Nursing Elites

1. A client in an acute mental health facility is being discharged and requires supervision due to a severe mental illness. The client’s partner works all day but is home by late afternoon. Which of the following strategies should the nurse suggest for follow-up care?

• A. Receiving daily care from a home health aide
• B. Having a weekly visit from a nurse case worker
• C. Attending a partial hospitalization program
• D. Visiting a community mental health center on a daily basis

Correct answer: C

Rationale: For clients requiring supervision due to severe mental illness, attending a partial hospitalization program provides structured care and support while allowing the client to return home in the evenings, making it a suitable option for follow-up care. The other choices are less appropriate: A home health aide may not provide the necessary level of care and supervision, a weekly visit from a nurse case worker may not be sufficient for the client's needs, and visiting a community mental health center on a daily basis may not offer the structured support required for someone with a severe mental illness.

2. When communicating with a client admitted for treatment of a substance use disorder, which of the following communication techniques should be identified as a barrier to therapeutic communication?

• A. Offering advice
• B. Reflecting
• C. Listening attentively
• D. Giving information

Correct answer: A

Rationale: Offering advice is a barrier to therapeutic communication because it can hinder the client's ability to explore their own solutions and feelings. It may come across as judgmental or dismissive of the client's experience, leading to a breakdown in trust and hindering the therapeutic relationship. Reflecting (choice B) is a helpful technique that involves paraphrasing or restating the client's words to show understanding. Listening attentively (choice C) is crucial for building rapport and demonstrating empathy. Giving information (choice D) is also important but should be done in a way that supports the client's understanding and autonomy, rather than directing their choices.

3. When working with a patient diagnosed with posttraumatic stress disorder (PTSD), which therapeutic approach is most appropriate?

• A. Encouraging the patient to avoid discussing the traumatic event.
• B. Using exposure therapy to help the patient confront their fears.
• C. Advising the patient to focus on positive thoughts.
• D. Suggesting that the patient keep busy to distract from traumatic memories.

Correct answer: B

Rationale: Exposure therapy is an evidence-based treatment for PTSD that involves gradually exposing the patient to their traumatic memories in a safe and controlled environment. This approach helps individuals confront and process their fears, reducing the impact of the traumatic event over time. Avoiding discussing the trauma (choice A) may lead to avoidance behaviors and hinder recovery. Focusing on positive thoughts (choice C) may provide temporary relief but does not address the underlying trauma. Keeping busy to distract from memories (choice D) is a form of avoidance that does not help in processing the traumatic experiences. Therefore, using exposure therapy (choice B) is the most appropriate approach to effectively treat PTSD.

4. A patient with bipolar disorder is experiencing a depressive episode. Which intervention is most appropriate?

• A. Encouraging the patient to participate in physical activities.
• B. Providing a stimulating environment to keep the patient engaged.
• C. Allowing the patient to isolate until they feel better.
• D. Encouraging the patient to express their feelings and concerns.

Correct answer: D

Rationale: During a depressive episode in bipolar disorder, it is essential to encourage patients to express their feelings and concerns. This intervention helps them feel heard, supported, and can aid in managing their emotions effectively.

5. A charge nurse is conducting a class on therapeutic communication with a group of newly licensed nurses. Which of the following aspects of communication should the nurse identify as a component of verbal communication?

• A. Personal space
• B. Posture
• C. Eye contact
• D. Intonation

Correct answer: D

Rationale: Verbal communication involves the use of words, tone, and pitch to convey messages. Intonation refers to the variation of pitch in speech, which can convey emotions, attitudes, and emphasize certain points. Therefore, intonation is a key component of verbal communication, making it the correct choice in this scenario. Choices A, B, and C are aspects of nonverbal communication. Personal space, posture, and eye contact are important nonverbal cues that contribute to effective communication, but they are not components of verbal communication.

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