31 Questions
What type of response involves indicating to the client that there is no cause for anxiety?
Reassuring the client
Which type of response involves refusing to consider or showing contempt for the client's ideas or behavior?
Disapproving the client's ideas
In which type of response is the nurse sanctioning the client's behavior or ideas?
Giving approval
Which response involves asking the client to consider appropriate behaviors in future situations?
Encouraging formulation of a plan of action
What kind of response involves organizing and summing up the conversation thus far?
Summarizing the conversation
Which type of response involves offering to work together with the client for his or her benefit?
Suggesting collaboration
What is the technique used when a nurse seeks mutual understanding and accord in the meaning of the client's words?
Seeking consensual validation
When a nurse asks a client, 'Are you suggesting that you feel lifeless?' What technique is being used?
Attempting to translate into feelings
Which technique involves expressing uncertainty about the reality of the client's perceptions?
Voicing doubt
When a nurse asks, 'Does this contribute to your discomfort?' which technique is being utilized?
Encouraging expression
In which technique does the nurse voice what the client has hinted at or suggested?
Verbalizing the implied
When a nurse asks, 'Are you using the word to convey the idea that...?' which technique is being demonstrated?
Seeking consensual validation
What is the purpose of 'agreeing' in the given context?
To indicate accord with the client
Which of the following is an example of 'challenging'?
"But how can you be President of the United States?"
What is the purpose of 'testing' in the given context?
To appraise the client's degree of insight
Which of the following is an example of 'advising'?
"I think you should..."
What should a nurse do when caring for a delusional client?
Present a factual account of the situation as observed
How should a nurse handle a paranoid client?
Avoid joking or discussing controversial issues
What is the recommended approach for dealing with hypersexual and seductive clients?
Maintain a non-judgmental attitude and set limits on inappropriate behavior
How should a nurse respond to an aggressive, violent client?
Use a calm, quiet tone of voice and encourage verbalization of feelings
What is an essential aspect of the passive ID approach in patient care according to the text?
Showing genuine interest by spending time with the patient
In conducting a psychosocial assessment, what is the main purpose according to the text?
To form the basis for plan of care
Which factor influences the assessment process according to the text?
The client's health status
When caring for a hypersexual client, what is important for nurses to avoid according to the text?
Placing oneself in a compromising position
What is an important aspect of the Demands Attitude - ID according to the text?
Setting limits and not allowing manipulation.
What is the term used when a client eventually answers a question but only after giving excessive unnecessary detail?
Circumstantial thinking
Which of the following is a delusional belief that others can hear or know what the client is thinking?
Thought broadcasting
What is the term used to describe a flow of unconnected words that convey no meaning to the listener?
Word salad
Which of the following describes a client's recognition of person, place, and time?
Orientation
What is the term used when a client stops abruptly in the middle of a sentence or train of thought, sometimes unable to continue the idea?
Thought blocking
Which of the following describes disorganized thinking that jumps from one idea to another with little or no evident relation between the thoughts?
Loose associations
Study Notes
Communication with Challenging Clients
- Approach delusional clients by presenting a factual account of the situation without accepting their delusions as reality and avoiding arguments
- When dealing with hallucinating clients, focus on the feelings surrounding the hallucination, closely observe the client to ensure their safety, and avoid conversations with the voices
- For paranoid clients, be non-threatening, answer questions directly, and avoid whispering or discussing controversial issues, while setting limits on behavior and not arguing about delusions
- With hypersexual or seductive clients, maintain a non-judgmental attitude, acknowledge sexual feelings, and set limits on inappropriate behavior
- When dealing with aggressive or violent clients, avoid isolation, give them space, use a calm tone, and encourage verbalizing feelings instead of acting out aggressions
Five Code Active Friendliness
- ID (Independent Doing): encourage socialization, initiate activities, recognize small wins, and spend time with the patient
- Passive ID: make the patient feel that you are available, present, and willing to help, but let them initiate actions
- Kind Firmness ID: use sympathy and distractions for depressed clients, while maintaining consistency and rules
- Matter of Fact Attitude ID: set firm limits, avoid being plastic, and focus on positive aspects
- No Demand Attitude ID: be firm, consistent, and non-judgmental, avoiding argumentation and verbalizing client feelings
Psychosocial Assessment
- The purpose of assessment is to construct a picture of the client's emotional state, mental capacity, and behavioral functions
- The mental status exam focuses on the client's cognitive abilities, including orientation, ability to interpret proverbs, math calculations, and memorization
- Factors influencing assessment include client participation, health status, previous experiences, and the nurse's attitude and approach
Therapeutic Communication Techniques
- Suggesting Collaboration: offer to share and work together with the client for their benefit
- Summarizing: organize and summarize the conversation to ensure understanding
- Encouraging Formulation of a Plan of Action: ask the client to consider appropriate behaviors for future situations
Non-Therapeutic Responses
- Reassuring: indicating that there is no cause for anxiety
- Giving Approval: sanctioning the client's behavior or ideas
- Rejecting: refusing to consider the client's ideas or behavior
- Disapproving: denouncing the client's behavior or ideas
- Voicing Doubt: expressing uncertainty about the reality of the client's perceptions
- Seeking Consensual Validation: searching for mutual understanding of the meaning of words
- Verbalizing the Implied: voicing what the client has hinted at or suggested
- Encouraging Expression: asking the client to appraise the quality of their experiences
- Attempting to Translate into Feelings: verbalizing feelings that are only expressed indirectly
- Agreeing: indicating accord with the client
- Disagreeing: opposing the client's ideas
- Advising: telling the client what to do
- Probing: persistent questioning of the client
- Challenging: demanding proof from the client
- Testing: appraising the client's degree of insight
Explore techniques used in therapeutic communication in nursing, such as voicing doubt, seeking consensual validation, and verbalizing the implied. Practice examples like expressing uncertainty about clients' perceptions and searching for mutual understanding.
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