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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.
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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.
During the first interview, a nurse notices that the patient does not make eye contact. What can the nurse correctly assume from this behavior?
- A. The patient is not truthful.
- B. The patient is feeling sad.
- C. The patient has a poor self-concept.
- D. The need for more information is required to draw a conclusion.
Correct Answer: D
Rationale: Lack of eye contact alone is insufficient to draw specific conclusions; further assessment is needed.
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.
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 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.