. Note that the correct option is the only option that involves dealing directly with people. Review: the psychiatric nurse’s role in responding to a disaster. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Implementation Content Area: Mental Health Giddens Concepts: Caregiving, Coping HESI Concepts: Grief &Loss, Stress & Coping 191). St. Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 18. A psychiatric nurse who is a member of a mobile crisis team is called to deal with a person who is threatening to jump off a bridge in a suicide attempt. On arrival at the site, the nurse immediately takes which action? A. Tries to grab the client to prevent the jump B. Directs law enforcement to prevent the jump C. Tells the client, “You’re making a mistake. I’ll help you.” D. Tries to communicate with the client and develop a therapeutic relationship Correct Rationale: When someone is in the act of preparing to commit suicide, the most appropriate action on the part of the nurse is to communicate with the client in an attempt to develop a therapeutic relationship. The nurse should communicate hope, and hope is often the most therapeutic element in any nursing intervention with a suicidal client. Telling the client he is making a mistake is inappropriate. The other incorrect options are also inappropriate and could prompt the client to follow through with the suicide attempt. Test-Taking Strategy: Use the process of elimination, focusing on the data in the question. Eliminate the comparable or alike options first in that they involve physically preventing the client from making the jump. To select from the remaining options, use your knowledge of therapeutic communication techniques to identify the correct option. Review: the nurse’s role in preventing a suicide . Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Implementation Content Area: Mental Health Giddens Concepts: Clinical Judgment, Safety HESI Concepts: Clinical Decision Making-Clinical Judgment-Critical Thinking, Safety Reference: Stuart, G. (2013). Principles & practice of psychiatric nursing (10th ed., p. 194 ). St. Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 19. A client tells the nurse, “I did my hair just like my favorite math teacher wears hers. I hope I can be a good teacher, too.” The nurse documents the client is using which defense mechanism? A. Projection B. Regression C. Identification Correct D. Intellectualization Rationale: Identification is the process in which a person tries to become like someone he or she admires by taking on the thoughts, mannerisms, or tastes of that person. Projection is attributing one's thoughts or impulses to another person. Regression is retreating to behavior characteristic of an earlier level of development. Intellectualization is the use of excessive reasoning or logic in an attempt to avoid disturbed feelings. Test-Taking Strategy: Use the process of elimination, focusing on the data in the question. Noting that the client is mimicking another person will direct you to the correct option. Review: defense mechanisms Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/ Assessment Content Area: Mental Health Giddens Concepts: Anxiety, Mood and Affect, HESI Concepts: Mood & Affect, Stress & Coping Reference: Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A communication approach to evidence-based care. (revised reprint)) (2nd ed. p. 173). St. Louis: Saunders. Awarded 99.0 points out of 99.0 possible points. 20. A nurse assesses a new client hospitalized on the mental health unit. The client is experiencing negative thinking and says, “I’m doomed to failure.” Which comment is the most appropriate comment for the nurse to make? A. “You feel you’re a failure?” Correct B. “It’s probably not as dark as you think” C. “Does your mother think of you in that way?” D. “Why don’t you try changing your major in college?” Rationale: The client exhibits negative thinking, and believes he or she is doomed to failure. The nurse should use reflection when communicating with the client. This allows the client to “hear” his/her statement and will likely communicate more details. The nurse should not use abstract terms such as “as dark as you think” when communicating with a client who is acutely suggest changing college majors because this comment gives advice and will likely close off communication. Test-Taking Strategy: Use knowledge of therapeutic communication techniques to assist with selection of the correct option. Eliminate options that use abstract terms, change the subject or give advice. Review: therapeutic communication techniques. Level of Cognitive Ability: Applying Client Needs: Psychosocial Integrity Integrated Process: Communicaion and Documentation Content Area: Mental Health Giddens Concepts: Communication, Mood and Affect HESI Concepts: Communication, Mood & Affect Louis: Mosby. Awarded 99.0 points out of 99.0 possible points. 21. A psychiatric nurse is sitting with several clients in the day room. A client who has been experiencing delusions and hallucinations says to the nurse, “That television is sending special messages to me.” Which response by the nurse is therapeutic? A. “The television is on for everyone.” Correct B. “What is the television telling you to do?” C. “The television is not sending messages to you.” D. “What message is the television sending to you?” Rationale: The therapeutic response is the one that provides reality for the client. In the incorrect options, the nurse feeds into the client’s delusions or hallucinations and denies the client the opportunity to see reality. Test-Taking Strategy: Use your knowledge of therapeutic communication techniques. Eliminate the comparable or alike options that relate to the television sending messages or telling the client what to do. From the remaining options the one that provides a sense of reality to the client is “The television is on for everyone.” Review: therapeutic communication techniques for the client experiencing delusions or hallucinations