A nurse is caring for a client who has social anxiety disorder. The client reports experiencing feelings of anxiousness that disrupt their sleep. Which of the following recommendations should the nurse make?

Choice A reason: This statement reflects a neutral observation of the client's behavior in therapy and does not indicate countertransference. Sharing feelings during group therapy sessions is a common and expected part of the therapeutic process, and the staff nurse's comment does not reveal any personal emotional response or projection onto the client.

Choice B reason: This statement is a clear example of countertransference. The staff nurse is identifying the client with a personal family member, which can cloud professional judgment. Such an emotional entanglement may lead to biased care, as the nurse may treat the client based on personal experiences with their brother rather than the client's individual needs and circumstances.

Choice C reason: Declining a client's inappropriate request for a date is a professional boundary that must be maintained. This statement does not reflect countertransference but rather appropriate professional conduct. It is important for the charge nurse to recognize that maintaining boundaries is crucial in a therapeutic setting, especially in cases of substance use disorder where clients may exhibit boundary-testing behaviors.

Choice D reason: This statement could be seen as a professional opinion regarding the client's need for accountability in their recovery process. It does not necessarily indicate countertransference unless the staff nurse's insistence on responsibility is driven by personal feelings or unresolved issues related to substance use.

Choice A reason:This client experiences psychological stress that manifests as neurological symptoms, such as blindness, deafness, or paralysis, without an underlying medical cause. These deficits are real to the client, creating significant safety risks. The nurse must prioritize assessing their ability to navigate the environment safely to prevent falls or injuries related to these sudden sensory losses.

Choice B reason: Mild anxiety disorder typically does not involve sensory impairments. Anxiety may cause heightened awareness or sensitivity to stimuli but does not result in a loss of sensory function.

Choice C reason: Narcissistic personality disorder is characterized by patterns of grandiosity, need for admiration, and lack of empathy. It does not include sensory impairments as a symptom.

Choice D reason:While this client may engage in time-consuming rituals or repetitive behaviors that interfere with daily life, the disorder does not typically present with neurological or sensory impairments. Potential physical risks for these clients usually involve skin integrity issues from excessive washing or nutritional imbalances rather than the loss of primary senses like sight or hearing.