A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent most of the session. Another patient comes to the door of the room, interrupts, and says to the nurse, "I really need to talk.”. What is the correct response from the nurse?

Choice A rationale Telling the interrupting patient, "I am not available to talk with you at the present time," abruptly dismisses their expressed need. While setting boundaries is important for maintaining the therapeutic contract with the current patient, this response fails to acknowledge the interrupting patient's concern or provide a clear expectation for when the nurse will be available, which can escalate their anxiety or distress. It lacks therapeutic closure. Choice B rationale Inviting the interrupting patient to join the current session immediately violates the established therapeutic contract and the confidentiality of the current patient-nurse relationship. The current patient is entitled to their privacy and uninterrupted time. The unexpected introduction of a third party fundamentally alters the therapeutic environment, potentially halting any progress made toward developing trust or communication with the patient who has been mostly silent. Choice C rationale Ending the unproductive session prematurely and spending time with the interrupting patient completely violates the principle of fidelity to the existing therapeutic relationship with the current patient. Even if the current session has been mostly silent, the nurse is committed to the agreed-upon time frame. Terminating early teaches the current patient that their time is disposable and that their needs can be easily overridden by others, damaging therapeutic trust. Choice D rationale Stating, "This session has 5 more minutes; then I will talk with you," is the most appropriate response as it simultaneously maintains therapeutic boundaries and fidelity to the current patient's remaining time while also acknowledging the interrupting patient's expressed need. This response sets a clear, immediate expectation and time boundary for the interrupting patient, reducing anxiety and validating their concern without violating the contract with the current patient.