Therapeutic Communication
Which nurse statements demonstrate therapeutic communication? (Select all that apply)
A. “Can you tell me more about what happened?”
B. “Why did you do that?”
C. “It sounds like you feel overwhelmed.”
D. “Everything will be fine.”
E. “What are you most concerned about right now?”
A. “Can you tell me more about what happened?”
C. “It sounds like you feel overwhelmed.”
E. “What are you most concerned about right now?”
Which finding reflects an abnormal thought process?
A. Logical responses
B. Racing thoughts
C. Oriented x4
D. Appropriate affect
B. Racing thoughts
Which are appropriate de-escalation techniques? (Select all that apply)
A. Calm tone of voice
B. Standing directly in front of patient
C. Maintaining personal space
D. Setting clear limits
E. Arguing to prove a point
A. Calm tone of voice
C. Maintaining personal space
D. Setting clear limits
Which patient is best managed in an outpatient setting?
A. Active suicidal plan
B. Acute psychosis
C. Stable anxiety on medication
D. Violent behavior
C. Stable anxiety on medication
A patient reports hearing voices telling them to hurt themselves. Which cues indicate high priority risk? (Select all that apply)
A. Command hallucinations
B. Flat affect
C. Suicidal content
D. Poor appetite
E. Disorganized thoughts
A. Command hallucinations
C. Suicidal content
E. Disorganized thoughts
A patient states, “I feel like nobody cares about me.” Which response is best?
A. “Your family cares about you.”
B. “Why do you think that?”
C. “Tell me what makes you feel that way.”
D. “You shouldn’t feel alone.”
C. “Tell me what makes you feel that way.”
Which assessments are included in the MSE? (Select all that apply)
A. Appearance
B. Vital signs
C. Mood
D. Thought content
E. Medication history
A. Appearance
C. Mood
D. Thought content
Which patient behavior indicates the highest risk for violence?
A. Crying quietly
B. Pacing with clenched fists
C. Speaking softly
D. Avoiding eye contact
B. Pacing with clenched fists
Which are benefits of telepsychiatry? (Select all that apply)
A. Increased access to care
B. Elimination of privacy concerns
C. Convenience
D. Reduced travel
E. Ability to perform full physical exams
A. Increased access to care
C. Convenience
D. Reduced travel
What is the nurse’s priority outcome for a suicidal patient?
A. Improved mood
B. Increased appetite
C. Patient remains safe
D. Better sleep
C. Patient remains safe
Which behaviors by the nurse create barriers to communication? (Select all that apply)
A. Offering false reassurance
B. Reflecting feelings
C. Giving unsolicited advice
D. Changing the subject
E. Asking open-ended questions
A. Offering false reassurance
C. Giving unsolicited advice
D. Changing the subject
A patient states they are happy, but appears tearful and withdrawn. The nurse documents this as:
A. Appropriate affect
B. Delusional thinking
C. Incongruent mood and affect
D. Hallucinations
C. Incongruent mood and affect
Which nursing actions promote safety for a suicidal patient? (Select all that apply)
A. Removing sharp objects
B. Frequent observation
C. Allowing privacy at all times
D. Developing a safety plan
E. Encouraging isolation
A. Removing sharp objects
B. Frequent observation
D. Developing a safety plan
A therapeutic environment should primarily promote:
A. Independence only
B. Strict control
C. Safety and healing
D. Competition
C. Safety and healing
Which interventions are appropriate for a patient experiencing acute agitation? (Select all that apply)
A. Calm verbal approach
B. Offer quiet space
C. Use restraints immediately
D. Encourage deep breathing
E. Speak firmly but respectfully
A. Calm verbal approach
B. Offer quiet space
D. Encourage deep breathing
E. Speak firmly but respectfully
A patient begins crying during an interview. What should the nurse do first?
A. Hand the patient tissues and continue questioning
B. Allow silence and remain present
C. Change the topic
D. Ask why the patient is crying
B. Allow silence and remain present
Which findings indicate impaired cognition? (Select all that apply)
A. Unable to recall three objects
B. Disoriented to time
C. Flat affect
D. Difficulty concentrating
E. Loud speech
A. Unable to recall three objects
B. Disoriented to time
D. Difficulty concentrating
A patient becomes increasingly loud and hostile. What is the nurse’s first action?
A. Call security immediately
B. Attempt calm verbal de-escalation
C. Apply restraints
D. Leave the room
B. Attempt calm verbal de-escalation
Which nursing responses help maintain a therapeutic milieu? (Select all that apply)
A. Enforcing rules consistently
B. Encouraging appropriate social interaction
C. Ignoring disruptive behavior
D. Providing structured activities
E. Allowing unsafe behaviors
A. Enforcing rules consistently
B. Encouraging appropriate social interaction
D. Providing structured activities
Which finding should the nurse address first?
A. Patient reports sadness
B. Patient has poor hygiene
C. Patient states plan to overdose
D. Patient has flat affect
C. Patient states plan to overdose
Which nurse actions help establish a therapeutic relationship in the orientation phase? (Select all that apply)
A. Explaining the nurse’s role
B. Setting boundaries
C. Exploring deeply rooted trauma
D. Establishing goals
E. Reviewing progress
A. Explaining the nurse’s role
B. Setting boundaries
D. Establishing goals
Which MSE finding requires immediate follow-up?
A. Poor hygiene
B. Flat affect
C. Command hallucinations
D. Slow speech
C. Command hallucinations
Which factors increase risk for patient harm in psychiatric settings? (Select all that apply)
A. Inadequate staffing
B. Excessive noise
C. Clear policies
D. Poor communication
E. Structured routines
A. Inadequate staffing
B. Excessive noise
D. Poor communication
Which environmental change best reduces patient agitation?
A. Increasing noise
B. Dim lighting and calm space
C. Crowded areas
D. Frequent interruptions
B. Dim lighting and calm space
Which cues suggest the need for inpatient psychiatric treatment? (Select all that apply)
A. Active suicidal ideation
B. Stable mood on meds
C. Psychosis with poor reality testing
D. Ability to perform ADLs independently
E. Threats of violence
A. Active suicidal ideation
C. Psychosis with poor reality testing
E. Threats of violence