The client tells the nurse, "I don't think you can help me. Every time I talk to you, I am reminded of my mother, and I hated her." The nurse should recognize this as:

incongruence.

confrontation.

transference.

countertransference.

Answer and Explanation

The Correct Answer is C

Transference is a psychodynamic phenomenon where a client unconsciously displaces feelings and attitudes belonging to a significant person from their past onto the healthcare provider. This process often involves unresolved conflicts and emotional reactions that distort the current therapeutic relationship.

Rationale:

A. Incongruence refers to a discrepancy between a person's self-perception and their actual experiences. It occurs when a client's verbal communication does not match their nonverbal behaviors or their internal reality, which is not the primary issue here.

B. Confrontation is a therapeutic communication technique used by the nurse to point out inconsistencies in a client’s behavior. It is an active intervention rather than a psychological defense mechanism or an unconscious emotional displacement initiated by the client.

C. Transference occurs when the client projects irrational feelings onto the nurse. By explicitly stating the nurse reminds them of their mother, the client is demonstrating a classic shift of hostility from an original object to the clinician.

D. Countertransference is the unconscious emotional response of the nurse toward the client. It also involves displacement, but it originates from the professional rather than the client, and would manifest as the nurse's own biased feelings or reactions.

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Correct Answer is A

Explanation

Obsessive-Compulsive Disorder (OCD) is characterized by obsessions (intrusive, persistent thoughts) and compulsions (repetitive behaviors performed to alleviate the anxiety caused by the obsessions). Because OCD is often a chronic condition, the goal of psychiatric nursing is not necessarily the total eradication of thoughts, but rather functional restoration and the reduction of the symptoms' power over the client’s life.

Rationale:

A. The most realistic and desired outcome is that the client can function effectively in their social and occupational roles. Success is measured by the client’s ability to manage their time and energy so that compulsions do not prevent them from fulfilling their daily responsibilities or maintaining relationships.

B. Relieving a client of all responsibilities is a counterproductive intervention. This approach encourages the sick role and can actually increase the time a client has available to engage in ritualistic behaviors, ultimately worsening the severity of the disorder and decreasing the client’s self-esteem.

C. While total symptom remission is an ideal, it is often unrealistic for many clients with OCD. Expecting a complete absence of symptoms can lead to frustration and a sense of failure if an intrusive thought occurs. The clinical focus is on management and control rather than a cure.

D. Anxiety is a universal human emotion and a core component of the OCD cycle. The goal is to help the client develop coping mechanisms to manage anxiety without resorting to rituals (such as through Exposure and Response Prevention), rather than the impossible goal of never experiencing anxiety again.

A. Sexual identity B. Self-discipline C. Control D. Codependence

Correct Answer is C

Explanation

Family systems theory suggests that anorexia nervosa often develops within a specific homeodynamic environment characterized by enmeshment and overprotection. In these families, the adolescent may feel a lack of autonomy, leading them to use food restriction as a way to exert sovereignty over the only thing they feel they can govern, that is, their own body.

Rationale:

A. Although issues of maturation and the physical changes of puberty are often central to the client's internal struggle, sexual identity is generally not the primary systemic issue addressed in family therapy for anorexia. The focus is more on the transition from childhood to independent adolescence.

B. Clients with anorexia typically possess an extreme, pathological level of self-discipline. The goal of therapy is often to decrease this rigid internal regulation rather than address a lack of it. High self-discipline is a symptom of the disorder's ego-syntonic nature, not the underlying familial conflict.

C. Control is the core psychological issue in the family of a client with anorexia. The family often struggles with allowing the client to develop a separate identity. By controlling their caloric intake to a life-threatening degree, the client is making a bid for individualization in a system that feels suffocatingly restrictive.

D. Codependence is a term more frequently associated with substance use disorders and "enabling" behaviors. The family of an anorexic client is often enmeshed, but the clinical priority is addressing the power struggles and the need for personal agency rather than the rescue-victim cycles typical of codependency.

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The client tells the nurse, "I don't think you can help me. Every time I talk to you, I am reminded of my mother, and I hated her." The nurse should recognize this as:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which is the desired outcome for a client with obsessive-compulsive disorder (OCD)?

Correct Answer is A

Explanation

When working with the family of a client with anorexia nervosa, which issue must be addressed?

Correct Answer is C

Explanation

A community health nurse is planning a substance abuse prevention program. Which group would be the best target audience for the nurse?

Which statements about anger, hostility, and aggression are accurate? Select all that apply.

Before the period of the enlightenment, treatment of the mentally ill included:

A client with bipolar disorder is admitted to the psychiatric unit. The client is talking loudly, walking back and forth rapidly, and exhibiting a short attention span. Which nursing intervention should occur first?

The nurse is having feelings of judgement regarding a client's contributory behavior to an automobile accident that resulted in deaths. Which action would the nurse take?

Which statements correctly depict the problem of feeling sympathy toward the client? Select all that apply.

The bereaved client has worked through many processes of grief with the nurse. Which are eventual outcomes of the emotional dimension of grieving? Select all that apply.

A client being discharged appears angry with the nurse when the nurse attempts to review discharge instructions with the client. The nurse can best assist the client in this stage of the relationship with which response?