A nurse explains to a nursing student how the therapeutic relationship differs from a social relationship. What is the best explanation for the therapeutic relationship between the nurse and patient?

“The focus of the relationship is socialization. Mutual needs are met, and feelings are openly shared.”

“The focus is the creation of a partnership in which each member is concerned with the growth and satisfaction of the other.”

“The focus is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient.”

“The focus shifts from nurse to patient as the relationship develops. Advice is given by both, and solutions are implemented.”

Answer and Explanation

The Correct Answer is C

Choice A reason: Socialization and mutual needs define social relationships, not therapeutic ones. Therapeutic relationships focus on patient needs, like addressing serotonin-driven depression, not reciprocal sharing. This approach risks blurring professional boundaries, making it incorrect for psychiatric nursing’s patient-centered focus.

Choice B reason: Mutual growth and satisfaction characterize social partnerships, not therapeutic relationships. In psychiatric care, the focus is on patient recovery, addressing issues like dopamine imbalances, not nurse satisfaction. This option misaligns with the professional, patient-centered nature of therapeutic relationships.

Choice C reason: The therapeutic relationship centers on the patient, addressing issues like amygdala-driven anxiety through collaborative discussion. Solutions, like medication adherence, are patient-driven to promote autonomy, aligning with neurobiological and psychological recovery principles, making this the correct description of the therapeutic dynamic.

Choice D reason: Shifting focus and mutual advice blur professional boundaries, resembling social relationships. Therapeutic relationships prioritize patient needs, like serotonin stabilization, with nurse guidance, not reciprocal advice. This option misrepresents the patient-centered, evidence-based nature of psychiatric therapeutic relationships.

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Correct Answer is D

Explanation

Choice A reason: Buspirone enhances serotonin activity, taking weeks to reduce anxiety. Panic attacks, driven by acute norepinephrine surges in the amygdala, require rapid intervention. Buspirone’s delayed onset makes it ineffective for acute symptom relief, unlike fast-acting options targeting immediate neurochemical imbalances.

Choice B reason: Venlafaxine, an SNRI, increases serotonin and norepinephrine over weeks, unsuitable for acute panic attacks. Panic involves rapid sympathetic activation, requiring immediate GABA enhancement or similar fast-acting mechanisms, not gradual reuptake inhibition, making venlafaxine incorrect for rapid relief.

Choice C reason: Imipramine, a tricyclic, modulates serotonin and norepinephrine but takes weeks to act. Acute panic, driven by locus coeruleus norepinephrine spikes, needs immediate relief. Imipramine’s slow onset and side effects make it inappropriate for rapid intervention in acute anxiety episodes.

Choice D reason: Alprazolam, a benzodiazepine, enhances GABA-A receptor activity, rapidly inhibiting excessive neural firing in the amygdala during panic attacks. This provides quick relief from acute anxiety symptoms, like tachycardia, within minutes, making it the correct choice for immediate neurobiological stabilization in panic episodes.

A. By suppressing their angry feelings B. By discussing their feelings of anger with their nurse manager C. By expressing their anger openly and directly with the patient D. By telling the nurse manager to assign the patient to another nurse

Correct Answer is B

Explanation

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.

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A nurse explains to a nursing student how the therapeutic relationship differs from a social relationship. What is the best explanation for the therapeutic relationship between the nurse and patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is experiencing a panic attack. What medication will provide the quickest relief from acute severe anxiety symptoms?

Correct Answer is D

Explanation

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?

Correct Answer is B

Explanation

Which of the following speech patterns is an example of tangential thinking?

A patient with paranoia states, “The state is monitoring us through the listening devices hidden in this room. Be careful what you say.” Which response by the nurse would be most therapeutic?

A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong with me except a stubborn chest cold.” The spouse reports that the patient smokes, coughs daily, has recently lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using?

Which remark by a patient indicates passage from the orientation phase to the working phase of a nurse-patient relationship?

The spouse of a patient who experiences delusions asks the nurse, “Are there any circumstances under which the treatment team is justified in violating the patient’s right to confidentiality?” What is the nurse’s best response?

A nurse uses Maslow’s hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority?

Which neurotransmitter is associated with the hallucinations, delusions, and bizarre behavior seen in schizophrenia?

At one point in an assessment interview, a nurse asks, “Does your faith help you in stressful situations?” What assessment topic does this question fall under?