Ichs Psychiatric Nursing

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Sample questions from Ichs Psychiatric Nursing

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

1. 1.During an outpatient visit, a client says, "I feel like a failure because I lost my job." Which response best demonstrates therapeutic communication?

   • A."You should focus on the positive; many people are unemployed."
   • B."I know exactly how you feel; I was laid off once, too."
   • C."Why didn't you look for another job sooner?"
   • D."Tell me more about what losing your job has meant to you."

   Rationale: Inviting the client to elaborate encourages expression and helps the nurse understand the client's experience. Reassurance can minimize feelings, asking "why" may sound judgmental, and shifting focus to the nurse's experience is not therapeutic. Use open-ended, client-centered responses to explore concerns.

2. 2.A client states, "The voices say I am worthless, and maybe they are right." Which response is most therapeutic?

   • A."I hear that the voices are upsetting. What are they saying right now?"
   • B."The voices are not real, so you should ignore them."
   • C."Why do you think the voices are talking to you?"
   • D."You are not worthless; your family cares about you."

   Rationale: Acknowledging the client's distress and asking about the current content assesses the experience without endorsing the hallucination. Telling the client the voices are unreal can feel dismissive, reassurance does not assess safety, and asking why may reinforce the delusional explanation. Assess for command content and risk when a client reports voices.

3. 3.A client newly admitted to an inpatient unit says, "I am terrified that I will never get better." Which nurse responses support therapeutic communication? Select all that apply.

   • A."Other clients have it much worse than you."
   • B."You will be fine once you get some sleep."
   • C."Let's talk about what has helped you cope in the past."
   • D."What feels most frightening to you right now?"
   • E."It sounds as though you are feeling overwhelmed."

   Rationale: Asking what is frightening explores the client's concern, reflecting the feeling communicates understanding, and exploring past coping can identify strengths. Promising that the client will be fine is false reassurance, and comparing suffering minimizes the client's experience. Therapeutic responses invite discussion and validate feelings without making unsupported promises.

4. 4.In a community clinic, a client who recently immigrated pauses for several seconds before answering questions. What is the nurse's best action?

   • A.Ask a family member to answer for the client.
   • B.Allow time for the client to respond and ask whether an interpreter is needed.
   • C.Repeat each question more loudly.
   • D.Assume the client does not understand and end the interview.

   Answer and rationale are in the full material.

5. 5.A client in a long-term care facility says, "I don't want to talk about my diagnosis." Which response is best?

   • A."If you don't talk, I cannot provide care."
   • B."Why are you avoiding the subject?"
   • C."That's okay. I can sit with you, and we can talk when you are ready."
   • D."You have to discuss it so I can help you."

   Answer and rationale are in the full material.