NCLEX Psychiatric Nursing Questions 16-22

Another set of NCLEX Psychiatric Nursing Questions to sharpen your critical thinking skills and prepare you for the actual NCLEX exam.

 16. The nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbor says to the nurse, “How is Carol doing? She is my best friend and is seen at your clinic every week.” Which is the most appropriate nursing response?

a) “I cannot discuss any client situation with you.”
b) “If you want to know about Carol, you need to ask her yourself.”
c) “Only because you’re worried about a friend, I’ll tell you that she is improving.”
d) “ Being her friend, you know she is having a difficult time and deserves her privacy.”

17. The nurse calls security and has physical restraints applied when a client who was admitted voluntarily becomes both physically and verbally abusive while demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions? Select all that apply.

a) Libel
b) Battery
c) Assault
d) Slander
e) False imprisonment

18. NCLEX Psychiatric Nursing Questions about the nurse who is in the mental health unit recognizes which as being therapeutic communication techniques? Select all that apply.

a) Restating
b) Listening
c) Asking the client, “Why?”
d) Maintaining neutral responses
e) Providing acknowledgment and feedback
f) Giving advice and approval or disapproval

19. A client being seen in the emergency department immediately after being sexually assaulted appears calm and controlled. The nurse analyzes this behavior as indicating which defense mechanism?

a) Denial
b) Projection
c) Rationalization
d) Intellectualization

20. A client’s unresolved feelings related to loss would be most likely observed during which phase of the therapeutic nurse-client relationship?

a) Trusting
b) Working
c) Orientation
d) Termination

21. NCLEX Psychiatric Nursing Questions about the nurse who is working with a client who despite making a heroic effort was unable to rescue a neighbor trapped in a house fire. Which client-focused action should the nurse engage in during the working phase of the nurse-client relationship?

a) Exploring the client’s ability to function
b) Exploring the client’s potential for self-harm
c) Inquiring about the client’s perception or appraisal of why the rescue was unsuccessful
d) Inquiring about and examining the client’s feelings for any that may block adaptive coping

22. Which statement demonstrates the best understanding of the nurse’s role regarding ensuring that each client’s rights are respected?

a) “Autonomy is the fundamental right of each and every client.”
b) “A client’s rights are guaranteed by both state and federal laws.”
c) “Being respectful and concerned will ensure that I’m attentive to my clients’ rights.”
d) “Regardless of the client’s condition, all nurses have the duty to respect client rights.”

NCLEX Psychiatric Nursing Questions
Answers and Rationale

16) A
- Rationale: The nurse is required to maintain confidentiality regarding the client and the client’s care. Confidentiality is basic to the therapeutic relationship and is a client’s right. The most appropriate response to the neighbor is the statement of that responsibility in a direct, but polite manner. A blunt statement that does not acknowledge why the nurse cannot reveal client information may be taken as disrespectful and uncaring. The remaining options identify statements that do not maintain client confidentiality.

- Test-Taking Strategy: Note the strategic words most appropriate. Focusing on maintaining confidentiality will direct you to the correct option. This focus will also assist you in eliminating options that inappropriately give such information without being unnecessarily blunt or rude.

17) B, C, E
- Rationale: False imprisonment is an act with the intent to confine a person to a specific area. The nurse can be charged with false imprisonment if the nurse prohibits a client from leaving the hospital if the client has been admitted voluntarily and if no agency or legal policies exist for detaining the client. Assault and battery are related to the act of restraining the client in a situation that did not meet criteria for such an intervention. Libel and slander are not applicable here since the nurse did not write or verbally make untrue statements about the client.

- NCLEX Psychiatric Nursing Questions Test-Taking Strategy: Focus on the subject, legal ramifications of nursing actions related to hospital admission. Noting the words admitted voluntarily will assist you in selecting the options related to inappropriately preventing the client from leaving the hospital; a right to which a voluntarily committed client is entitled. The remaining options do not relate to acts that prevent the client from leaving the hospital.

18) A, B, D, E
- Rationale: Therapeutic communication techniques include listening, maintaining silence, maintaining neutral responses, using broad openings and open-ended questions, focusing and refocusing, restating, clarifying and validating, sharing perceptions, reflecting, providing acknowledgment and feedback, giving information, presenting reality, encouraging formulation of a plan of action, providing nonverbal encouragement, and summarizing. Asking why is often interpreted as being accusatory by the client and should also be avoided. Providing advice or giving approval or disapproval are barriers to communication.

- Test-Taking Strategy: Use knowledge of therapeutic communication techniques. This will assist you in both selecting the correct answers and eliminating the examples of nontherapeutic communication.

19) A
- NCLEX Psychiatric Nursing Questions Rationale: Denial is refusal to admit to a painful reality and may be a response by a victim of sexual abuse. In this case the client is not acknowledging the trauma of the assault either verbally or nonverbally. Projection is transferring one’s internal feelings, thoughts, and unacceptable ideas and traits to someone else. Rationalization is justifying the unacceptable attributes about oneself. Intellectualization is the excessive use of abstract thinking or generalizations to decrease painful thinking.

- Test-Taking Strategy: Focus on the subject, a defense mechanism, and note the words calm and controlled. These behaviors indicate denial in a sexually abused victim.

20) D
- Rationale: In the termination phase, the relationship comes to a close. Ending treatment sometimes may be traumatic for clients who have come to value the relationship and the help. Because loss is an issue, any unresolved feelings related to loss may resurface during this phase. The remaining options are not specifically associated with this issue of unresolved feelings.

- Test-Taking Strategy: Note the strategic words most likely and the words unresolved and loss in the question. Considering the phases of the therapeutic nurse-client relationship will direct you to the correct option.

21) D
- Rationale: The client must first deal with feelings and negative responses before the client can work through the meaning of the crisis. The correct option pertains directly to the client’s feelings and is client-focused. The remaining options do not directly focus on or address the client’s feelings.

- NCLEX Psychiatric Nursing Questions Test-Taking Strategy: Focus on the subject, the working phase of the nurse-client relationship. Also, note the words client-focused action. Think about the interventions that occur in this phase. Select the option that focuses on the feelings of the client.

22) C
- Rationale: The nurse needs to respect and have concern for the client; this is vital to protecting the client’s rights. While it is true the autonomy is a basic client right, there are other rights that must also be both respected and facilitated. State and federal laws do protect a client’s rights, but it is sensitivity to those rights that will ensure that the nurse secures these rights for the client. It is a fact that safeguarding a client’s rights is a nursing responsibility, but stating that fact does not show understanding or respect for the concept.

- Test-Taking Strategy: Note the strategic word best. Focus on the broad issue of client rights and how the nurse will respect and preserve these rights. This is the umbrella option. Also note the word respected in the question and respectful in the correct option.

After you reviewed your answers through its rationale, you can go to the next page to continue your review: 

NCLEX Psychiatric Nursing Questions 23-30

Or go back to the first page:

NCLEX Psychiatric Nursing Questions 1-5

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