The nurse struggles with providing care to a particular client because they remind them of a past abusive boyfriend.
What type of behavior is the nurse experiencing?
Countertransference.
Blurred boundaries.
Normal findings.
Transference.
The Correct Answer is A
Choice A rationale
Countertransference is a phenomenon where the nurse unconsciously redirects feelings from a past relationship onto the client. In this case, the client's behavior or appearance triggers unresolved emotions and memories related to a past abusive boyfriend. This is an unconscious process that can interfere with the nurse's ability to provide objective, therapeutic care, as the nurse's emotional response is not about the client, but rather an echo of a past experience.
Choice B rationale
Blurred boundaries occur when the professional relationship between a nurse and client becomes less defined or crosses into personal or social territory. This can involve sharing excessive personal information, inappropriate physical contact, or becoming overly involved in the client's life. While a nurse's feelings could lead to blurred boundaries, the initial experience of struggling with a client due to a past relationship is specifically countertransference.
Choice C rationale
Experiencing strong, unhelpful emotional reactions to a client is not considered a normal finding in a therapeutic relationship. While nurses are human and have personal histories, the professional expectation is to recognize and manage these feelings to ensure that care remains client-focused and therapeutic. If the nurse is struggling with providing care, it indicates a professional challenge that needs to be addressed, not a normal state of affairs.
Choice D rationale
Transference is the opposite phenomenon, where the client unconsciously projects feelings and attitudes from a past relationship onto the nurse. For example, if a client sees the nurse as a parental figure, they may act out a dependent relationship with the nurse. In this scenario, the nurse is the one having the emotional reaction based on their past, not the client, making this an example of countertransference.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
This client poses an immediate and severe risk of harm to others due to command hallucinations. Command hallucinations are auditory hallucinations that instruct the individual to perform an action. These are considered a psychiatric emergency due to the high potential for violence. The client requires immediate inpatient admission for safety and stabilization to protect both the baby and the client.
Choice B rationale
A superficial cut is a self-inflicted injury that is not life-threatening. While this client is in distress and requires evaluation, the risk of immediate, lethal harm is not as high as the client with command hallucinations to harm someone else. This client could likely be managed on an outpatient basis or with a less restrictive intervention than immediate inpatient admission.
Choice C rationale
This client is experiencing an adjustment disorder with depressed mood and anxiety. While the client is in psychological distress, they do not present with a high risk of harm to self or others. This condition can often be treated effectively in an outpatient setting with therapy and possibly medication, without the need for an inpatient psychiatric bed.
Choice D rationale
The client is experiencing side effects from their antipsychotic medication, specifically dry mouth and tremors. This is not a psychiatric emergency but rather a pharmacological issue. These symptoms can be managed by adjusting the medication dosage or switching to a different medication. This can be done in an outpatient setting and does not require an inpatient bed.
Correct Answer is D
Explanation
Choice A rationale
This choice may induce anxiety and frustration by highlighting the client's current limitations in contrast to a former, healthier state. Focusing on an unattainable image can trigger a stress response, increasing sympathetic nervous system activity. This can lead to bronchoconstriction and a higher respiratory rate, exacerbating their shortness of breath, which is counterproductive to the goal of guided imagery. The aim is to calm and relax the client.
Choice B rationale
This choice is inappropriate for a client with emphysema because surfing is a strenuous activity. Suggesting this image could create a mental conflict for the client, as their physical limitations prevent them from performing such an action. The incongruity between the imagined activity and their physical reality can cause stress, leading to an increase in oxygen consumption and a higher respiratory rate, which would worsen their dyspnea.
Choice C rationale
This choice is unsuitable because it denies the client's need for oxygen, which is a critical part of their treatment plan. Visualizing an activity without supplemental oxygen may lead to anxiety and a sense of vulnerability when they must use it. Guided imagery should reinforce positive coping mechanisms, not dismiss necessary medical interventions. This can trigger a fear of suffocation, increasing their respiratory effort and anxiety.
Choice D rationale
This choice is the most effective because it focuses on a positive, attainable state of being. The image of feeling relaxed and taking deep breaths directly addresses the client's fear and physiological symptoms. It promotes a parasympathetic response, which can lead to bronchodilation and a reduced respiratory rate, thereby easing their shortness of breath and lowering their anxiety. This image provides a concrete and therapeutic focus. *.
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