Deck 2: Nursing Practice in the Clinical Setting

Question 1

An often expressed intrinsic reward of psychiatric mental health nursing is:

A) Seeing the seriously ill recover their health
B) Working with patients of all ages and walks of life
C) Working with well-trained, caring health care providers
D) Having time to really focus on the human who is the patient

Answer 1

Having time to really focus on the human who is the patient

Question 2

Which statement is an example of an inference?

A) "He is an alcoholic because his wife nags a lot."
B) "He states he binges after arguing with his wife."
C) "You say your alcohol intake exceeds a quart a day."
D) "So you are saying that you were drinking earlier today."

Answer 2

"He is an alcoholic because his wife nags a lot."

Question 3

Which response by the nurse manager to a novice mental health nurse is most effective when the nurse asks,"How do I justify not keeping a patient's secret?"

A) "Never promise the patient that you will keep a secret for them."
B) "Always stop the patient from telling you something as a secret."
C) "Let the patient know that you will not keep a secret that could ultimately cause harm or affect their treatment."
D) "Keep reminding yourself that you are not the patient's friend but rather a professional mental health provider."

Answer 3

"Let the patient know that you will not keep a secret that could ultimately cause harm or affect their treatment."

Question 4

Which action on the part of a novice mental health nurse will best minimize fear related to effectively working with the psychotic patient?

A) Be knowledgeable about psychotropic medications and their affect on psychosis.
B) Always arrange for staff support when working one-on-one with a psychotic patient.
C) Take advantage of opportunities to attend workshops devoted to the care of the psychotic patient.
D) Recognize that the psychotic patient is not in control of their behaviors due to their altered though processes.

Question 5

Which action on the part of a novice psychiatric mental health nurse shows a need for future development of altruism?

A) Excusing a patient from attending group because, "all that talking makes me so anxious"
B) Not permitting two patients who are physically attracted to each other to engage in public displays of affection
C) Placing a physically aggressive patient in restraints when they are unable to internally calm their anger
D) Self-reflecting on "why I continue to work with patients who are so emotionally damaged they will never be normal"

Question 6

Which nursing action is a reflection of Hildegard Peplau's theoretic framework regarding psychiatric mental health nursing?

A) Basing patient outcomes on expected instinctual responses
B) Discussing a patient's feelings regarding parents and siblings
C) Providing the patient with clean clothes and wholesome food
D) Centering professional practice in a state run psychiatric facility

Question 7

The nurse is attempting to minimize the group's display of resistance during a therapy session.Which patients are at risk for displaying such behavior? Select all that apply

A) The patient who is cognitively impaired
B) The patient who is older and well educated
C) The patient who is aggressive and attention seeking
D) The patient who has attended similar therapy groups in the past
E) The patient who has been diagnosed with paranoid schizophrenia

Question 8

The nurse demonstrates objective patient care when:

A) Being sympathetic to the patient's recent loss of a spouse
B) Protecting the anxious patient by eliminating stressors in the milieu
C) Responding to the patient by stating, "I know exactly how you feel."
D) Facilitating the patient's exploration of various stress reduction techniques

Question 9

The greatest negative outcome resulting from a nurse's fear of a mentally ill patient is that the:

A) Nurse will reinforce negative stereotyping of the mentally ill.
B) Patient will experience increased bias against the nursing staff.
C) Public's fearfulness of the mentally ill will continue to be exaggerated.
D) Therapeutic alliance between the nurse and patient will not develop effectively.

Question 10

The nurse is attempting to provide a safe environment for a patient at great risk for self-harm.Which intervention shows an understanding of evidence-based practice (EBP)?

A) Using physical restraints only after all other options have been proven ineffective
B) Referring to the facility's policies manual for guidelines for applying physical restraints
C) Collecting data regarding the short-term effects of using physical restraints on an aggressive patient
D) Requiring constant monitoring of a patient whose inability to self-regulate anger has required the use of physical restraints

Question 11

Which nursing intervention would be appropriately addressed during the orientation phase of the nurse-patient relationship?

A) Self reflection by the nurse regarding personal biases and prejudices regarding the patient
B) Patient works at prioritizing personal needs and develops realistic expected outcomes
C) Establishing the contract between the nurse and the patient regarding mutual needs and expectations
D) Patient commits to the reinforcement of positive personal characteristics while working on problems and concerns

Question 12

Which interactions are likely outcomes of a well-established therapeutic alliance? Select all that apply.

A) The nurse states, "I'm not here to judge but rather to help."
B) The patient states, "I really think I can handle this problem now."
C) The patient asks his abusive father to attend counseling with him.
D) The nurse sets boundaries for a patient who has few social skills.
E) The patient with anger issues voluntarily goes into the seclusion room.

Question 13

Which nursing interventions are directly related to the principles on which a therapeutic alliance is based? Select all that apply.

A) Graciously declining to, "Come visit when I get discharged."
B) Establishing the topic to be discussed at each group session
C) Explaining to the patient the purpose of terminating the alliance
D) Sharing how the nurse also has experienced the same problems
E) Providing subjective feedback to the patient's efforts at therapy

Question 14

Which statement by the patient reflects patient education that was based on the concept of integrated patient care?

A) "I know I'm anxious when I get a tension headache."
B) "My anxiety is a result of stressors I don't cope well with."
C) "Medication has helped me tremendously with anxiety control."
D) "Anxiety runs in my family; my entire family is trying to deal with it."

Question 15

The nurse is effectively facilitating the nurse-patient relationship when:

A) Sharing with an angry patient who is verbally abusive that, "Although I can accept that you are angry, I cannot and will not accept your verbal abuse."
B) Focusing on the patient's life experience without relating to the similarities of one's own experiences
C) Objectively providing constructive criticism that is directed to helping the patient identify inappropriate behaviors
D) Refraining from abandoning the patient regardless of the frustration the interaction causes