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A community mental health nurse has worked with a patient for 3 years but is moving out of the city and terminates the relationship. What is the role of the new nurse who begins working with this patient?
- A. Beginning at the orientation phase
- B. Resuming the working relationship
- C. Entering into a social relationship
- D. Returning to the emotional catharsis phase
Correct Answer: A
Rationale: A new nurse must start at the orientation phase to build trust and establish a new therapeutic relationship.
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A new psychiatric nurse is providing care to a parent diagnosed with bipolar disorder. This nurse angrily recalls embarrassing events concerning the parent's behavior in the community. Select the best ways for this nurse to cope with these feelings. (Select all that apply.)
- A. Seeking ways to use the understanding gained from childhood to help patients cope with their own illnesses
- B. Recognizing that these feelings are unhealthy and try to suppress them when working with patients
- C. Recognizing that psychiatric nursing is not an appropriate career choice and explore other nursing specialties er??s
- D. Beginning new patient relationships by saying, 'My own parent had mental illness, so I accept it without stigma'
- E. Recognizing that the feelings may add sensitivity to the nurse's practice, but supervision is important
Correct Answer: A,E
Rationale: Using personal experiences constructively and seeking supervision help manage feelings and enhance practice.
As a nurse escorts a patient being discharged after treatment for major depressive disorder, the patient gives the nurse a gold necklace with a heart pendant and says, 'Thank you for helping mend my broken heart.' Which is the nurse's best response?
- A. Accepting gifts violates the policies and procedures of the facility.'
- B. I'm glad you feel so much better now. Thank you for the beautiful necklace.'
- C. I'm glad I could help you, but I can't accept the gift. My reward is seeing your renewed sense of hope.'
- D. Helping people is what nursing is all about. It's rewarding to me when patients recognize how hard we work.'
Correct Answer: C
Rationale: Accepting gifts blurs therapeutic boundaries. Acknowledging the gesture while declining maintains professionalism.
Which behavior shows that a nurse values autonomy?
- A. Setting limits on a patient's romantic overtures toward the nurse
- B. Suggesting one-on-one supervision for a patient who is suicidal
- C. Informing a patient that the spouse will not be in during visiting hours
- D. Helping the patient weigh the consequences of their behaviors and decisions
Correct Answer: D
Rationale: Supporting autonomy involves helping the patient make informed decisions by weighing alternatives.
A nurse assesses a confused older adult. The nurse experiences sadness and reflects, 'The patient is like one of my grandparents, so helpless.' What feelings does the nurse describe?
- A. Transference
- B. Countertransference
- C. Catastrophic reaction
- D. Defensive coping reaction
Correct Answer: B
Rationale: Countertransference is the nurse's transference or response to a patient that is based on the nurse's unconscious needs, conflicts, problems, or view of the world.
A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent for most of the session. Another patient comes to the door of the room, interrupts, and says to the nurse, 'I really need to talk to you right now.' What action is most appropriate?
- A. Saying to the interrupting patient, 'I am not available to talk with you at the present time.'
- B. Ending the unproductive session with the current patient and spend time with the patient who has just interrupted.
- C. Inviting the interrupting patient to join in the session with the current patient.
- D. Telling the patient who interrupted, 'This session will end in 5 minutes; then, I will talk with you.'
Correct Answer: D
Rationale: Adhering to the session schedule demonstrates trust and prioritizes the current patient. This response respects the contract while addressing the interrupting patient's needs.