Editing Mental Health and Psychosocial Nursing – RN Flashcards (section)

== Therapeutic Relationship and Communication ==

;Four nontherapeutic responses that are almost always the wrong exam answer
:False reassurance ("Everything will be fine"), giving advice ("If I were you..."), approval or disapproval, and asking "why," which demands justification. Also avoid changing the subject, minimizing, defending the institution, and challenging a delusion with logic.

;When does safety outrank therapeutic exploration on an exam item?
:Whenever the stem contains a physiologic emergency, a suicidal plan with available means, command hallucinations directing harm, or escalating violence. Otherwise, choose the open-ended response that stays with the client's feeling.

;Three limits to confidentiality the nurse must disclose during orientation
:Serious threat of harm to self, serious threat of harm to an identifiable other (duty to warn and protect, the Tarasoff principle), and suspected abuse or neglect of a child or vulnerable adult. Court orders also compel disclosure.