A nurse is caring for a client who was involuntarily committed and is scheduled to receive electroconvulsive therapy (ECT). The client refuses the treatment and will not discuss why with the health care team. Which of the following actions should the nurse take?

Nurses have an ethical and legal responsibility to maintain the privacy and confidentiality of a client’s personal and health information obtained in the context of the therapeutic nurse-client relationship.There is both federal and provincial legislation to protect a client’s personal and health information, such as the Health Insurance Portability and Accountability Act (HIPAA) and the HIPAA Privacy Rule in the United States.Nurses should only disclose a client’s information to those who have a need to know, such as other health care providers involved in the client’s care, or with the client’s consent.

Based on this information, the appropriate nursing action when the client’s employer calls to discuss the client’s condition is toconsult the client. The nurse should ask the client if they want to share any information with their employer, and respect their wishes.The nurse should not contact the provider, the facility legal department, or the client’s family without the client’s permission, unless there is a legal obligation or a substantial risk of harm to the client or others

The correct answer is c. Reacting to the nurse as though she were his mother.

Choice A rationale:

• Refusing to participate in group activities can be a sign of social anxiety,withdrawal,or other mental health issues,but it's not specifically indicative of transference.
• Individuals with personality disorders may withdraw from social interactions for various reasons,such as fear of rejection,discomfort in social settings,or a preference for isolation.
• While refusal to participate in group activities could be a manifestation of transference in some cases,it's not the most typical or defining characteristic.

Choice B rationale:

• Talking negatively about other staff members can occur due to dissatisfaction with treatment,personality traits,or interpersonal conflicts.
• It's not directly related to transference,which involves projecting feelings and expectations from past relationships onto current ones.
• While individuals with personality disorders may engage in negative talk about others,this behavior doesn't necessarily stem from transference.

Choice C rationale:

• Reacting to the nurse as though she were his mother is a classic example of transference.
• In this case,the client is unconsciously transferring feelings,thoughts,and behaviors associated with his mother onto the nurse.
• This can manifest in various ways,such as seeking excessive attention or reassurance from the nurse,becoming overly dependent on her,or reacting with anger or hostility if she doesn't meet his expectations.
• This behavior is a key indicator that the client is using transference as a coping mechanism.

Choice D rationale:

• Expressing frustration regarding unit rules can be a sign of difficulty with authority or adjusting to the structure of a treatment setting.
• It's not inherently a sign of transference,as it doesn't involve projecting feelings from past relationships onto the current one.
• Individuals with personality disorders may struggle with rules and authority,but this behavior is not a direct manifestation of transference.