A female client with severe depression is about to be discharged from an inpatient mental health unit.

The client’s highest level of education is seventh grade, and she reads at a fifth-grade level.

The nurse is giving her discharge instructions.

Which instruction is most appropriate for this client?

Choice A rationale
A therapeutic area refers to a specific location or setting where therapeutic activities or treatments occur. However, it doesn’t necessarily imply a comprehensive environment designed to assist patients in replacing inappropriate behaviors with more effective personal and psychosocial skills.
Choice B rationale
A therapeutic environment, also known as a therapeutic milieu, is a broad term that describes settings designed to help patients replace inappropriate behaviors with more effective personal and psychosocial skills.
Choice C rationale
A therapeutic unit could refer to a specific department or team within a healthcare facility that provides therapeutic services. However, it doesn’t necessarily denote an environment designed for behavioral and psychosocial skill development.
Choice D rationale
A therapeutic setting could refer to any location where therapeutic services are provided. It’s a more general term and doesn’t specifically denote an environment designed to help patients replace inappropriate behaviors with more effective personal and psychosocial skills.

Choice A rationale
Rejecting is a non-therapeutic communication technique where the nurse refuses to discuss certain topics with the patient. In this case, the nurse telling the patient not to talk about her history of childhood sexual abuse is an example of rejecting. This approach can make the patient feel unheard or invalidated, which can hinder the therapeutic relationship and impede the patient’s healing process.
Choice B rationale
Providing inadequate responses is another non-therapeutic communication technique. It involves giving vague or insufficient responses to the patient’s concerns or questions. However, in this scenario, the nurse is not providing an inadequate response but rather refusing to engage in the conversation altogether, which is more aligned with rejecting.
Choice C rationale
Being judgmental is a non-therapeutic communication technique where the nurse makes negative judgments or evaluations about the patient. In this scenario, the nurse is not making any judgments about the patient or her experiences. Instead, the nurse is avoiding the topic, which is indicative of rejecting.
Choice D rationale
Failing to probe is a non-therapeutic communication technique that involves not seeking further information from the patient, thereby missing important details. While the nurse in this scenario is not seeking more information about the patient’s history, the behavior is more accurately described as rejecting because the nurse is actively discouraging the patient from discussing her experiences.