A nurse is caring for patients receiving clozapine, lithium, fluoxetine, and venlafaxine. Which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance?

Choice A reason: Silence in group therapy provides space for reflection, allowing members to process emotions and thoughts. This supports therapeutic goals by fostering insight and self-awareness, aligning with psychiatric principles of facilitating emotional processing, making this the correct choice.

Choice B reason: Silence does not encourage immediate verbal responses; it promotes contemplation. Encouraging quick responses may pressure participants, disrupting therapeutic processing, which relies on reflective pauses, making this statement contrary to the therapeutic use of silence and incorrect.

Choice C reason: Using silence to discipline is punitive, not therapeutic. Silence in therapy aims to facilitate reflection, not control behavior, which contradicts psychiatric nursing principles of fostering a supportive environment, making this choice incorrect and non-therapeutic.

Choice D reason: Silence complements, not replaces, active listening. Active listening involves verbal and nonverbal engagement, while silence provides reflective space. Replacing listening with silence undermines therapeutic communication, making this statement incorrect for the role of silence in therapy.

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.