A nurse caring for a withdrawn, suspicious patient recognizes the development of feelings of anger toward the patient.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 B
Explanation
Choice A reason: Histamine blockade, as in antipsychotics like olanzapine, promotes sedation, not weight loss. Weight gain is common due to histamine’s role in appetite regulation via hypothalamic signaling. Weight loss is not a typical side effect, making this response inaccurate for histamine-blocking medications.
Choice B reason: Histamine receptor blockade, common in medications like quetiapine, reduces wakefulness by inhibiting histamine’s alerting effects in the cortex. This causes drowsiness, a frequent side effect in psychiatric treatments, aligning with the pharmacological mechanism and making this the correct response.
Choice C reason: Insomnia is not typical with histamine blockade, which promotes sedation. Histamine enhances alertness; blocking it, as in antihistaminic antipsychotics, induces sleepiness, not wakefulness. This response contradicts the neuropharmacological effect, making it incorrect for expected side effects.
Choice D reason: Blood pressure increase is unrelated to histamine blockade. Histamine affects wakefulness and appetite, not vascular tone directly. Antihistaminic drugs may cause orthostatic hypotension via other receptors, not hypertension, making this response inaccurate for histamine-blocking medication effects.
Correct Answer is A
Explanation
Choice A reason: This question verifies the nurse’s interpretation, ensuring accurate understanding of concerns linked to emotional dysregulation, possibly from serotonin imbalances. It promotes therapeutic communication, engaging prefrontal cortex processing to clarify patient emotions, reducing miscommunication and fostering trust in psychiatric interactions.
Choice B reason: Asking for common elements seeks patterns, not clarification of specific concerns. Emotional concerns, tied to amygdala hyperactivity, require precise understanding. This question is too vague, risking misinterpretation of neurobiological emotional cues, making it less effective for therapeutic clarification in psychiatric care.
Choice C reason: Requesting a full recount is inefficient and may overwhelm patients with anxiety or cognitive deficits, like those from dopamine dysregulation. Clarification needs targeted questions to confirm specific concerns, not a broad restart, making this approach inappropriate for effective therapeutic communication.
Choice D reason: Asking to repeat experiences may frustrate patients and fail to clarify specific points. Emotional concerns, linked to stress-induced cortisol spikes, need focused verification. This vague request risks missing neurobiological nuances, making it less effective than direct confirmation for therapeutic clarification.
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