NURS 2362 Module 3 Exam – 2020 Chamberlain School of Nursing
Questions
1. ID: 8482587678The mother of a 3-year-old child tells the nurse that her
... [Show More] child hit her doll after the mother scolded her for picking the neighbors’ flowers. Which defense mechanism used by the child does the nurse identify in the mother’s report?
Projection Sublimation Displacement Correct Identification
Rationale: The defense mechanism of displacement involves the discharge of intense feelings for one person onto a substitute person or object that is less threatening to satisfy an impulse. Projection involves attributing an attitude, behavior, or impulse, such as that which occurs in blaming or scapegoating, to someone else. Sublimation is the act of rechanneling an impulse into a more socially acceptable object. Identification involves modeling behavior after someone else's.
Test-Taking Strategy: Note the subject of the question, defense mechanisms.
Focusing on the data in the question and the child’s behavior will direct you to the correct option. Review: these defense mechanisms .
Reference: Varcarolis, E., & Halter, M. (2009). Essentials of psychiatric mental health nursing: A communication approach to evidence-based care (p. 133). St. Louis: Saunders.
Cognitive Ability: Understanding
Client Needs: Psychosocial Integrity
Integrated Process: Nursing Process/Assessment
Content Area: Mental Health
Giddens Concepts: Development, Mood and Affect
HESI Concepts: Developmental, Mood and Affect Awarded 1.0 points out of 1.0 possible points.
2. ID: 8482589936A client says to the nurse, “I’ve been following my diet and taking my medication. What else do you want to talk about today?” Which response would be most helpful during the working phase of the therapeutic alliance?
“Sounds fine to me. Let’s meet again in 6 months.”
“I don’t believe that you have been following your diet, because you haven’t lost any weight.” “Well, you’ve talked about diet in your terms, but perhaps I should test you on specific things.” “Some people have added exercise to diet and medication therapy and gotten positive results. Do you think that this would work for you?” Correct
Rationale: Although suggestion or overt giving of advice is sometimes nontherapeutic, these strategies are therapeutic when used in the working phase, because in this situation they will increase the client’s perception of all available options in the treatment plan. Answering, “Sounds fine to me. Let’s meet again in 6 months” stops the communication process. Stating to the client that he or she has not lost any weight implies disbelief and does not explore the reasons for the client’s failure to lose weight. “Testing” challenges the client and is nontherapeutic.
Test-Taking Strategy: Note the strategic word “most” and remember therapeutic communication techniques. Noting the words “working phase” in the question will direct you to the correct option. Review: therapeutic communication techniques .
Reference: Stuart, G. (2009). Principles & practice of psychiatric nursing (9th ed., pp. 27-31, 553). St. Louis: Mosby.
Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Content Area: Mental Health
Giddens Concepts: Communication, Health Promotion
HESI Concepts: Communication, Health, Wellness, and Illness—Health Promotion Awarded 1.0 points out of 1.0 possible points.
3. ID: 8482589970As the nurse prepares to interview a client being admitted to the mental health unit, the client says, “I asked my family to bring me in here to talk to someone, but now I don’t know where to begin.” Which response by the nurse would be most helpful?
“Why not just start talking and see where it takes you?”
“If I were you, I’d begin with what you were doing this morning.”
“Perhaps you can start by sharing some of your most recent concerns.” Correct
“Don’t worry. Everyone who comes in here for the first time feels reluctant to talk.”
Rationale: The intake interview is usually the first contact with the client. It is intended to establish rapport, to help the nurse understand the client’s current problem and level of functioning, and to help the nurse formulate a nursing care plan. The clinician usually allows the client to set the pace of the interview and uses open-ended questions to elicit a comprehensive diagnostic picture of the client’s problems and level of coping. Sharing concerns is a good place to start the conversation, because it will allow the client to express feelings. The response “Why not just start talking and see where it takes you?” is too general and does not provide the client with a focus on self. Telling the client not to worry is nontherapeutic and avoids addressing the client’s concerns.
Test-Taking Strategy: Note the strategic word “most.” Use your knowledge of therapeutic communication techniques. Focusing on the client’s feelings will direct you to the correct option. Review: therapeutic communication techniques .
References: Stuart, G. (2009). Principles & practice of psychiatric nursing (9th ed., pp. 27-31). St. Louis: Mosby.
Varcarolis, E., & Halter, M. (2009). Essentials of psychiatric mental health nursing: A communication approach to evidence-based care (pp. 117-118). St. Louis: Saunders.
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 and Affect Awarded 1.0 points out of 1.0 possible points.
4. ID: 8482592914During a mental health intake interview, a young adult client who lives with his family rent free says, “I’m tired of not being able to offer my friends a beer just because my folks don’t believe in taking a drink socially.” Which nursing response would be therapeutic?
“Well, I guess you could move out and live on your own if you wanted to.”
“It seems that your parents expect you to follow their rules when you live under their roof.”
Correct
“You tell me you live rent free, yet you expect the same privileges as an adult who supports the household?” [Show Less]