Nursing 3381- Psychiatric-Mental Health Nursing of Individuals, Families, and Groups
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Free Nursing 3381- Psychiatric-Mental Health Nursing of Individuals, Families, and Groups Questions
The spouse of a patient who experiences delusions asks the nurse, “Are there any circumstances under which the treatment team is justified in violating the patient’s right to confidentiality?” What is the nurse’s best response?
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“We are not bound if the patient threatens the life of another person.”
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“We can’t violate that confidence under any circumstances.”
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“We are obligated to answer questions asked by law enforcement.”
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“We can do that only at the discretion of the psychiatrist.”
Explanation
The Correct Answer is:
A. “We are not bound if the patient threatens the life of another person.”
Detailed Explanation:
The duty to warn and protect—established in the landmark Tarasoff v. Regents of the University of California case—requires mental health professionals to breach confidentiality if a patient poses a credible threat to harm an identifiable person. In such cases, the treatment team is legally and ethically justified in disclosing necessary information to protect potential victims and notify authorities.
This exception to confidentiality is based on the principle of nonmaleficence—the obligation to prevent harm. Outside of these circumstances, all patient information must remain confidential.
"I'm concerned whether we are behaving ethically by restraining one patient to prevent them from self-mutilating while placing another patient on one-on-one supervision to prevent them from self-mutilating." Which ethical principle most clearly applies to this situation?
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Justice
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Autonomy
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Fidelity
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Beneficence
Explanation
The Correct Answer is:
A. Justice.
Detailed Explanation:
The ethical principle of justice refers to fairness and equality in the distribution of care and resources. In this situation, the nurse is questioning whether two patients with the same risk for self-harm are being treated equitably—one being restrained and the other placed on one-on-one supervision. Justice requires that similar cases be handled in similar ways unless there are clear, ethically sound reasons for differences in treatment. The nurse’s concern reflects a desire to ensure fair and unbiased decision-making in the application of interventions.
A nurse uses Maslow’s hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority?
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needs to be taught about medication action and side effects
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reports feelings of alienation from his family and friends
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is reluctant to participate in unit social activities
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is hearing voices telling him to protect himself from others
Explanation
The Correct Answer is:
D. is hearing voices telling him to protect himself from others.
Detailed Explanation:
According to Maslow’s hierarchy of needs, physiological and safety needs take priority over psychological and self-fulfillment needs. A patient who is hearing voices instructing him to protect himself is experiencing command hallucinations, which may lead to self-harm or harm to others. This represents a threat to safety, making it the highest-priority concern. The nurse must take immediate action to ensure the patient’s safety and that of others—such as maintaining a calm environment, continuous observation, and notifying the healthcare team.
A patient says to the nurse, “I dreamed I was pusillanimous. When I woke up, I felt emotionally drained, as though I hadn’t rested well.” Which comment would be appropriate if the nurse seeks clarification?
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“Can you give me an example of what you mean by ‘pusillanimous’?”
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“I understand what you’re saying. Bad dreams leave me feeling tired, too.”
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“It sounds as though you were uncomfortable with the content of your dream.”
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“So, all in all, you feel as though you had a rather poor night’s sleep?”
Explanation
The Correct Answer is:
A. “Can you give me an example of what you mean by ‘pusillanimous’?”
Detailed Explanation:
When the nurse seeks clarification, the goal is to ensure accurate understanding of what the patient means—especially when unfamiliar, complex, or ambiguous terms are used. By asking the patient to explain or give an example of “pusillanimous,” the nurse promotes clearer communication and allows the patient to express their thoughts in their own words. This response encourages elaboration without making assumptions and demonstrates active listening and respect for the patient’s perspective.
Which of the following options best describes the basic elements of the communication model?
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Receiver, feedback, flow, and expression
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Sender, receiver, flow, and message
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Message, sender, feedback, and gesture
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Feedback, sender, receiver, and message
Explanation
The Correct Answer is:
D. Feedback, sender, receiver, and message.
Detailed Explanation:
The communication model consists of four key elements: sender, message, receiver, and feedback. The sender is the person who initiates the communication by encoding and delivering a message. The message is the information, idea, or emotion being conveyed. The receiver is the individual who decodes and interprets the message, and feedback is the receiver’s response that lets the sender know whether the message was understood as intended.
This dynamic process ensures two-way interaction and mutual understanding between participants. Effective communication relies on clarity of the message, active listening, and accurate interpretation of feedback.
When assessing patients at a mental health clinic, our judgment about their current level of overall functioning should be made on the basis of:
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a continuum from mentally healthy to mentally unhealthy
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the rate of both their intellectual and emotional growth
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the degree of conformity of the individual to society’s norms
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the degree to which an individual appears logical and rational
Explanation
The Correct Answer is:
A. a continuum from mentally healthy to mentally unhealthy.
Detailed Explanation:
Mental health is best understood as a continuum rather than a fixed state. Individuals move along this continuum depending on factors such as stress, coping abilities, relationships, and life circumstances. At one end of the continuum is optimal mental health, characterized by resilience, emotional balance, and positive functioning; at the other end is mental illness, marked by significant distress or impairment.
Nurses assess where a person falls on this continuum by evaluating mood, behavior, thought processes, and the ability to function in daily life. This perspective recognizes that mental health fluctuates and allows for individualized, compassionate, and nonjudgmental care.
A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Which statement is an example of “attending”?
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“You will feel better after we get some antidepressant medication started for you.”
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“We all have stress in life. Being in a psychiatric hospital is not the end of the world.”
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“I’d like to sit with you for a while, so you may feel more comfortable talking with me.”
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“Tell me why you felt you had to be hospitalized to receive treatment for your depression.”
Explanation
The Correct Answer is:
C. “I’d like to sit with you for a while, so you may feel more comfortable talking with me.”
Detailed Explanation:
Attending is a therapeutic communication technique in which the nurse demonstrates presence, active listening, and genuine interest in the patient. By offering to sit quietly and provide supportive presence, the nurse conveys empathy, respect, and a willingness to engage without pressure. This nonverbal and verbal behavior encourages trust and comfort, allowing the patient to open up in a safe, therapeutic environment.
Which patient would a nurse refer to partial hospitalization?
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One who spent yesterday in the 24-hour supervised crisis care center and continues to be actively suicidal.
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One who is experiencing agoraphobia and panic episodes and who would benefit from psychoeducation for relaxation therapy.
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One who has a therapeutic lithium level and reports regularly for blood tests and clinic follow-up
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One who states, "I'm not sure I can avoid using alcohol when my spouse goes to work every morning."
Explanation
The Correct Answer is:
D. One who states, "I'm not sure I can avoid using alcohol when my spouse goes to work every morning."
Detailed Explanation:
Partial hospitalization programs (PHPs) are structured, daytime treatment programs designed for patients who require intensive therapy and monitoring but do not need 24-hour inpatient care. They are ideal for individuals who are medically stable but still at risk for relapse, such as patients recovering from substance use disorders who need daily support to prevent relapse. PHPs provide therapy, medication management, and coping skills training while allowing the patient to return home in the evenings.
A nurse explains to a nursing student how the therapeutic relationship differs from a social relationship. What is the best explanation for the therapeutic relationship between the nurse and patient?
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“The focus of the relationship is socialization. Mutual needs are met, and feelings are openly shared.”
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“The focus is the creation of a partnership in which each member is concerned with the growth and satisfaction of the other.”
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“The focus is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient.”
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“The focus shifts from nurse to patient as the relationship develops. Advice is given by both, and solutions are implemented.”
Explanation
The Correct Answer is:
C. “The focus is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient.”
Detailed Explanation:
A therapeutic nurse–patient relationship is goal-directed and patient-centered, focusing on helping the patient develop insight, coping skills, and independence. The nurse facilitates discussion, provides support, and guides the patient through the problem-solving process—but it is the patient who takes responsibility for implementing solutions. This approach fosters self-reliance, empowerment, and growth, rather than dependency on the nurse.
The nursing student understands that the purpose of completing a process recording for the nurse–patient interview is to:
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provide the client with a way to identify abnormalities in their communication style.
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analyze the effect of their communication style on the client.
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identify abnormalities in the client’s communication techniques.
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allow the client to explore alternate communication techniques that can be used
Explanation
The Correct Answer is:
B. analyze the effect of their communication style on the client.
Detailed Explanation:
A process recording is a tool used primarily in psychiatric and mental health nursing education to help students develop self-awareness and therapeutic communication skills. It involves a detailed written account of an interaction between the nurse and the patient, including both verbal and nonverbal communication. The purpose is for the nursing student to analyze their own communication techniques—what was said, how it was said, and how the patient responded.
By reviewing the process recording with an instructor, the student gains insight into how their words, tone, and body language influence the patient’s reactions and emotions. This reflective exercise promotes growth in therapeutic communication and helps identify areas for improvement.
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