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 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.
Correct Answer is D
Explanation
Choice A reason: Buspirone is not used as needed; it requires weeks for serotonin modulation to reduce anxiety. Diazepam’s rapid GABA enhancement suits acute use. Buspirone’s chronic dosing schedule makes this characteristic incorrect for explaining its preference over diazepam for long-term anxiety management.
Choice B reason: Buspirone is slower-acting, taking weeks to enhance serotonin activity, unlike diazepam’s rapid GABA-mediated effects. For anxiety driven by amygdala hyperactivity, diazepam acts faster, making buspirone’s slower onset an incorrect reason for its prescription over diazepam in this context.
Choice C reason: Blood dyscrasias are not a known side effect of buspirone, which primarily affects serotonin receptors. This is unrelated to its preference over diazepam, which carries dependence risks. This characteristic is inaccurate and irrelevant to the rationale for choosing buspirone.
Choice D reason: Buspirone’s lack of dependence risk, unlike diazepam’s GABA-mediated addiction potential, makes it safer for long-term anxiety management. By enhancing serotonin in the prefrontal cortex, it reduces chronic anxiety without habit-forming effects, aligning with its preference for sustained treatment, making this the correct reason.
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