A charge nurse is discussing the care of a client who has a substance use disorder with a staff nurse. Which of the following statements by the staff nurse should the charge nurse identify as countertransference?

"The client generally shares his feelings during group therapy sessions."

"The client is just like my brother who finally overcame his habit."

"The client asked me to go on a date with him, but I refused."

"The client needs to accept responsibility for his substance use."

Answer and Explanation

The Correct Answer is B

Choice A reason: This statement reflects a neutral observation of the client's behavior in therapy and does not indicate countertransference. Sharing feelings during group therapy sessions is a common and expected part of the therapeutic process, and the staff nurse's comment does not reveal any personal emotional response or projection onto the client.

Choice B reason: This statement is a clear example of countertransference. The staff nurse is identifying the client with a personal family member, which can cloud professional judgment. Such an emotional entanglement may lead to biased care, as the nurse may treat the client based on personal experiences with their brother rather than the client's individual needs and circumstances.

Choice C reason: Declining a client's inappropriate request for a date is a professional boundary that must be maintained. This statement does not reflect countertransference but rather appropriate professional conduct. It is important for the charge nurse to recognize that maintaining boundaries is crucial in a therapeutic setting, especially in cases of substance use disorder where clients may exhibit boundary-testing behaviors.

Choice D reason: This statement could be seen as a professional opinion regarding the client's need for accountability in their recovery process. It does not necessarily indicate countertransference unless the staff nurse's insistence on responsibility is driven by personal feelings or unresolved issues related to substance use.

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Correct Answer is ["A","C","G","H"]

Explanation

Being well-groomed can be an indicator of improved mental health, as it suggests the client is taking care of their personal hygiene and appearance, which can be neglected during severe anxiety episodes.

An increase in the amount of sleep and a decrease in the frequency of nightmares can be seen as an improvement in the client’s condition, as sleep disturbances are common in anxiety disorders.

Engagement in thought-stopping behavioral therapy and cognitive restructuring indicates that the client is actively participating in therapeutic activities designed to manage anxiety, which is a positive sign of improvement.

Consistent medication adherence, as reported by the client taking escitalopram 20 mg daily, is crucial for managing anxiety symptoms and indicates the client’s commitment to following the treatment plan.

The client’s weight remaining stable could be neutral, as it does not indicate a significant change. Verbalizing decreased appetite and gastrointestinal discomfort, feeling anxious about leaving the house, and stating that past bullying has led to anxiety are all signs that the client is still experiencing symptoms of anxiety. Therefore, these choices do not reflect an improvement in the client’s condition.

A. Encourage the client to attend weekly support group meetings. B. Discuss the appropriate use of assertive behavior with the client. C. Implement measures to prevent intentional self-inflicted injury. D. Assist the client to maintain awareness of their thoughts and feelings.

Correct Answer is C

Explanation

Choice A reason: While attending support group meetings can be beneficial for individuals with borderline personality disorder by providing a sense of community and shared experiences, it is not the immediate priority. Support groups can offer emotional support and coping strategies, but they do not directly address the urgent safety concerns that may arise with this disorder.

Choice B reason: Discussing the use of assertive behavior is an important aspect of therapy for individuals with borderline personality disorder, as it can help them express their needs and feelings in a healthy way. However, this is part of a long-term strategy for improving interpersonal relationships and communication skills, rather than an immediate safety concern.

Choice C reason: Implementing measures to prevent intentional self-inflicted injury is the priority when planning care for a client with borderline personality disorder. Due to the high risk of self-harm and suicidal behaviors associated with this disorder, ensuring the client's safety is the most critical and immediate concern. This may include creating a safe environment, developing a crisis plan, and closely monitoring the client.

Choice D reason: Assisting the client to maintain awareness of their thoughts and feelings is a key component of therapy for borderline personality disorder, as it can help them understand and manage their emotions more effectively. However, while this is important for long-term management, it is not the immediate priority when compared to ensuring the client's safety.

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A charge nurse is discussing the care of a client who has a substance use disorder with a staff nurse. Which of the following statements by the staff nurse should the charge nurse identify as countertransference?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C","G","H"]

Explanation

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Correct Answer is C

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