Principles And Practice of Psychiatric Nursing,10th Edition by Gail Wiscarz Stuart -Test Bank

Principles And Practice of Psychiatric Nursing,10th Edition by Gail Wiscarz Stuart -Test Bank

Chapter 6: Psychological Context of Psychiatric Nursing Care
Test Bank

MULTIPLE CHOICE

1. A patient admitted for treatment of uncontrolled diabetes mellitus is withdrawn and tearful. The patient says, “I just want to be normal again.” The nurse determines there is a need for a psychiatric evaluation primarily to assist:
a. the patient in verbalizing distress about the disease.
b. in assessing the emotional factors affecting the patient’s present condition.
c. in assessing priorities to be set for the patient’s overall nursing plan of care.
d. the patient in emotionally accepting the chronic nature of the disease.

ANS: B
The primary purpose would be to assess emotional factors that may have an effect on the patient’s current condition. The patient has given clues to psychological distress. Holistic care requires the assessment of biological, psychological, and sociocultural health status.

DIF: Cognitive Level: Application REF: Text Pages: 88-89
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

2. Success in obtaining sufficient data in the initial psychiatric interview depends largely on the:
a. patient’s ability to communicate effectively.
b. interviewer’s ability to establish good rapport.
c. number of psychiatric interviews the nurse has performed.
d. interviewer’s ability to organize and systematically record data.

ANS: B
Patients with whom the nurse has established rapport will feel understood by the examiner and will be more willing to cooperate with the examiner’s questions. Although the remaining options have an impact on the success of the interview, they are not the primary factor.

DIF: Cognitive Level: Application REF: Text Page: 89
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

3. A nurse plans to engage in participant observation while conducting a mental status examination. This will require the nurse to:
a. increase verbalization with the patient.
b. listen attentively to the patient’s response.
c. engage in communication and observation simultaneously.
d. advise the patient on what to do about data obtained during the interview.

ANS: C
Participant observation is a clinical approach that allows the nurse to critically observe a patient while structuring the examination in a way that allows for the broad exploration of many areas to screen for potential problems and for the in-depth exploration of obvious symptoms or maladaptive coping responses. Discussing treatment options is not the purpose of this intervention. Verbalization and attentive listening are required but may not need to be increased.

DIF: Cognitive Level: Comprehension REF: Text Pages: 89-90
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Management of Care

4. A nurse conducting a mental status examination should plan to:
a. compare results with at least one other nurse.
b. perform the examination without the patient knowing.
c. integrate the examination into the nursing assessment.
d. perform the examination as the first communication with the patient.

ANS: C
Many observations can be made during other aspects of the nursing assessment, and specific questions can be blended into the general flow of the interview. Planning to compare results requires the assumption that more than one assessment will be conducted. This examination requires input from the patient that is best secured when the patient-nurse relationship has been established.

DIF: Cognitive Level: Application REF: Text Page: 88
TOP: Nursing Process: Assessment
MSC: NCLEX: Safe, Effective Care Environment: Management of Care

5. A patient visiting from Puerto Rico has become psychotic while staying with family here in the United States. When conducting the mental status examination, the nurse remembers that:
a. sociocultural factors may greatly affect the examination.
b. liking the patient as a person is important to the outcome.
c. an interpreter may help facilitate the verbal portion of the examination.
d. biological expressions of psychiatric illness are not relevant to someone from another culture.

ANS: A
Dress, eye contact, personal hygiene, speech and use of language, personal space, and body language are a few aspects of the mental status examination that vary with culture and social status.

DIF: Cognitive Level: Comprehension REF: Text Page: 88
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

6. A cognitively impaired patient reports to the nurse that, “I had the best time. My husband took me out to dinner and then to a concert. The music was wonderful.” Knowing that the patient is a widow, the nurse determines her remarks are an example of:
a. tangential thinking.
b. confabulation.
c. hallucination.
d. circumstantiality.

ANS: B
Confabulation means covering one’s inability to remember by making up a story of something that might have happened.

DIF: Cognitive Level: Application REF: Text Page: 93
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity