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During which phase of the nurse-patient relationship can the nurse anticipate that identified patient issues will be explored and resolved?
- A. Preorientation
- B. Orientation
- C. Working
- D. Termination
Correct Answer: C
Rationale: The working phase involves assisting the patient in connecting dysfunctional behaviors, thoughts, and emotions, and trying alternative coping strategies.
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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.
A nurse explains to the family of a patient who is mentally ill how the nurse-patient relationship differs from social relationships. Which is the best explanation?
- A. The focus is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient.'
- B. The focus shifts from nurse to patient as the relationship develops. Advice is given by both, and solutions are implemented.'
- C. The focus of the relationship is socialization. Mutual needs are met, and feelings are openly shared.'
- D. The focus-Is the creation of a partnership in which each member is concerned with the growth and satisfaction of the other.'
Correct Answer: A
Rationale: The therapeutic relationship focuses on the patient's needs and solutions, distinguishing it from social relationships.
Which issues should a nurse address during the first interview with a patient diagnosed with a psychiatric disorder?
- A. Trust, congruence, attitudes, and boundaries
- B. Goals, resistance, unconscious motivations, and diversion
- C. Relationship parameters, the contract, confidentiality, and termination
- D. Transference, countertransference, intimacy, and developing resources
Correct Answer: C
Rationale: These issues establish the foundation of the therapeutic relationship during the orientation phase.
A patient says, 'I've done a lot of cheating and manipulating in my relationships.' What nonjudgmental response by the nurse is most appropriate?
- A. How do you feel about that?'
- B. It's good that you realize this.'
- C. That's not a good way to behave.'
- D. Have you outgrown that type of behavior?'
Correct Answer: A
Rationale: A nonjudgmental response encourages reflection on feelings without implying judgment.
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.