NCA2

PSYCHIATRIC NURSING POST-TES

1. The nurse is explaining the therapeutic nurse-client relationship to a new client. The focus of
this relationship is on the client’s:
a. Needs as he/she perceives them
b. Needs as the nurse perceives them
c. Problems as identified by the psychiatrist

2. Trust is developed in the nurse-patient relationship when the nurse:

D.

3. The termination phase of the nurse-client relationship is best described in one of the following
statements:

a. Establish trust as a basis for therapeutic relationship

b. Identify and resolve patient’s problems

c. Explore patient’s thoughts feelings and concerns

d. Review progress of therapy and attainment of goals

D.

4. The student nurses are taught that they should have an unconditional and non-judgmental
attitude towards clients. The students are expected to call the client by name and spend time with
the client. These actions are examples of which of the following:

a. Value

b. Positive regard

c. empathy

d. self-disclosure

B.

5. The nurse should prepare for the termination phase during:

a. pre-orientation phase

b. orientation phase
c. working phase

d. termination phase

B.

6. A client says to the nurse, “I must tell you something, but you must not tell anyone else.” Which
of the following responses by the nurse would be appropriate?

a. I am glad you can trust me.

b. I have to reveal anything that would be essential to your treatment.

c. the nurse and the patient have a special relationship.

d. I am bound to keep it a secret because of confidentiality

B.

7. which of the following behaviors occurs when the nurse’s voice or body language is consistent
with the words he or she speaks.

a. empathy

b. genuine interest

c. trust

d. congruence

D.

8. the nurse is told that she will be handling a client who has been sexually assaulted. She is in the
pre-orientation phase of the nurse-client relationship. The nurse in this phase of the relationship
should

a. establish acceptance, trust and boundaries

b. explore personal ideas, stereotypes, and biases that may affect the nurse-client relationship

c. identify themes of patterns of patient behavior and possible coping mechanism

d. actively listens to the client express his thoughts and feelings

9. during the termination phase of the nurse-client relationship the client verbalizes that he again
has difficulty dealing with his problems and asks the nurse if she can extend her time with him for
another week. The most appropriate response of the nurse is.
a. to tell the client that she has to ask permission from the supervisor

b. to redirect the client to his newly developed coping skills

c. to tell the client that she has to stay with him for another week

d. to refer the client to her supervisor

10. formulation of a contract during the orientation phase is an essential aspect of consideration. It
includes the following except

a. nurse’s and client’s responsibilities

b. when the sessions will terminate

c. time and place of the interaction

d. treatment goals

11. the client tells the nurse “I don’t think you can help me. Every time I talk to you, I am reminded
of my mother and I hated her” the nurse should recognize this as

a. confrontation

b. countertransference

c. incongruence

d. transference

D.

12. the following interaction is an example of which therapeutic communication technique?

Client: “I had an accident.”

Nurse: “tell me about your accident”

a. accepting

b. general lead

c. making observation

d. offering self

B.

13. the client is fearful and reluctant to talk. Which of the following techniques is most effective
when trying to engage the client in interaction?

a. broad opening
b. focusing

c. giving information

d. silence

A.

14. the following are examples of nontherapeutic communication techniques except

a. always look at the brighter side so you won’t feel depressed

b. I can’t talk to you right now

c. its going to be all right

d. I find it hard to believe that when you said yesterday that

15. a patient diagnosed with terminal cancer says to the nurse “I’m going to die, and I wish my
family would stop hoping for a cure I get so angry when they carry on like this. After all I’m the one
who’s dying. which response by the nurse is therapeutic?

a. have you shared your feelings with your family?

b. I think we should talk more about your anger with your family

c. you’re feeling angry that your family continues to hope for you to be cured?

d. you are probably very depressed which is understandable with such a diagnosis

C.

16. a middle-aged patient says to the nurse “I don’t deserve to live”. The most therapeutic initial
response by the nurse would be to:

a. continue to listen to the patient while maintaining direct eye contact

b. remain with the patient until she states she feels better.

c. say to the patient, “you sound depressed and lean forward

d. asks the patient what she means by “I don’t deserve to live”

D.

17. which nursing statement is a good example of the therapeutic communication technique of
focusing.

a. “Describe one of the best things that happened to you this week”
b. “I m having a difficult time understanding what you mean”

c. “your counseling session is in 30 minutes. I’ll stay with you until then”

d. “You mentioned your relationship with your father. Let’s discuss that further

D.

18. when observing nonverbal communication, the nurse knows that:

a. clients are usually aware of their nonverbal cues

b. nonverbal cues have obvious meaning and are easily interpreted

c. nonverbal cues provide significant information but must be validated or clarified

d. verbal response are more reliable than nonverbal cues

B.

19. a client speaks loudly, rapidly taps his feet and has rapid speech. Yet he says “I feel calm today”
what would be the most appropriate response by the nurse?

a. you’re telling me that you’re calm but your body seems to be sending a different meaning

b. I’m glad you’re feeling so calm. Things will be better for you now trust me

c. I’m glad to hear that you’re feeling calm and settled

d. Do you like to talk about how calm the weather is today

20. when the community health nurse visits a client at home, the client states “I haven’t slept at all
the last couple of nights” which response by the nurse illustrates a therapeutic communication
response to this patient?

a. I see

b. really?

c. you’re having a difficulty of sleeping?

d. sometimes, I have trouble sleeping too

C.

21. the nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store.
The neighbor says to the nurse how is carol doing? She is my best friend and I have seen her at your
clinic every week. Which is the MOST APPROPRIATE nursing response?

a. I cannot discuss anu patient situation with you

c. only because you’re worried about a friend ill tell you that she is improving

d. being her friend, you know she is having a difficult time and deserves her privacy

A.

22. a client tells the nurse “I’m too depressed to talk to you. Leave me alone” which of the following
responses of the nurse would be most therapeutic?

a. ill be back in two hours

b. why are you so depressed?

c. I’ll sit here with you for a moment

d. call me when you feel like talking to me

C.

23. during a nurse-client interaction, which nursing statement may belittle the clients’ feelings and
concerns?

a. don’t worry everything will be alright

b. you appear uptight

c. I notice you have bitten your nails to the quick

d. tell me more about this anger you are feeling

A.

24. a client states “You won’t believe what my husband said to me during visiting hours he has no
right treating me that way” Which nursing response would best assess the situation that occurred?

a. does your husband treat you like this very often?

b. what do you think is your role in this relationship?

c. why do you think he behaved like that?

d. describe what happened during your time with your husband

D.

25. the nurse is preparing a patient for the termination phase of the nurse-patient relationship. The
nurse prepares to implement which nursing task that is MOST APPROPRIATE for this phase?

a. planning short-term goals

c. developing realistic solutions

d. identifying expected outcomes

B.

26. which therapeutic communication technique is being used in this nurse-client interaction?
Client: “when I get angry I get into a fist fight wit my wife or I take it out on the kids” Nurse: “I
notice that you are smiling as you talk about this physical violence”

a. encouraging comparison

b. exploring

c. formulating a plan of action

d. making observation

D.

27. a nurse state to a client “things will look better tomorrow after a good night sleep” this is an
example of which communication technique?

a. the therapeutic technique of “giving advice”

b. the therapeutic technique of “defending”

c. the nontherapeutic technique of “presenting reality”

d. the nontherapeutic technique of “giving false reassurance”

D.

28. a nurse is assessing a client diagnosed with schizophrenia for the presence of hallucinations.
Which therapeutic communication technique use by the nurse is an example of making
observations?

a. you appear to be talking to someone I do not see

b. please describe what you are seeing

c. why do you continually look in the corner of this room?

d. if you hum a tune the voices may not be so distracting

A.
29. after assertiveness training a formerly passive client appropriately confronts a peer in group
therapy. The group leader states “I m so proud of you being assertive you are so good” which
communication technique has the leader employed?

a. the nontherapeutic technique of giving approval

b. the nontherapeutic technique of interpreting

c. the therapeutic technique of presenting reality

d. the therapeutic technique of making observations

30. when interviewing a client which is nonverbal behavior should a nurse employ?

a. maintaining indirect eye contact with the client

b. providing space by leaning back away from the client

c. sitting squarely. Facing the client

d. maintaining open posture with arms and legs crossed

C.