A nurse is reviewing the DSM-5 diagnostic criteria for schizophrenia. Which of the following symptoms must be present for a client to be diagnosed with schizophrenia? (Select all that apply.)

Choice A reason:

A teenager who refuses to participate in the planned therapy does not necessarily meet the criteria for involuntary commitment. Refusal to participate in therapy can be addressed through other means, such as motivational interviewing or adjusting the treatment plan to better engage the client.

Choice B reason:

A 24-year-old client who refuses to take the prescribed medication also does not automatically qualify for involuntary commitment. Non-compliance with medication can be managed through education, support, and exploring the reasons behind the refusal. Involuntary commitment is typically reserved for situations where the client poses a danger to themselves or others.

Choice C reason:

A 45-year-old client who is homeless and has been diagnosed with a mental disorder may need support and resources, but homelessness and a mental health diagnosis alone do not justify involuntary commitment. The focus should be on providing housing and mental health services rather than involuntary hospitalization.

Choice D reason:

An elderly client who is confused, screaming obscenities in the street, and disturbing neighbors is exhibiting behavior that may pose a risk to themselves or others. This situation suggests a level of acute distress or potential danger that could warrant involuntary commitment to ensure the client’s safety and provide necessary treatment.

Choice A reason:

Having an empathetic relationship with the client is important, but it is not the most important principle. Empathy helps build trust and rapport, but the primary focus should always be on the client’s needs and experiences.

Choice B reason:

The client being the primary focus of the interaction is the most important principle in therapeutic communication. This ensures that the nurse’s attention and efforts are directed towards understanding and addressing the client’s concerns, promoting their well-being and recovery.

Choice C reason:

Self-disclosure by the nurse should be used sparingly and only when it benefits the client. While it can help build rapport, it is not the primary focus of therapeutic communication. The nurse’s primary role is to listen and support the client.

Choice D reason:

Recording the client’s conversations is not a standard practice in therapeutic communication and can breach confidentiality. The focus should be on creating a safe and trusting environment where the client feels comfortable sharing their thoughts and feelings.