A nurse caring for a withdrawn, suspicious patient recognizes the development of feelings of anger toward the patient. What is the nurse’s best response to these feelings?
By suppressing their angry feelings
By discussing their feelings of anger with their nurse manager
By expressing their anger openly and directly with the patient
By telling the nurse manager to assign the patient to another nurse
The Correct Answer is B
Choice A reason: Suppressing anger ignores countertransference, which can impair therapeutic neutrality. Anger may stem from patient behaviors linked to dopamine-driven paranoia, but suppression risks unconscious bias affecting care. Addressing feelings through supervision maintains professionalism, making this response less effective for managing emotions.
Choice B reason: Discussing anger with a manager addresses countertransference, a reaction to patient behaviors like suspicion from dopamine dysregulation. This allows reflection, reducing bias and maintaining therapeutic neutrality. It supports professional care by processing emotions, aligning with evidence-based psychiatric nursing practices for managing countertransference.
Choice C reason: Expressing anger directly risks damaging the therapeutic alliance. Suspicion, tied to mesolimbic dopamine excess, may escalate with confrontation, increasing patient anxiety. This approach disregards professional boundaries and neurobiological sensitivities, making it inappropriate for maintaining effective psychiatric care.
Choice D reason: Reassigning the patient avoids addressing countertransference, neglecting professional growth. Suspicion, linked to neurobiological paranoia, requires consistent care. Reassignment disrupts continuity, potentially worsening patient trust and outcomes, making this an ineffective response compared to processing feelings through supervision.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Medication education addresses self-actualization or esteem needs in Maslow’s hierarchy, which are lower priority. Psychotic symptoms like hallucinations, driven by dopamine dysregulation, pose immediate safety risks, taking precedence over education, which assumes cognitive stability not yet achieved in acute psychosis, per Maslow’s prioritization.
Choice B reason: Alienation relates to belongingness needs, third in Maslow’s hierarchy. While important, psychotic hallucinations, linked to hyperactive mesolimbic dopamine pathways, indicate a safety threat, a basic physiological need. Addressing safety precedes social needs, as unresolved psychosis can exacerbate isolation, making this a lower priority.
Choice C reason: Reluctance for social activities reflects belongingness needs, lower in Maslow’s hierarchy. Hallucinations, driven by neurochemical imbalances like excess dopamine, pose immediate safety risks, a physiological need. Social participation requires cognitive stability, which is compromised in psychosis, making this issue secondary to urgent safety concerns.
Choice D reason: Hearing voices urging self-protection indicates a safety threat, a basic physiological need in Maslow’s hierarchy. Hallucinations, linked to dopamine overactivity in the mesolimbic pathway, can lead to harmful behaviors. Addressing this stabilizes the patient, taking priority over higher-level needs like social connection or education, per Maslow’s framework.
Correct Answer is B
Explanation
Choice A reason: Process recordings are for nurse self-reflection, not client analysis. They examine nurse communication, not patient abnormalities. Client communication issues, like disorganized speech in schizophrenia, are assessed clinically, not via recordings, making this option incorrect for the tool’s purpose in psychiatric practice.
Choice B reason: Process recordings analyze the nurse’s communication impact, assessing verbal and nonverbal cues on client responses. Effective communication, processed via mirror neurons, fosters therapeutic alliances, calming amygdala-driven anxiety. This self-evaluation improves nurse effectiveness, aligning with the scientific purpose of process recordings in psychiatric care.
Choice C reason: Identifying client communication abnormalities is a clinical assessment task, not the purpose of process recordings. Recordings focus on nurse interactions, not patient speech patterns, like those in mania. This option misaligns with the tool’s introspective goal, making it incorrect for its intended use.
Choice D reason: Clients exploring alternate techniques is a therapeutic goal, not the purpose of process recordings. Recordings analyze nurse communication, not patient skill-building. Effective nurse responses can reduce stress-related cortisol spikes, but this is secondary, making this option incorrect for the recording’s primary purpose.
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