A nurse is caring for a group of clients in an acute mental health facility. Which of the following clients has the legal right to refuse treatment?

Choice A reason: Hysterical crying may indicate emotional distress but does not necessarily constitute a behavioral crisis unless it escalates to danger. It reflects an emotional response, not an immediate threat requiring urgent intervention, making it less severe than harm threats.

Choice B reason: Making threats to harm self and others indicates a behavioral crisis, signaling imminent danger due to a mental health condition. This requires immediate intervention to ensure safety, aligning with psychiatric emergency criteria, making this the correct choice.

Choice C reason: Nervous pacing suggests anxiety but does not inherently indicate a behavioral crisis. It lacks the immediate risk of harm to self or others, requiring monitoring but not urgent intervention, making this choice incorrect for a crisis scenario.

Choice D reason: Being wrapped in a blanket during group therapy suggests withdrawal or discomfort, not a behavioral crisis. It does not indicate imminent danger or severe behavioral dysregulation, making it an incorrect choice compared to explicit harm threats.

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.