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During the working phase of a therapeutic relationship, a client with methamphetamine use disorder displays transference behavior. Which action by the client indicates transference behavior?
- A. The client asks the nurse if they will go out to dinner together
- B. The client accuses the nurse of being controlling just like an ex-partner
- C. The client reminds the nurse of a friend who died from substance toxicity
- D. The client becomes angry and threatens to engage in self-harm
Correct Answer: B
Rationale: Transference occurs when a client projects feelings, often unconscious, onto the nurse that are associated with significant figures in their past or present life. In this scenario, the client accusing the nurse of being controlling like an ex-partner demonstrates transference behavior by attributing characteristics of someone from their past onto the nurse. Choices A, C, and D do not reflect transference behavior. Choice A involves a social invitation, which is not necessarily transference. Choice C is more related to countertransference as it triggers memories in the nurse, not the client. Choice D describes aggressive behavior and self-harm threats, which are not indicative of transference.
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What principle about patient communication should guide a nurse's fear of 'saying the wrong thing' to a patient?
- A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
- B. Patients are more interested in talking to you than listening to what you have to say, so they are not likely to be offended.
- C. Considering the patient's history, there is little chance that the comment will do any actual harm.
- D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.
Correct Answer: A
Rationale: Effective patient communication is guided by the principle that patients value genuine acceptance, respect, and concern from their caregivers. This approach helps to build trust and fosters effective communication, enhancing the nurse-patient relationship. Choice B is incorrect because patients value both talking and listening in effective communication. Choice C is incorrect because a nurse should always consider the impact of their words on the patient, regardless of the patient's history. Choice D is incorrect as it generalizes about people with mental illness and forgiveness, which is not directly relevant to patient communication.
A healthcare provider decides to put a client who has a psychotic disorder in seclusion overnight because the unit is very short-staffed, and the client frequently fights with other clients. The healthcare provider's actions are an example of which of the following torts?
- A. Invasion of privacy
- B. False imprisonment
- C. Assault
- D. Battery
Correct Answer: B
Rationale: The correct answer is B: False imprisonment. False imprisonment occurs when an individual is intentionally restricted in their freedom of movement without consent and without lawful justification. In this scenario, placing the client in seclusion overnight due to staffing shortages and behavioral issues constitutes false imprisonment as the client is confined against their will. Choice A, invasion of privacy, does not apply as the situation is about physical confinement, not privacy violation. Assault (choice C) involves the threat of harm, which is not the case here. Battery (choice D) refers to the intentional harmful or offensive touching of another person, which is not happening in this scenario.
In an acute mental health facility, a nurse is communicating with a client. The client states, "I can't sleep. I stay up all night." The nurse responds, "You are having difficulty sleeping?" Which of the following therapeutic communication techniques is the nurse demonstrating?
- A. Offering general leads
- B. Summarizing
- C. Focusing
- D. Restating
Correct Answer: D
Rationale: The nurse is using the restating technique, where the nurse paraphrases or repeats the main idea expressed by the client to show understanding and encourage further communication. Restating helps clarify the client's message and fosters a therapeutic relationship. Choice A, offering general leads, involves encouraging the client to continue talking with nonverbal or minimal verbal prompts. Summarizing (Choice B) involves condensing and organizing the client's message. Focusing (Choice C) involves centering the conversation on a key element or topic.
A healthcare professional is caring for a group of clients. Which of the following clients should the healthcare professional consider for referral to an assertive community treatment (ACT) group?
- A. A client in an acute care mental health facility who has fallen several times while running down the hallway
- B. A client who lives at home and keeps forgetting to come in for a scheduled monthly antipsychotic injection for schizophrenia
- C. A client in a day treatment program who reports increasing anxiety during group therapy
- D. A client in a weekly grief support group who reports still missing a deceased partner who has been dead for 3 months
Correct Answer: B
Rationale: The client who lives at home and repeatedly forgets to come in for a scheduled monthly antipsychotic injection for schizophrenia should be considered for referral to an assertive community treatment (ACT) group. ACT teams provide intensive community-based treatment and support for individuals with severe mental illness who may have difficulty adhering to treatment on their own. Choices A, C, and D do not describe individuals with severe mental illness who have difficulty adhering to treatment or need intensive community-based support, which are the typical candidates for referral to an ACT group.
A nurse hears a newly licensed nurse discussing a client's hallucinations in the hallway with another nurse. Which of the following actions should the nurse take first?
- A. Notify the nurse manager
- B. Tell the nurse to stop discussing the behavior
- C. Provide an in-service program about confidentiality
- D. Complete an incident report
Correct Answer: B
Rationale: The correct action the nurse should take first in this situation is to tell the newly licensed nurse to stop discussing the client's hallucinations with another nurse. Maintaining client confidentiality is a critical aspect of nursing practice. By addressing the behavior immediately, the nurse helps prevent the inappropriate sharing of sensitive information about a client. Choice A is not the first action to take because addressing the behavior directly is more immediate and can prevent further breaches of confidentiality. Choice C is not the priority at this moment as immediate action is required to address the current situation. Choice D, completing an incident report, should come after addressing the immediate issue and ensuring that the inappropriate behavior ceases.