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A nurse caring for a withdrawn, suspicious patient recognizes the development of feelings of anger toward the patient. How should the nurse respond?
- A. By suppressing the angry feelings.
- B. By expressing the anger openly and directly with the patient.
- C. By telling the nurse manager to assign the patient to another nurse.
- D. By discussing the anger with a clinician during a supervisory session.
Correct Answer: D
Rationale: Supervision helps address countertransference, maintaining objectivity in the therapeutic relationship.
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As a patient diagnosed with mental illness is being discharged from a facility, a nurse invites the patient to the annual staff picnic. What is the best analysis of this scenario?
- A. The invitation facilitates dependency on the nurse.
- B. The nurse's action blurs the boundaries of the therapeutic relationship.
- C. The invitation is therapeutic for the patient's diversional activity deficit.
- D. The nurse's action assists the patient's integration into community living.
Correct Answer: B
Rationale: The invitation creates a social rather than therapeutic relationship, blurring professional boundaries.
A patient says, 'Please don't share information about me with the other people.' How should the nurse respond?
- A. I won't share information with others without your permission, but I will share information about you with other staff members.'
- B. A therapeutic relationship is just between the nurse and the patient. It's up to you to tell others what you want them to know.'
- C. It really depends on what you choose to tell me. I will be glad to disclose at the end of each session what I will report to others.'
- D. I cannot tell anyone about you. It will be as though I am talking about my own problems, and we can help each other by keeping it between us.'
Correct Answer: A
Rationale: A patient has the right to know with whom the nurse will share information and that confidentiality will be protected. Other staff members need pertinent data, making this response appropriate.
A nurse explains to the family of a patient who is mentally ill how the nurse-patient relationship differs from social relationships. Which is the best explanation?
- A. The focus is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient.'
- B. The focus shifts from nurse to patient as the relationship develops. Advice is given by both, and solutions are implemented.'
- C. The focus of the relationship is socialization. Mutual needs are met, and feelings are openly shared.'
- D. The focus-Is the creation of a partnership in which each member is concerned with the growth and satisfaction of the other.'
Correct Answer: A
Rationale: The therapeutic relationship focuses on the patient's needs and solutions, distinguishing it from social relationships.
As a nurse discharges a patient, the patient gives the nurse a card of appreciation made in an arts and crafts group. What is the nurse's best action?
- A. Accept the card while recognizing the effectiveness of the relationship and the patient's thoughtfulness.
- B. Inform the patient that accepting gifts violates the policies of the facility. Decline the card regretfully.
- C. Acknowledge the patient's transition through the termination phase but decline the card.
- D. Accept the card and invite the patient to return to participate in other arts and crafts groups.
Correct Answer: A
Rationale: Accepting a low-value, meaningful gift like a card acknowledges the patient's gratitude without blurring boundaries.
A patient says, 'People should be allowed to commit suicide without interference from others.' A nurse replies, 'You're wrong. Nothing is bad enough to justify death.' What is the best analysis of this interchange?
- A. The patient is correct.
- B. The nurse is correct.
- C. Neither person is totally correct.
- D. Differing values are reflected in the two statements.
Correct Answer: D
Rationale: The statements reflect differing values on autonomy and life, highlighting the need for nurses to be aware of their own values.