NURSING 2362 Module 3 Exam

NURSING 2362 Module 3 Exam

Questions

1.ID: 8482587678The mother of a 3-year-old child tells the nurse that her child

hit her doll after the mother scolded her for picking the neighbors’ flowers. Which

defense mechanism used by the child does the nurse identify in the mother’s

report?

A Projection

B Sublimation

C Displacement Correct

D Identification

Rationale: The defense mechanism of displacement involves the discharge of

intense feelings for one person onto a substitute person or object that is less

threatening to satisfy an impulse. Projection involves attributing an attitude,

behavior, or impulse, such as that which occurs in blaming or scapegoating, to

someone else. Sublimation is the act of rechanneling an impulse into a more

socially acceptable object. Identification involves modeling behavior after

someone else's.

Test-Taking Strategy: Note the subject of the question, defense mechanisms.

Focusing on the data in the question and the child’s behavior will direct you to the

correct option. Review: these defense mechanisms .

Reference: Varcarolis, E., & Halter, M. (2009). Essentials of psychiatric mental

health nursing: A communication approach to evidence-based care (p. 133). St.

Louis: Saunders.

Cognitive Ability: Understanding

Client Needs: Psychosocial Integrity

Integrated Process: Nursing Process/Assessment

Content Area: Mental Health

Giddens Concepts: Development, Mood and Affect

HESI Concepts: Developmental, Mood and Affect Awarded 1.0 points out of 1.0

possible points.

2.ID: 8482589936A client says to the nurse, “I’ve been following my diet and

taking my medication. What else do you want to talk about today?” Which

response would be most helpful during the working phase of the therapeutic

alliance?

A “Sounds fine to me. Let’s meet again in 6 months.”

B “I don’t believe that you have been following your diet, because you haven’t lost

any weight.”

C “Well, you’ve talked about diet in your terms, but perhaps I should test you on

specific things.”

D “Some people have added exercise to diet and medication therapy and gotten

positive results. Do you think that this would work for you?” Correct

Rationale: Although suggestion or overt giving of advice is sometimes

nontherapeutic, these strategies are therapeutic when used in the working phase,

because in this situation they will increase the client’s perception of all available

options in the treatment plan. Answering, “Sounds fine to me. Let’s meet again in

6 months” stops the communication process. Stating to the client that he or she

has not lost any weight implies disbelief and does not explore the reasons for the

client’s failure to lose weight. “Testing” challenges the client and is

nontherapeutic.

Test-Taking Strategy: Note the strategic word “most” and remember therapeutic

communication techniques. Noting the words “working phase” in the question

will direct you to the correct option. Review: therapeutic communication

techniques .

Reference: Stuart, G. (2009). Principles & practice of psychiatric nursing (9th

ed., pp. 27-31, 553). St. Louis: Mosby. Cognitive Ability: Applying

Client Needs: Psychosocial Integrity

Integrated Process: Communication and Documentation

Content Area: Mental Health

Giddens Concepts: Communication, Health Promotion

HESI Concepts: Communication, Health, Wellness, and Illness—Health

Promotion Awarded 1.0 points out of 1.0 possible points.

3.ID: 8482589970As the nurse prepares to interview a client being admitted to the

mental health unit, the client says, “I asked my family to bring me in here to talk

to someone, but now I don’t know where to begin.” Which response by the nurse

would be most helpful?

A “Why not just start talking and see where it takes you?”

B “If I were you, I’d begin with what you were doing this morning.”

C “Perhaps you can start by sharing some of your most recent concerns.” Correct

D “Don’t worry. Everyone who comes in here for the first time feels reluctant to

talk.”

Rationale: The intake interview is usually the first contact with the client. It is

intended to establish rapport, to help the nurse understand the client’s current

problem and level of functioning, and to help the nurse formulate a nursing care

plan. The clinician usually allows the client to set the pace of the interview and

uses open-ended questions to elicit a comprehensive diagnostic picture of the

client’s problems and level of coping. Sharing concerns is a good place to start the

conversation, because it will allow the client to express feelings. The response

“Why not just start talking and see where it takes you?” is too general and does

not provide the client with a focus on self. Telling the client not to worry is

nontherapeutic and avoids addressing the client’s concerns.

Test-Taking Strategy: Note the strategic word “most.” Use your knowledge of

therapeutic communication techniques. Focusing on the client’s feelings will

direct you to the correct option. Review: therapeutic communication techniques . 

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References: Stuart, G. (2009). Principles & practice of psychiatric nursing (9th

ed., pp. 27-31). St. Louis: Mosby.

Varcarolis, E., & Halter, M. (2009). Essentials of psychiatric mental health nursing:

A communication approach to evidence-based care (pp. 117-118). St.