A male adolescent patient is admitted to a mental health facility due to repeated school fights, multiple instances of running away, and theft from family members.

He has been diagnosed with a conduct disorder.

What history might the nurse expect to find in this patient?

Choice A rationale
Becoming helpless might be a response to a stressful situation or a symptom of a mental health disorder. However, it is not specifically a regressive response to the termination of a therapeutic relationship.
Choice B rationale
Returning to previous maladaptive behavior is a regressive response to the termination of a therapeutic relationship. It indicates a relapse into old, unhelpful patterns of behavior.
Choice C rationale
Bringing up new problems might indicate ongoing struggles or the emergence of new issues. However, it is not specifically a regressive response to the termination of a therapeutic relationship.
Choice D rationale
Denying caregiver’s help might indicate resistance or a lack of trust in the therapeutic process. However, it is not specifically a regressive response to the termination of a therapeutic relationship.

Choice A rationale
The nurse’s response of asking the client, “How do you feel about being discharged?” is the most therapeutic. This open-ended question encourages the client to express their feelings and concerns about being discharged. It allows the nurse to assess the client’s readiness for discharge and to provide appropriate education or referrals if needed. It also demonstrates empathy and respect for the client’s feelings, which are key components of a therapeutic relationship.
Choice B rationale
Telling the client, “I will send you a note in a few weeks,” is not the best response. While it may seem like a kind gesture, it could potentially blur the boundaries of the therapeutic relationship. Nurses must maintain professional boundaries with clients to ensure that the focus remains on the client’s needs and not the personal feelings or needs of the nurse.
Choice C rationale
Saying, “I know you will do well living out in the community,” is an assumption and does not invite the client to share their feelings or concerns. It’s important for the nurse to encourage the client to express their feelings about discharge and to provide support and education based on the client’s individual needs.
Choice D rationale
Asking the client, “Aren’t you excited about being discharged today?” is a closed-ended question that assumes the client is excited about discharge. This type of question does not encourage the client to share their feelings or concerns. It’s important for the nurse to use open-ended questions to encourage the client to express their feelings about discharge.