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A nurse says, 'I am the only one who truly understands this patient. Other staff members are too critical.' What does the nurse's statement indicate?
- A. Boundary blurring
- B. Sexual harassment
- C. Positive regard
- D. Advocacy
Correct Answer: A
Rationale: Overinvolvement suggests boundary blurring, likely due to countertransference, requiring supervision.
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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 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.
A patient says, 'I'm still on restriction, but I want to attend some off-unit activities. Would you ask the doctor to change my privileges?' What is the nurse's best response?
- A. Why are you asking me when you're able to speak for yourself?'
- B. I will be glad to address it when I see your doctor later today.'
- C. That's a good topic for you to take up with your doctor.'
- D. Do you think you can't speak to a doctor?'
Correct Answer: C
Rationale: Encouraging the patient to advocate for themselves promotes independence and optimal functioning.
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.
Which statement shows a nurse has empathy for a patient who made a suicide attempt?
- A. You must have been very upset when you tried to hurt yourself.'
- B. It makes me sad to see you going through such a difficult experience.'
- C. If you tell me what is troubling you, I can help you solve your problems.'
- D. Suicide is a drastic solution to a problem that may not be such a serious matter.'
Correct Answer: A
Rationale: Empathy permits the nurse to see an event from the patient's perspective, understand the patient's feelings, and communicate this to the patient. The incorrect responses are nurse-centered, belittling, or sympathetic.