As you begin working with her, you notice Ms. V has an uncanny resemblance to your younger sister. As a child, this sister lied and criticized you constantly, then screamed and cried to others if you challenged her. You realize that you are responding negatively to this patient. What's going on here?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Countertransference. Countertransference occurs when a healthcare provider projects their feelings, attitudes, or unresolved conflicts onto a patient. In this case, the nurse is reacting negatively to Ms. V due to the unconscious transfer of feelings from their past experiences with their younger sister onto the patient. Option A) Mutuality refers to the sharing of emotions, experiences, and understanding between individuals, which is not applicable in this context. Option B) Self-System pertains to the individual's perception of themselves, which is not directly related to the nurse's reaction. Option C) Self-actualization is the process of realizing personal potential and self-fulfillment, which is not relevant to the nurse's response to the patient. From an educational perspective, understanding countertransference is crucial in nursing practice as it can impact the therapeutic relationship and patient outcomes. Nurses need to be self-aware, recognize their biases, and seek supervision or support to address and manage countertransference reactions effectively for providing quality patient care. It is essential to acknowledge and process these emotions to prevent them from interfering with professional judgment and patient care.

Correct Answer: B

Rationale: In a behavioral nursing context, developing a relapse prevention plan for a client in a detoxification unit is crucial for their successful recovery. Option B, which includes finding a support person or sponsor, identifying triggers, and developing new coping skills, is the correct choice. This option is effective because it addresses the need for social support, awareness of triggers that may lead to relapse, and the development of healthy coping strategies to manage cravings and stress. Option A is incorrect because while locking up substances and turning over finances can be helpful strategies, limiting partying with former friends to once weekly may still expose the client to high-risk situations that can trigger relapse. Option C is also incorrect as isolation and limiting social contacts can exacerbate feelings of loneliness and increase the risk of relapse. Taking a leave of absence from the job may not be necessary if the client has a supportive work environment. Option D is not ideal as having a support person live in the client's home and preventing substance use may create a codependent relationship and hinder the client's autonomy and responsibility in managing their recovery. Educationally, understanding the importance of social support, trigger identification, and coping skills in relapse prevention plans equips nurses with the knowledge to provide comprehensive and effective care for clients undergoing detoxification. By focusing on empowering clients to develop self-awareness and healthy coping mechanisms, nurses can support long-term recovery and well-being.

Correct Answer: A

Rationale: The correct answer is A) Heart disease and stroke. When a client regularly uses methamphetamine, they are at high risk for developing blood vessel constriction and spasming, leading to increased blood pressure and strain on the cardiovascular system. This can result in a higher likelihood of developing heart disease and experiencing a stroke due to the increased stress on the heart and blood vessels. Option B) Brain trauma and injury is incorrect because while methamphetamine use can have neurological effects, such as altering brain function and increasing the risk of stroke, the primary concern related to blood vessel constriction and spasming is the cardiovascular impact rather than direct brain trauma. Option C) Bone loss and osteoporosis is incorrect as these conditions are not directly associated with the vascular effects of methamphetamine use. Bone health is typically affected by factors such as nutrition, physical activity, and hormonal balance rather than blood vessel constriction. Option D) Liver and pancreatic disease is incorrect because although methamphetamine use can have detrimental effects on the liver and pancreas, the immediate concern related to blood vessel constriction and spasming is more closely linked to cardiovascular complications rather than specific liver or pancreatic diseases. In an educational context, understanding the potential health consequences of substance use is crucial for nurses to provide comprehensive care to clients. By recognizing the specific risks associated with methamphetamine use, nurses can implement appropriate interventions and educate clients on the importance of addressing these health concerns to prevent long-term complications.

Correct Answer: D

Rationale: In the context of behavioral nursing, understanding personality disorders is crucial for providing effective care to patients. Cluster C personality disorders are characterized by anxious and fearful behaviors. Dependent personality disorder, the correct answer (D), falls under this cluster. This disorder is marked by a pervasive need to be taken care of, leading to submissive and clinging behavior. Antisocial personality disorder (A) belongs to cluster B, characterized by dramatic, emotional, or erratic behaviors. Borderline personality disorder (B) also falls under cluster B and is marked by instability in relationships, self-image, and emotions. Paranoid personality disorder (C) is part of cluster A, which includes odd or eccentric behaviors. Educationally, understanding the clusters of personality disorders helps nurses differentiate between them and tailor interventions accordingly. Recognizing the characteristics of each cluster aids in developing individualized care plans and providing appropriate support to patients with personality disorders.

Correct Answer: C

Rationale: The correct answer is C) To treat pain and ease anxiety. This option is the most plausible reason for the client starting to use opioids based on their history of chronic pain, anxiety, and recent opioid use disorder diagnosis. Opioids are commonly prescribed for pain management and can also provide a sense of relief from anxiety, making them appealing to individuals dealing with these issues. Option A) To promote sleep and rest, is less likely as the client's primary issues are pain and anxiety, not sleep disturbances. Option B) To treat hallucinations and perform better at work, is incorrect as there is no mention of hallucinations in the client's history, and opioids are not typically used to enhance work performance. Option D) Because they witnessed their parents using drugs or alcohol to cope, is less relevant in this scenario as the client's own medical conditions and personal struggles are more likely to have influenced their opioid use. From an educational standpoint, understanding the underlying reasons for substance use is crucial in nursing practice to provide holistic care. Nurses need to assess clients comprehensively, considering their physical and psychological needs to address the root causes of substance use disorders effectively. In this case, the connection between pain, anxiety, and opioid use highlights the importance of exploring these factors in clients with similar presentations.