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At what point in the nurse-patient relationship should a nurse plan to first address termination?
- A. In the orientation phase
- B. During the working phase
- C. In the termination phase
- D. When the patient initially brings up the topic
Correct Answer: A
Rationale: Informing the patient about the relationship's conditions, including termination, early in the orientation phase ensures clarity and sets expectations.
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A nurse wants to enhance the growth of a patient by showing positive regard. What nursing action is consistent with this wish?
- A. Making patient rounds daily
- B. Staying with a tearful patient
- C. Administering daily medication as prescribed
- D. Examining personal feelings about a patient
Correct Answer: B
Rationale: Staying with a tearful patient demonstrates positive regard by offering support and presence.
A nurse caring for a withdrawn, suspicious patient recognizes the development of feelings of anger toward the patient.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 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.
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.
Termination of a therapeutic nurse-patient relationship with a patient has been successful when nurse engages in what action?
- A. Avoids upsetting the patient by shifting focus to other patients before the discharge.
- B. Gives the patient a personal telephone number and permission to call after discharge.
- C. Discusses with the patient changes that have happened during the relationship and evaluates the outcomes.
- D. Offers to meet the patient for coffee and conversation three times a week after discharge.
Correct Answer: C
Rationale: Summarizing and evaluating progress validates the experience and facilitates closure. Other options promote dependency or avoidance.