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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.
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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.
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.
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.
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.
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.