Comprehensive exams for Mental Health Q 3
A psychotic client reports to the evening nurse that the day nurse put something suspicious in his water with his medication. The nurse replies, “You’re worried about your medication?” The nurse’s communication is:
A. An example of presenting reality
B. Reinforcing the client’s delusions
C. Focusing on emotional content
D. A non-therapeutic technique called mind-reading
Correct Answer: C. Focusing on emotional content
The nurse should help the client focus on the emotional content rather than delusional material. Sometimes during a conversation, patients mention something particularly important. When this happens, nurses can focus on their statement, prompting patients to discuss it further. Patients don’t always have an objective perspective on what is relevant to their case; as impartial observers, nurses can more easily pick out the topics to focus on.
Option A: Presenting reality isn’t helpful because it can lead to confrontation and disengagement. It’s frequently useful for nurses to summarize what patients have said after the fact. This demonstrates to patients that the nurse was listening and allows the nurse to document conversations. Ending a summary with a phrase like “Does that sound correct?” gives patients explicit permission to make corrections if they’re necessary.
Option B: Agreeing with the client and supporting his beliefs are reinforcing delusions. Patients often ask nurses for advice about what they should do about particular problems or in specific situations. Nurses can ask patients what they think they should do, which encourages patients to be accountable for their own actions and helps them come up with solutions themselves.
Option D: Mind reading isn’t therapeutic. Similar to active listening, asking patients for clarification when they say something confusing or ambiguous is important. Saying something like “I’m not sure I understand. Can you explain it to me?” helps nurses ensure they understand what’s actually being said and can help patients process their ideas more thoroughly