A nurse is caring for a patient with bipolar disorder who is in a manic phase and refuses to attend a scheduled group therapy session. Which response by the nurse best promotes therapeutic engagement?

Choice A reason: Mood stabilizers, like lithium, are used for bipolar disorder to regulate mood swings, not for acute anxiety. They target long-term mood stabilization, not immediate symptom relief, which is critical for post-traumatic anxiety, making this category inappropriate for the patient’s condition.

Choice B reason: Antidepressants, such as SSRIs, treat depression and chronic anxiety over weeks, not acute anxiety. Their delayed onset makes them unsuitable for immediate relief following a traumatic event like a car accident, where rapid symptom management is needed, making this choice incorrect.

Choice C reason: Antipsychotics treat psychosis or severe agitation, not primary anxiety. Their use in anxiety is off-label and typically reserved for cases unresponsive to anxiolytics, with higher side effect risks. This makes them inappropriate for acute anxiety management, rendering this choice incorrect.

Choice D reason: Anxiolytics, like benzodiazepines, provide rapid relief for acute anxiety by enhancing GABA activity, calming the central nervous system. They are the primary choice for short-term management of anxiety post-trauma, aligning with clinical guidelines, making this the correct medication category for patient teaching.

Choice A reason: Asking if the client felt this way before hospitalization focuses on past feelings, which may not address the current emotional state or therapeutic needs. While it gathers history, it lacks empathy and does not encourage the client to elaborate on their current concerns, making it less therapeutic.

Choice B reason: Reflecting the client’s statement by asking if they feel the setting is wrong demonstrates active listening and empathy, key components of therapeutic communication. It encourages the client to express feelings, fostering trust and exploration of their concerns, aligning with psychiatric nursing principles, making this the correct choice.

Choice C reason: Suggesting the client discuss concerns later with a doctor dismisses their current emotional state, potentially undermining trust in the nurse-client relationship. It avoids immediate engagement and fails to address the client’s feelings, which is critical in psychiatric care, making this response non-therapeutic and incorrect.

Choice D reason: Labeling the client’s statement as inappropriate is judgmental and dismissive, hindering therapeutic communication. It may increase the client’s sense of alienation or shame, contrary to psychiatric nursing goals of building trust and validating feelings. This response is non-therapeutic and does not support the client’s emotional needs.