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A nurse ends a relationship with a patient. Which actions by the nurse should be included in the termination phase? (Select all that apply.)
- A. Focus dialog with the patient on problems that may occur in the future.
- B. Help the patient express feelings about the relationship with the nurse.
- C. Help the patient prioritize and modify socially unacceptable behaviors.
- D. Reinforce expectations regarding the parameters of the relationship.
- E. Help the patient identify strengths, limitations, and problems.
Correct Answer: A,B
Rationale: Termination involves discussing future challenges and expressing feelings about the relationship to facilitate closure.
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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.
After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?
- A. The patient's reactions toward the nurse seem realistic and appropriate.
- B. The patient states, 'Talking to you feels like talking to my parents.'
- C. The nurse feels unusually happy when the patient's mood begins to lift.
- D. The nurse develops a trusting relationship with the patient.
Correct Answer: C
Rationale: Strong positive or negative reactions toward a patient or overidentification signal possible countertransference. Nurses must monitor their feelings to detect countertransference and seek supervision.
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.
At what point in the nurse-patient relationship should a nurse plan to first address termination?
- A. In the orientation phase
- B. During the working phase
- C. In the termination phase
- D. When the patient initially brings up the topic
Correct Answer: A
Rationale: Informing the patient about the relationship's conditions, including termination, early in the orientation phase ensures clarity and sets expectations.
During the first interview, a nurse notices that the patient does not make eye contact. What can the nurse correctly assume from this behavior?
- A. The patient is not truthful.
- B. The patient is feeling sad.
- C. The patient has a poor self-concept.
- D. The need for more information is required to draw a conclusion.
Correct Answer: D
Rationale: Lack of eye contact alone is insufficient to draw specific conclusions; further assessment is needed.