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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.
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As a nurse escorts a patient being discharged after treatment for major depressive disorder, the patient gives the nurse a gold necklace with a heart pendant and says, 'Thank you for helping mend my broken heart.' Which is the nurse's best response?
- A. Accepting gifts violates the policies and procedures of the facility.'
- B. I'm glad you feel so much better now. Thank you for the beautiful necklace.'
- C. I'm glad I could help you, but I can't accept the gift. My reward is seeing your renewed sense of hope.'
- D. Helping people is what nursing is all about. It's rewarding to me when patients recognize how hard we work.'
Correct Answer: C
Rationale: Accepting gifts blurs therapeutic boundaries. Acknowledging the gesture while declining maintains professionalism.
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.
A nurse assesses a confused older adult. The nurse experiences sadness and reflects, 'The patient is like one of my grandparents, so helpless.' What feelings does the nurse describe?
- A. Transference
- B. Countertransference
- C. Catastrophic reaction
- D. Defensive coping reaction
Correct Answer: B
Rationale: Countertransference is the nurse's transference or response to a patient that is based on the nurse's unconscious needs, conflicts, problems, or view of the world.
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.
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.