Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A patient with cognitive impairment, who has been a widow for 30 years, is desperately trying to leave the facility, stating, “I have to go home to cook dinner before my husband gets home from work.”. How should the nurse intervene using validation therapy?
A. “You want to go home to prepare your husband’s dinner?”
Validation therapy is a method of therapeutic communication which can be used to connect with someone who has moderate to late-stage dementia. It places more emphasis on the emotional aspect of a conversation and less on the factual content, thereby imparting respect to the person, their feelings, and their beliefs. In this scenario, the nurse should validate the patient’s feelings and emotions by saying, “You want to go home to prepare your husband’s dinner?”
B. “You must come away from the door.”.
C. “Your husband gets angry if you don’t have dinner ready on time?”
D. “You have been a widow for many years.”.
This question is an excerpt from Nurse Dive's nursing test bank - Lpn Ati Mental Health Psychosocial Proctored Exam. Take the full exam now
Full Explanation
Validation therapy is a method of therapeutic communication which can be used to connect with someone who has moderate to late-stage dementia. It places more emphasis on the emotional aspect of a conversation and less on the factual content, thereby imparting respect to the person, their feelings, and their beliefs. In this scenario, the nurse should validate the patient’s feelings and emotions by saying, “You want to go home to prepare your husband’s dinner?”
Similar Questions
During the assessment of a mental health client, it is crucial for the nurse to thoroughly check for symptoms of depression. Which symptom is indicative of Depression?
A. Impaired self-care.
Impaired self-care is a common symptom of depression. Individuals with depression may struggle with daily tasks such as bathing, dressing, and eating. This can be due to a lack of energy, decreased motivation, or feelings of worthlessness.
B. Impaired circulation.
C. Impaired sensory function.
D. Impaired oxygen exchange.
Full Explanation
Impaired self-care is a common symptom of depression. Individuals with depression may struggle with daily tasks such as bathing, dressing, and eating. This can be due to a lack of energy, decreased motivation, or feelings of worthlessness.
A patient with a history of suicidal ideation is under observation. When is the patient at the highest risk for self-harm?
A. During the first few days after admission.
While the initial days after admission can be stressful and potentially risky for a patient with suicidal ideation, they are not typically considered the highest risk period.
B. On the anniversary of significant life events in the patient’s life.
Anniversaries of significant life events can indeed trigger emotional distress and potentially increase suicide risk. However, these are specific time points and not a continuous period of heightened risk.
C. Approximately 2 weeks after starting antidepressant medication.
The highest risk for self-harm in a patient with a history of suicidal ideation is often approximately 2 weeks after starting antidepressant medication. This is because as their mood begins to lift, they may still have suicidal thoughts but now have the energy to act on them.
D. Immediately after a family visit.
While family visits can be emotionally charged and potentially distressing, they do not typically represent the highest risk period for self-harm.
Full Explanation
Choice A rationale
While the initial days after admission can be stressful and potentially risky for a patient with suicidal ideation, they are not typically considered the highest risk period.
Choice B rationale
Anniversaries of significant life events can indeed trigger emotional distress and potentially increase suicide risk. However, these are specific time points and not a continuous period of heightened risk.
Choice C rationale
The highest risk for self-harm in a patient with a history of suicidal ideation is often approximately 2 weeks after starting antidepressant medication. This is because as their mood begins to lift, they may still have suicidal thoughts but now have the energy to act on them.
Choice D rationale
While family visits can be emotionally charged and potentially distressing, they do not typically represent the highest risk period for self-harm.
During a therapy session, which statement made by the nurse indicates a need for further training in effective therapeutic communication techniques?
A. “Why did you get so angry when she ignored you?”
The statement “Why did you get so angry when she ignored you?” indicates a need for further training in effective therapeutic communication techniques. Asking “why” can make patients defensive and is generally avoided in therapeutic communication.
B. “It is doubtful the president is out to get you.”.
The statement “It is doubtful the president is out to get you” is a reality-oriented response and can be appropriate in certain contexts, such as when a patient is experiencing delusions.
C. “Tell me more about the day your child died.”.
The statement “Tell me more about the day your child died” invites the patient to share more about their experiences and feelings, which is a key aspect of therapeutic communication.
D. “I don’t understand what you mean. Can you give me an example?”
The statement “I don’t understand what you mean. Can you give me an example?” is an appropriate therapeutic communication technique, as it seeks to clarify the patient’s message.
Full Explanation
Choice A rationale
The statement “Why did you get so angry when she ignored you?” indicates a need for further training in effective therapeutic communication techniques. Asking “why” can make patients defensive and is generally avoided in therapeutic communication.
Choice B rationale
The statement “It is doubtful the president is out to get you” is a reality-oriented response and can be appropriate in certain contexts, such as when a patient is experiencing delusions.
Choice C rationale
The statement “Tell me more about the day your child died” invites the patient to share more about their experiences and feelings, which is a key aspect of therapeutic communication.
Choice D rationale
The statement “I don’t understand what you mean. Can you give me an example?” is an appropriate therapeutic communication technique, as it seeks to clarify the patient’s message.