After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?
The nurse develops a trusting relationship with the patient
The patient states, “Talking to you feels like talking to my parents.”
The patient’s reactions toward the nurse seem realistic and appropriate
The nurse feels extremely happy when the patient’s mood begins to lift
The Correct Answer is D
Choice A reason: A trusting relationship is the goal of therapeutic alliances, not countertransference. It reflects effective communication, calming amygdala-driven distress in suicidal patients. This is a normal outcome, not an emotional overreaction, making it an incorrect indicator of countertransference in psychiatric care.
Choice B reason: The patient comparing the nurse to parents suggests transference, not countertransference. Transference involves patient projections, often tied to past emotional patterns, not nurse emotions. This is unrelated to the nurse’s feelings, making it an incorrect choice for countertransference concerns.
Choice C reason: Realistic patient reactions indicate a healthy therapeutic dynamic, not countertransference. Appropriate responses align with stabilizing neurobiological states, like serotonin balance in depression. This reflects effective care, not nurse emotional overinvolvement, making it an incorrect indicator of countertransference in this context.
Choice D reason: Extreme happiness tied to the patient’s mood improvement suggests countertransference, where the nurse’s emotions, possibly influenced by mirror neuron activation, overly align with the patient’s state. This indicates personal overinvolvement, risking bias in care for suicidal patients with serotonin imbalances, making it the correct choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Prolonged silences may cause withdrawal in some patients, as anxiety from serotonin or GABA imbalances can heighten discomfort. However, this does not guide silence’s use. Silence is therapeutic when timed appropriately, not avoided due to potential withdrawal, making this principle incorrect.
Choice B reason: Nurses breaking silences assumes discomfort, ignoring therapeutic benefits. Silence allows processing, potentially calming amygdala hyperactivity in anxiety. The nurse’s role is to use silence strategically, not to interrupt it routinely, making this principle misaligned with effective interview techniques.
Choice C reason: Silence facilitates reflection, allowing patients to process emotions, reducing stress via hypothalamic calming. In disorders like depression, it supports cognitive restructuring by giving time to integrate thoughts. This principle guides therapeutic silence, aligning with neurobiological benefits of reflective pauses in interviews.
Choice D reason: Silence does not inherently confirm understanding. It may allow emotional processing, but assuming it signals comprehension risks miscommunication. In conditions like anxiety, silence supports reflection, not validation, making this principle less accurate than reflection for guiding its therapeutic use.
Correct Answer is A
Explanation
Choice A reason: Clarifying “pusillanimous” seeks specific meaning, ensuring accurate understanding of the patient’s emotional state. Dreams reflecting fear or inadequacy may involve amygdala hyperactivity or serotonin imbalances. This promotes therapeutic communication, addressing emotional distress linked to neurobiological stress responses, making it the most appropriate response.
Choice B reason: Relating personal experience shifts focus from the patient, reducing therapeutic effectiveness. Emotional drainage, possibly tied to REM sleep disruptions or cortisol spikes, requires exploration, not nurse self-disclosure. This risks dismissing the patient’s unique neurobiological experience, making it inappropriate for clarification.
Choice C reason: Assuming discomfort generalizes the dream’s impact without clarifying “pusillanimous.” Emotional drainage may reflect amygdala-driven stress responses, but this response lacks specificity. Clarification requires direct exploration of the term to understand its emotional and neurobiological significance, making this less effective.
Choice D reason: Summarizing poor sleep oversimplifies the emotional drainage, potentially linked to serotonin dysregulation or heightened stress responses. It fails to explore “pusillanimous,” missing the dream’s specific emotional content. Clarification requires detailed inquiry into the term’s meaning, making this response inadequate.
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