NR410 Holistic Mental Health and Wellness Nursing

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Sample questions from NR410 Holistic Mental Health and Wellness Nursing

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A client in the inpatient psychiatric unit states, 'I feel like nobody here really cares if I get better or not.' Which response by the nurse demonstrates the therapeutic technique of paraphrasing?

   • A."Does this feeling remind you of how you feel at home?"
   • B."You feel as though the staff is indifferent to your recovery."
   • C."I care about you, and I want to see you get back on your feet."
   • D."Why do you feel that the staff does not care about you?"

   Rationale: Paraphrasing involves restating the client's message in fewer, different words to confirm understanding. The statement about the staff being indifferent to recovery captures the essence of the client's message without adding new meaning. Asking 'why' can be perceived as challenging or accusatory and is non-therapeutic. Expressing personal feelings ('I care about you') shifts the focus to the nurse rather than the client's experience. Asking about home life is the technique of 'exploring' or 'relating to past experiences' rather than paraphrasing.

2. 2.During a group therapy session, a 28-year-old client becomes silent and looks at the floor after another member shares a traumatic experience. Which action should the nurse take first?

   • A.Ask the client directly to share what they are thinking.
   • B.Move on to a different topic to decrease the client's discomfort.
   • C.Encourage the other group members to support the silent client.
   • D.Allow for a period of silence to occur.

   Rationale: Silence is a therapeutic communication tool that allows the client time to process emotions and formulate thoughts. Immediately asking a question or changing the topic can interrupt the client's internal processing and may be perceived as pressure. Moving on prematurely avoids the emotional work of the session. While peer support is valuable, the nurse should first allow the silence to serve its purpose before intervening.

3. 3.A nurse is conducting an admission interview with a client experiencing severe anxiety. Which communication strategies should the nurse employ to facilitate the interview? Select all that apply.

   • A.Speak in a calm, low-pitched voice.
   • B.Minimize environmental stimuli.
   • C.Give detailed explanations of all unit rules.
   • D.Ask open-ended questions to encourage venting.
   • E.Use short, simple sentences.

   Rationale: Clients with severe anxiety have a narrowed perceptual field and difficulty processing complex information; therefore, short, simple sentences and a calm voice are essential. Minimizing stimuli helps prevent further escalation of anxiety. Detailed explanations are inappropriate because the client cannot concentrate on complex data at this level. While open-ended questions are usually therapeutic, they can be overwhelming for a client in severe anxiety who may need more direct, concrete communication to feel safe.

4. 4.An adolescent client tells the nurse, 'My parents are so controlling. They never let me do anything!' Which response by the nurse is an example of reflection?

   • A."It sounds like you are angry with your parents."
   • B."You feel frustrated because you want more independence."
   • C."What specific things do they not let you do?"
   • D."All parents are strict sometimes; they just want you to be safe."

   Answer and rationale are in the full material.

5. 5.In the community clinic, an older adult client who recently lost their spouse says, 'What's the point of taking all these pills? I'm just waiting to join my wife anyway.' Which response is the priority?

   • A."It sounds like you are feeling very lonely without her."
   • B."We can talk to the doctor about reducing the number of medications."
   • C."Are you having thoughts of harming yourself?"
   • D."Your wife would want you to keep taking care of your health."

   Answer and rationale are in the full material.