A nurse in an inpatient mental health facility is reviewing the medical record of a client who has bipolar disorder. When planning to establish a nurse-client relationship with the client, which of the following actions should the nurse plan to take first?

Assist the client to use new coping strategies.

Establish confidentiality guidelines with the client.

Help the client to make behavioral changes.

Share information with the client about their disorder.

Answer and Explanation

The Correct Answer is B

Choice A reason: Assisting the client to use new coping strategies is an important part of managing bipolar disorder, but it is not the first action a nurse should take when establishing a nurse-client relationship. Coping strategies will be more effective once a trusting relationship has been established and the client feels secure in sharing personal information.

Choice B reason: Establishing confidentiality guidelines with the client is the first and most crucial step in forming a therapeutic nurse-client relationship. It sets the foundation for trust and openness, ensuring the client understands that their personal information will be protected and shared only with those directly involved in their care.

Choice C reason: Helping the client to make behavioral changes is a goal in the treatment of bipolar disorder. However, before any interventions can be planned or implemented, the nurse must first establish a rapport and trust with the client, which begins with ensuring confidentiality.

Choice D reason: Sharing information with the client about their disorder is essential for their understanding and participation in care. However, this should occur after establishing a relationship in which the client feels comfortable and secure, knowing their privacy is respected.

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Correct Answer is C

Explanation

Choice A reason: Naltrexone is primarily used to manage alcohol or opioid dependence and is not typically prescribed for smoking cessation. It works by blocking the euphoric effects of these substances, which is not directly applicable to nicotine addiction.

Choice B reason: Disulfiram is used as a deterrent agent in the treatment of alcoholism. It causes unpleasant effects when even small amounts of alcohol are consumed, thus it is not suitable for smoking cessation.

Choice C reason: Varenicline is a medication specifically designed to aid in smoking cessation. It works by binding to nicotine receptors in the brain, reducing cravings and the pleasurable effects of smoking. This makes it easier for individuals to quit smoking.

Choice D reason: Donepezil is a medication used to treat cognitive symptoms of Alzheimer's disease. It is not indicated for smoking cessation and does not have an effect on nicotine addiction.

A. "The client generally shares his feelings during group therapy sessions." B. "The client is just like my brother who finally overcame his habit." C. "The client asked me to go on a date with him, but I refused." D. "The client needs to accept responsibility for his substance use."

Correct Answer is B

Explanation

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.

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A nurse in an inpatient mental health facility is reviewing the medical record of a client who has bipolar disorder. When planning to establish a nurse-client relationship with the client, which of the following actions should the nurse plan to take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is seeking help to quit smoking. Which of the following prescriptions should the nurse expect the provider to prescribe?

Correct Answer is C

Explanation

A charge nurse is discussing the care of a client who has a substance use disorder with a staff nurse. Which of the following statements by the staff nurse should the charge nurse identify as countertransference?

Correct Answer is B

Explanation

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