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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.
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What patient behavior is the desirable outcome for the orientation stage of a nurse-patient relationship?
- A. Gaining a sense of independence
- B. Building rapport and trust with the nurse
- C. Assuming self-responsibility and autonomy
- D. Effective resolution of feelings of transference
Correct Answer: B
Rationale: Rapport and trust are necessary for the relationship to progress to the working phase. Other behaviors occur later.
A new nurse tells a mentor, 'I want to convey to my patients that I am interested in them and that I want to listen to what they have to say.' Which behaviors are helpful in meeting the nurse's goal? (Select all that apply.)
- A. Sitting behind a desk, facing the patient
- B. Introducing self to a patient and identifying own role
- C. Using facial expressions that convey interest and encouragement
- D. Assuming an open body posture and sometimes mirror imaging
- E. Maintaining control of the topic under discussion by asking direct questions
Correct Answer: B,C,D
Rationale: Introducing oneself, using encouraging facial expressions, and open body posture foster trust and convey interest.
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.
Which descriptors exemplify consistency regarding therapeutic nurse-patient relationships? (Select all that apply.)
- A. Having the same nurse care for a patient on a daily basis
- B. Encouraging a patient to share initial impressions of staff
- C. Providing a schedule of daily activities to a patient
- D. Setting a time for regular sessions with a patient
- E. Offering solutions to a patient's problems
Correct Answer: A,C,D
Rationale: Consistency involves predictability, such as same nurse, daily schedules, and regular session times, fostering security.
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.