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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.
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A nurse caring for a withdrawn, suspicious patient recognizes the development of feelings of anger toward the patient.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.
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.
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.
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 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.