A nurse is caring for a client who has an anxiety disorder and is scheduled for a procedure.
The client informs the nurse that they do not want to have the procedure.
Which of the following actions should the nurse take?

Obtain consent from the client's family member.

Inform the client that they have the legal right to refuse treatment at any time.

Request another nurse to review the procedure with the client.

Encourage the client to have the procedure.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Obtaining consent from the client's family member is not the appropriate action in this scenario. The client has the right to make decisions about their own medical treatment, and the consent should come from the client themselves, not a family member.

Choice B rationale:

Informing the client that they have the legal right to refuse treatment at any time is the correct action. Informed consent is a fundamental principle of medical ethics, and the nurse should respect the client's autonomy and right to make decisions about their own healthcare.

Choice C rationale:

Requesting another nurse to review the procedure with the client may be helpful in providing additional information and support, but it does not address the client's right to refuse treatment. The primary responsibility is to ensure that the client is aware of their right to refuse.

Choice D rationale:

Encouraging the client to have the procedure goes against the principle of respecting the client's autonomy and right to make their own decisions about their healthcare. The nurse should not pressure the client into having the procedure.

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Correct Answer is D

Explanation

Choice A rationale:

Maintaining the group's focus on identified issues is a valuable aspect of group therapy, but it is not specific to the orientation phase. This action should be integrated throughout the entire support group process.

Choice B rationale:

Encouraging the use of problem-solving skills is an important part of support group facilitation, but this is also not unique to the orientation phase. Problem-solving skills can be encouraged and developed throughout the support group sessions.

Choice C rationale:

Managing conflict within the group is an essential skill for a support group leader, but again, this is not specific to the orientation phase. Conflict management should be an ongoing process in group therapy.

Choice D rationale:

Establishing a rapport with group members is a critical action during the orientation phase of a support group. This phase sets the tone for the group and helps build trust and comfort among the members. It is essential for the nurse to create a safe and supportive environment where group members feel comfortable sharing their experiences and emotions. .

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

Correct Answer is C

Explanation

Choice A rationale:

"The client asked me to go on a date with him, but I refused.”. This statement does not demonstrate countertransference. It is a clear example of professional boundaries being maintained, as the staff nurse refused the client's request for a date, which is appropriate in the context of the nurse-client relationship.

Choice B rationale:

"The client needs to accept responsibility for his substance use.”. This statement does not indicate countertransference. It reflects a common and appropriate therapeutic goal, which is to help clients take responsibility for their actions and substance use disorder.

Choice C rationale:

"The client is just like my brother who finally overcame his habit.”. This statement represents countertransference. Countertransference occurs when a healthcare professional's emotions, attitudes, or past experiences influence their perceptions and interactions with a client. In this case, the staff nurse is making a connection between the client and their own brother, suggesting a personal bias based on past experiences. This can hinder the staff nurse's ability to provide objective care.

Choice D rationale:

"The client generally shares his feelings during group therapy sessions.”. This statement does not demonstrate countertransference. It is a straightforward observation of the client's behavior during group therapy sessions and does not involve any emotional or personal bias on the part of the staff nurse.

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A nurse is caring for a client who has an anxiety disorder and is scheduled for a procedure.The client informs the nurse that they do not want to have the procedure.Which of the following actions should the nurse take?

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A nurse is caring for a client who has an anxiety disorder and is scheduled for a procedure.
The client informs the nurse that they do not want to have the procedure.
Which of the following actions should the nurse take?