ATI LPN
Test Bank for Essentials of Psychiatric Mental Health Nursing: A Communication Approach to Evidence-Based Care, 4e 4th Edition
Chapter 8 Questions
Question 1 of 5
Documentation in a patient's chart shows, 'Throughout a 5-minute interaction, patient fidgeted and tapped left foot, periodically covered face with hands, and looked under chair while stating, I enjoy spending time with you."' Which analysis is most accurate?"
Correct Answer: C
Rationale: When a verbal message is not reinforced with nonverbal behavior, the message is confusing and incongruent. Some clinicians call it a 'mixed message.' It is inaccurate to say that the patient is giving positive feedback about the nurse's communication techniques. The concept of a cultural filter is not relevant to the situation; a cultural filter determines what a person will pay attention to and what he or she will ignore. Data are insufficient to draw the conclusion that the patient is demonstrating psychotic behaviors.
Question 2 of 5
A patient cries as the nurse explores the patient's relationship with a deceased parent. The patient says, 'I shouldn't be crying like this. It happened a long time ago.' Which responses by the nurse will facilitate communication? (Select all that apply.)
Correct Answer: B,C,D
Rationale: Reflecting ('I can see that you feel sad' or 'This is very painful for you') and giving information ('Crying is a way of expressing hurt') are therapeutic techniques. 'Why' questions often imply criticism or seem intrusive or judgmental, and they are difficult to answer. Changing the subject is a barrier to communication.
Question 3 of 5
During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the patient's hand. Select the correct analysis of the nurse's behavior.
Correct Answer: B
Rationale:
Touch has various cultural and individual interpretations. Nurses should refrain from using touch until an assessment can be made regarding the way in which the patient will perceive touch. The other options present prematurely drawn conclusions.
Question 4 of 5
An African-American patient says to a Caucasian nurse, 'There's no sense talking. You wouldn't understand because you live in a white world.' What would be the nurse's best action?
Correct Answer: B
Rationale: Having the patient speak in specifics rather than globally helps the nurse understand the patient's perspective. This approach helps the nurse engage the patient.
Question 5 of 5
The patient says, 'My marriage is just great. My spouse and I usually agree on everything.' The nurse observes the patient's foot moving continuously as the patient twirls a shirt button. What type of communication is the patient presenting?
Correct Answer: B
Rationale: Mixed messages involve the transmission of conflicting or incongruent messages by the speaker. The patient's verbal message that all is well in the relationship is modified by the nonverbal behaviors denoting anxiety. Data are not present to support the choice of the verbal message being clear, explicit, or inadequate.