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As a nurse discharges a patient, the patient gives the nurse a card of appreciation made in an arts and crafts group. What is the nurse's best action?
- A. Accept the card while recognizing the effectiveness of the relationship and the patient's thoughtfulness.
- B. Inform the patient that accepting gifts violates the policies of the facility. Decline the card regretfully.
- C. Acknowledge the patient's transition through the termination phase but decline the card.
- D. Accept the card and invite the patient to return to participate in other arts and crafts groups.
Correct Answer: A
Rationale: Accepting a low-value, meaningful gift like a card acknowledges the patient's gratitude without blurring boundaries.
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A nurse caring for a withdrawn, suspicious patient recognizes the development of feelings of anger toward the patient.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 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 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.
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.
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.