A fearful patient has an increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter?

Choice A reason: Using coercive language, like stating attendance is mandatory for progress, undermines patient autonomy and may increase resistance, especially in a manic phase where defiance is common. This non-therapeutic approach hinders trust, making it incorrect for promoting engagement.

Choice B reason: Reporting refusal to the doctor without exploring the patient’s reasons dismisses their feelings and escalates authority rather than fostering collaboration. Therapeutic engagement requires understanding the patient’s perspective, making this response non-therapeutic and incorrect.

Choice C reason: Asking about the patient’s hesitation uses open-ended questioning, a therapeutic communication technique that encourages expression of feelings and builds trust. This aligns with psychiatric nursing principles to engage patients respectfully, especially during mania, making this the correct choice.

Choice D reason: Warning about missing treatment is mildly coercive and does not explore the patient’s reasons for refusal. It fails to address underlying concerns, such as anxiety or grandiosity, which are critical in mania, making this less therapeutic than exploring hesitancy.

Choice A reason: Focusing on the nurse’s experiences shifts attention from the patient, undermining therapeutic communication. This violates psychiatric nursing principles, which prioritize patient-centered dialogue to build trust and explore feelings, making this a non-therapeutic technique that disrupts effective mental health care.

Choice B reason: Making value judgments imposes the nurse’s beliefs on the patient, creating a judgmental environment. This hinders open communication, fosters defensiveness, and undermines trust, contrary to therapeutic communication goals in mental health nursing, making this a correct choice for non-therapeutic behavior.

Choice C reason: Giving advice assumes the nurse knows best, disempowering the patient and limiting self-exploration. Therapeutic communication encourages patients to find their own solutions, making advice-giving non-therapeutic, as it disrupts autonomy and trust, correctly identifying this as a non-therapeutic technique.

Choice D reason: Active listening, involving empathy and nonverbal cues, is a cornerstone of therapeutic communication. It fosters trust and validates patient feelings, essential in mental health care. This technique enhances therapeutic relationships, making it incorrect as a non-therapeutic communication example.