Therapeutic Communication
A client says, "Nothing ever goes right in my life." What therapeutic communication technique would encourage further discussion?
Open-ended questioning.
A client diagnosed with depression remains in bed most of the day and declines activities. What symptom is being demonstrated?
Decreased motivation
What is the most important question to ask a client who expresses hopelessness?
Ask directly about suicidal thoughts.
Why should clients continue taking antidepressants even if they do not feel better immediately?
Therapeutic effects may take several weeks.
A client refuses to acknowledge a recent diagnosis despite clear evidence. Which defense mechanism is being used?
Denial
A client begins crying while discussing a recent loss. What is the nurse's best initial response?
Use therapeutic silence and remain present.
A client speaks rapidly, jumps from topic to topic, and reports sleeping only 2 hours per night. What mood state is most likely occurring?
Mania
A client has a specific suicide plan and access to means. How would this affect suicide risk?
It significantly increases suicide risk
A client taking an antipsychotic develops a fever and sore throat. What serious complication should the nurse suspect?
Agranulocytosis
A client who failed an exam blames the instructor for unfair questions. Which defense mechanism is this?
Projection
A client asks the nurse, "What would you do if you were me?" What communication principle should guide the nurse's response?
Encourage the client to explore their own solutions rather than giving advice.
What nursing intervention is most important for a client experiencing mania who forgets to eat meals?
Provide high-calorie finger foods and monitor nutrition.
Name one protective factor that may reduce suicide risk.
Family support, religious involvement, social connections, or access to mental health care.
Which laboratory value is especially important to monitor in clients taking clozapine?
White blood cell count.
A client is excessively concerned with rules, schedules, and perfection. Which personality disorder traits are being demonstrated?
Obsessive-Compulsive Personality Disorder.
A nurse notices a client avoiding eye contact and speaking very softly. What communication skill helps the nurse explore the client's feelings?
Making observations.
A client with depression suddenly appears happier after several weeks of severe symptoms. Why might the nurse continue close observation?
Increased suicide risk may occur when energy improves before mood fully recovers.
Why should nurses avoid promising confidentiality when a client reports suicidal thoughts?
Safety concerns must be communicated to appropriate healthcare providers.
A client taking an SSRI reports nausea during the first week. What should the nurse teach?
Mild side effects often improve as the body adjusts.
Which personality disorder is characterized by excessive attention-seeking and dramatic behavior?
Histrionic Personality Disorder.
During discharge, a client tells the nurse, "I'll miss talking with you." What phase of the nurse-client relationship is occurring?
Termination phase.
What symptom differentiates mania from generalized anxiety?
Elevated mood, grandiosity, or decreased need for sleep.
A client states, "Everyone would be better off without me." What warning sign is being expressed?
Feelings of burdensomeness and suicidal ideation.
What is the primary purpose of antipsychotic medications?
Reduce psychotic symptoms such as hallucinations and delusions.
A client constantly seeks reassurance before making even simple decisions. What personality disorder is most likely?
Dependent Personality Disorder.