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?
Defensive coping reaction
The presence of countertransference
The presence of transference
Catastrophic reaction
The Correct Answer is B
Choice A reason: Defensive coping involves mechanisms like denial to manage stress, not personal emotional connections to a patient. The nurse’s sadness reflects personal feelings, not a defense against anxiety. This term does not apply to the nurse’s emotional response to the patient’s condition or perceived helplessness.
Choice B reason: Countertransference occurs when a nurse projects personal feelings, like sadness, onto a patient due to similarities with personal experiences (e.g., grandparents). This emotional response can influence care if not managed, as it stems from the nurse’s unresolved feelings, making it the accurate description of the situation.
Choice C reason: Transference involves the patient projecting feelings onto the nurse, not the nurse’s emotions about the patient. The scenario describes the nurse’s feelings, not the patient’s, making transference inapplicable. The nurse’s sadness reflects personal emotional involvement, not a patient-driven dynamic.
Choice D reason: Catastrophic reaction refers to a patient’s exaggerated emotional response to stress, often in dementia, not the nurse’s feelings. The nurse’s sadness is a personal emotional reaction, not a patient behavior, making this term irrelevant to the described situation of the nurse’s emotional reflection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Implementing interventions addresses specific needs but is not the primary goal of therapeutic communication during admission. Interventions follow after building trust, as depression and anxiety require a strong therapeutic alliance to ensure effective treatment engagement, making this a secondary priority at this stage.
Choice B reason: Teaching self-care skills is important for long-term management but not the initial communication goal. Clients with depression and anxiety need trust and emotional safety first to engage in learning, making skill-building secondary to establishing a therapeutic relationship during the admission assessment.
Choice C reason: Facilitating emotional expression is a key component of therapeutic communication but depends on a trusting relationship. Without a strong nurse-client bond, clients with depression and anxiety may resist sharing emotions, making this goal important but secondary to establishing rapport during the initial assessment.
Choice D reason: Establishing a therapeutic nurse-client relationship is the priority during admission, as it builds trust and safety, critical for clients with depression and anxiety. This foundation enables emotional expression, engagement in interventions, and skill-building, ensuring effective communication and treatment adherence, making it the primary goal in this context.
Correct Answer is B
Explanation
Choice A reason: Antihypertensives are routinely used in ESRD to manage hypertension caused by fluid overload and renin-angiotensin system dysregulation. Controlling blood pressure prevents cardiovascular complications like heart failure or stroke, which are common in ESRD due to chronic volume and pressure overload, making this medication appropriate.
Choice B reason: ADH is not used in ESRD, as it promotes water reabsorption, worsening fluid overload in anuric patients. ESRD patients rely on dialysis for fluid balance, and ADH could exacerbate hypertension or pulmonary edema. Its use is more relevant in conditions like diabetes insipidus, not renal failure.
Choice C reason: Erythrocyte-stimulating agents, like erythropoietin, are standard in ESRD to treat anemia caused by reduced erythropoietin production by failing kidneys. These agents stimulate red blood cell production, improving oxygen delivery and reducing fatigue, making them essential for managing ESRD-related anemia and improving quality of life.
Choice D reason: Phosphate binders are used in ESRD to manage hyperphosphatemia by binding dietary phosphate in the gut, preventing its absorption. This reduces the risk of vascular calcification and secondary hyperparathyroidism, common complications in ESRD due to impaired phosphate excretion, making these medications a standard part of therapy.
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