A client is concerned that information given to the nurse remains confidential. Which is the nurse’s best response regarding confidentiality?
All your information is confidential and will be kept just between us.
I will share information with the staff members only with your approval.
Some things like suicidal thinking must be reported to the treatment team.
You must select who I can discuss your care with.
The Correct Answer is C
Confidentiality is a critical aspect of the nurse-patient relationship. However, there are specific circumstances where confidentiality must be breached to ensure the patient's safety and well-being. For instance, if a patient is expressing suicidal ideation or harm to others, the nurse has an ethical and legal obligation to report it to the treatment team to prevent harm. It is essential to explain this to the client to establish trust and clarify the limitations of confidentiality.
Option (a) is incorrect because not all information can remain confidential.
Option (b) is incorrect because not all information requires the client's approval to share.
Option (d) is incorrect because the nurse has the responsibility to disclose certain information to other healthcare professionals for the patient's benefit.
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Correct Answer is D
Explanation
This response is open-ended and non-judgmental, allowing the client to reflect on their behavior and share their thoughts and feelings. It also avoids blaming the client or making assumptions about their intentions, which could escalate the situation and damage the therapeutic relationship.
Option A, “I feel angry when I hear that tone of voice,” focuses on the nurse's own feelings and could be perceived as confrontational or defensive.
Option B, “You make me so angry when you talk to me that way,” places blame on the client and may trigger a defensive response.
Option C, “Are you trying to make me angry?” is also confrontational and may be interpreted as accusing the client of intentionally provoking the nurse.
Correct Answer is C
Explanation
Sigmund Freud was an Austrian neurologist who developed psychoanalytic theory and therapy in the late 19th and early 20th centuries. He believed that unconscious thoughts, feelings, and experiences from childhood could influence behavior and mental health in adulthood. Psychoanalytic therapy is a type of talk therapy that aims to bring these unconscious thoughts and experiences to the surface, in order to help patients gain insight into their behavior and mental health.
Defence mechanisms are psychological strategies that individuals use unconsciously to protect themselves from anxiety and emotional pain. Freud identified several defense mechanisms, including repression, denial, projection, and displacement. Psychoanalytic therapy is designed to help patients identify and understand these defense mechanisms, in order to develop healthier coping strategies.
Dorothea Dix was a social reformer who advocated for the humane treatment of the mentally ill. Erick Erickson was a developmental psychologist who developed a theory of psychosocial development.
Hildegard Peplau was a nurse theorist who developed a theory of interpersonal relationships in nursing. None of these individuals were associated with the development of psychoanalytic therapy.
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