Question 1

During a mental status examination (MSE) a patient says, "I am a special messenger sent to provide the world a cure for cancer." The patient's statement indicates the presence of what form of dysfunctional thought content?

Accepted Answer

A)  Phobia 
B)  Delusion 
C)  Hypervigilance 
D)  Loose associations

Question 2

The nurse writing a discharge summary for a patient should include achievements as well as what additional information?

Accepted Answer

A)  Care plan updates 
B)  A list of patient strengths 
C)  Effective nursing interventions 
D)  Outcomes that still need to be addressed

Question 3

A nurse and patient who developed a therapeutic relationship enter into the final phase of their relationship as the patient prepares for discharge.What is an important nursing intervention for this stage of the relationship?

Accepted Answer

A)  Providing structure and intensive support 
B)  Informing the patient of the progress made 
C)  Encouraging the patient to describe goals for change 
D)  Discussing feelings about termination with the patient

Question 4

Which goal statement is most appropriate for a newly admitted patient currently in the orientation stage of the nurse-patient relationship?

Accepted Answer

A)  By the end of the orientation stage of the therapeutic relationship, the patient will demonstrate greater independence. 
B)  By the end of the orientation stage of the therapeutic relationship, the patient will demonstrate increased self-responsibility. 
C)  By the end of the orientation stage of the therapeutic relationship, the patient will demonstrate trust and rapport with two staff members. 
D)  By the end of the orientation stage of the therapeutic relationship, the patient will demonstrate ability to problem-solve one issue.

Question 5

A patient has identified the need for better anger management and tells the nurse, "I'm afraid that someday I might explode." What is the best strategy for reducing this patient's fear of losing control?

Accepted Answer

A)  Talking about these feelings openly and directly 
B)  Discussing feelings in general without reference to the patient 
C)  Avoiding any discussion concerning feelings until the patient feels comfortable 
D)  Reassuring the patient that expressing feelings is the first step to resolving them

Question 6

Following the admission interview, a spouse of a patient asks the nurse, "Why did you ask my partner all those questions? Some of them had nothing to do with the current problems." The nurse's best response is based on what assessment focus of the mental status examination (MSE)?

Accepted Answer

A)  The patient's current status 
B)  The complete family history 
C)  The patient's past experiences 
D)  What the patient's prognosis will be

Question 7

A patient with a history of self-mutilation says to the nurse, "I want to stop hurting myself." What is the initial step of the problem-solving process to be taken toward resolution of a patient's identified problem?

Accepted Answer

A)  Deciding on a plan of action 
B)  Determining necessary changes 
C)  Considering alternative behaviors 
D)  Describing the problem or situation

Question 8

What fact about a particular patient will have the greatest impact on nurse-patient collaboration?

Accepted Answer

A)  Involuntary admission 
B)  Advance age 
C)  Hallucinations 
D)  Terminal diagnosis

Question 9

A student states, "I do not see the value of process recordings." The response to this concern should be based on what information related to process recording?

Accepted Answer

A)  It is a tool for analyzing communication. 
B)  It is a verbatim record of a patient interview. 
C)  It is a legal document that becomes part of the medical record. 
D)  It is a note written at the time of a patient interview to provide information to team members.

Question 10

A nurse and patient agree on problems to be addressed during a brief hospital stay.Which interpretation of this action is correct?

Accepted Answer

A)  The relationship is moving into the working stage. 
B)  The nurse should reinforce messages about termination. 
C)  The nurse needs to direct the patient to begin journaling. 
D)  Management of emotions must be ensured before work can continue.

Question 11

A patient shouts at a nurse who just entered the room, "You're an incompetent fool.Leave me alone." The nurse's response should be based on which rationale?

Accepted Answer

A)  The anger was created by a situation or significant person, not the nurse. 
B)  The reaction probably results from transference and countertransference. 
C)  The patient is probably reacting to fear of loss of emotional control. 
D)  The patient has a right to openly express negative feelings.

Question 12

What is the most effective outcome for a nurse to include in the care plan for a withdrawn patient who says, "I would like to have more friends"? Within 3 days:

Accepted Answer

A)  the patient will be more outgoing. 
B)  the patient will develop greater independence. 
C)  the patient will participate in one group activity. 
D)  the patient will increase socialization with others.

Question 13

The nurse performing a mental status examination wants to assess for hallucinations.The nurse should ask which question?

Accepted Answer

A)  "Can you tell me where you are now?" 
B)  "Do you hear or see things when others don't?" 
C)  "Do your moods shift more than those of other people?" 
D)  "What would you do if you found a stamped, addressed letter on the floor?"

Question 14

An inpatient says, "Last time I was here, a primary nurse talked with me every day.This time, different nurses work with me.How can I make progress?" Which nursing response best addresses the patient's concern?

Accepted Answer

A)  "Your comments are interesting.With your permission I will share them with the treatment team." 
B)  "We are using a new system because of managed-care requirements.We are hopeful it will be effective." 
C)  "Shift reports, care plans, and progress notes help different nurses work with all patients toward their individual goals." 
D)  "It sounds like you are feeling dissatisfied with your care.After you are discharged, you will receive a form to provide feedback."

Question 15

A patient says, "I went out drinking only one time last week.At least I'm trying to change." The nurse responds, "I appreciate your effort, but you agreed to abstain from alcohol completely." The nurse's response demonstrates the ability to manage what potential patient centered problem?

Accepted Answer

A)  Cognitive restructuring 
B)  Manipulation 
C)  Hostility 
D)  Denial

Question 16

Which statement is most therapeutic when working with a patient believed to be experiencing emotional pain?

Accepted Answer

A)  "I hear how painful this is for you.I would like to help you deal with it." 
B)  "I'm so sorry this has happened to you.You don't deserve it." 
C)  "What would you like me to do to help you through this pain?" 
D)  "I don't think this is as serious as you believe it is."

Question 17

A patient hospitalized for 6 days has made little progress toward outcomes written at the time of admission.The nurse decides that the lack of progress toward goals indicates a need for what intervention?

Accepted Answer

A)  A reassessment 
B)  Delayed discharge 
C)  Incorrect nursing diagnoses 
D)  Inaccurate nursing interventions

Question 18

A patient is hospitalized for severe depression.Knowing that the patient will be discharged after a short stay, what is the nurse's first priority?

Accepted Answer

A)  Maximize the benefits of milieu management. 
B)  Immediately begin to explore acute patient issues. 
C)  Develop a goal-directed, problem-centered relationship. 
D)  Choose a specific theoretical model as the basis for care.

Question 19

A patient diagnosed with schizophrenia says to the nurse, "I feel really close to you.You're the only true friend I have." What is the nurse's most therapeutic response?

Accepted Answer

A)  "We are not friends.Our relationship is a professional one." 
B)  "I feel sure there are other friends in your life.Can you name some?" 
C)  "I am glad you trust me.Trust is important for the work we are doing together." 
D)  "Our relationship is professional, but let's explore ways to strengthen personal friendships."

Question 20

A nurse tells a patient, "I know how you feel.My spouse can be very insensitive too.I am also considering divorce." What behavior is the nurse demonstrating?

Accepted Answer

A)  Inappropriate self-disclosing 
B)  Countertransference 
C)  Establishment of trust with the patient 
D)  Encouraging the patient to express negative feelings

Exam 9: Working With an Individual Patient