The nurse is caring for a client diagnosed with catatonia. Which of the following should be a priority action by the nurse?

Choice A reason:

Associative looseness refers to a disorganized thought process where connections between ideas are unclear or illogical. The use of the word "flakala" does not demonstrate a loose association between ideas but rather the creation of a new word.

Choice B reason:

Tangentiality occurs when a person goes off on a tangent and does not return to the original topic. In this case, the client is not going off on a tangent but is repeatedly using a made-up word, which is indicative of neologism.

Choice C reason:

Neologism is the creation of new words that others may not understand. The client's use of "flakala" fits this definition, as it appears to be a word created by the client that is not part of standard language¹. This can be a sign of disorganized thinking, where the client's internal thoughts do not align with conventional language patterns.

Choice D reason:

Circumstantiality involves providing unnecessary detail that makes communication less efficient but eventually returns to the original point. The client's statement does not include unnecessary details; it is the repetition of a newly created word, suggesting neologism.

Choice A Reason:
Providing sympathy can be comforting, but it may not always be conducive to establishing a therapeutic relationship. Sympathy involves feeling pity for someone else's misfortune, which can sometimes create a power imbalance or imply that the nurse sees the client as unable to cope. In contrast, empathy, which is understanding and sharing the feelings of another, is more aligned with therapeutic communication principles.

Choice B Reason:
Focusing on the words of the clients is important, but it is only one aspect of communication. Therapeutic relationships are built on understanding the full context of communication, including non-verbal cues and emotional undertones. Active listening involves not just hearing words, but also interpreting the message being conveyed and responding appropriately.

Choice C Reason:
Controlling the pace of establishing nurse-client relationships might be necessary in certain situations, but it should not be the primary action. Each client is unique, and the development of a therapeutic relationship will vary depending on individual needs and circumstances. The nurse should be flexible and patient, allowing the relationship to develop naturally.

Choice D Reason:
Demonstrating genuineness when communicating is fundamental to building trust and rapport, which are essential components of a therapeutic relationship. Genuineness involves being open, honest, and sincere. When nurses are genuine, clients are more likely to feel respected and understood, leading to a stronger therapeutic alliance.