TEST BANK PRIMARY CARE PSYCHIATRY 2nd Edition McCarron Xiong

Chapter 1: The Primary Care Psychiatric Interview
Primary Care Psychiatry 2nd Edition McCarron Xiong Test Bank
MULTIPLE CHOICE
1. A patient says to the nurse, I dreamed I was stoned. When I woke up, I felt emotionally
drained, as though I hadnt rested well. Which response should the nurse use to clarify the
patients comment?
a. It sounds as though you were uncomfortable with the content of your dream.
b. I understand what youre saying. Bad dreams leave me feeling tired, too.
c. So you feel as though you did not get enough quality sleep last night?
d. Can you give me an example of what you mean by stoned?
ANS: D
The technique of clarification is therapeutic and helps the nurse examine the meaning of the
patients statement. Asking for a definition of stoned directly asks for clarification. Restating that
the patient is uncomfortable with the dreams content is parroting, a non-therapeutic technique.
The other responses fail to clarify the meaning of the patients comment.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: mcs 154 (dm 9-2) TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
2. A patient diagnosed with schizophrenia tells the nurse, The CIA is monitoring us through the
fluorescent lights in this room. Be careful what you say. Which response by the nurse would be
most therapeutic?
a. Lets talk about something other than the CIA.
b. It sounds like youre concerned about your privacy.
Stuvia.com - The Marketplace to Buy and Sell your Study Material
c. The CIA is prohibited from operating in health care facilities.
d. You have lost touch with reality, which is a symptom of your illness.
ANS: B
It is important not to challenge the patients beliefs, even if they are unrealistic. Challenging
undermines the patients trust in the nurse. The nurse should try to understand the underlying
feelings or thoughts the patients message conveys. The correct response uses the therapeutic
technique of reflection. The other comments are non-therapeutic. Asking to talk about something
other than the concern at hand is changing the subject. Saying that the CIA is prohibited from
operating in health care facilities gives false reassurance. Stating that the patient has lost touch
with reality is truthful, but uncompassionate.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: mcs 154 (dm 9-2) TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. The patient says, My marriage is just great. My spouse and I always agree. The nurse observes
the patients foot moving continuously as the patient twirls a shirt button. The conclusion the
nurse can draw is that the patients communication is:
a. clear. c. precise.
b. mixed. d. inadequate.
ANS: B
Mixed messages involve the transmission of conflicting or incongruent messages by the speaker.
The patients verbal message that all was well in the relationship was modified by the nonverbal
behaviors denoting anxiety. Data are not present to support the choice of the verbal message
being clear, explicit, or inadequate.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: mcs 150-151 TOP: Nursing Process: Assessment