A nurse works with a patient to establish goals/outcomes. The nurse believes that one outcome suggested by the patient is not in the patient’s best interest. What is the nurse’s best action?

Choice A reason: Socialization and mutual needs define social relationships, not therapeutic ones. Therapeutic relationships focus on patient needs, like addressing serotonin-driven depression, not reciprocal sharing. This approach risks blurring professional boundaries, making it incorrect for psychiatric nursing’s patient-centered focus.

Choice B reason: Mutual growth and satisfaction characterize social partnerships, not therapeutic relationships. In psychiatric care, the focus is on patient recovery, addressing issues like dopamine imbalances, not nurse satisfaction. This option misaligns with the professional, patient-centered nature of therapeutic relationships.

Choice C reason: The therapeutic relationship centers on the patient, addressing issues like amygdala-driven anxiety through collaborative discussion. Solutions, like medication adherence, are patient-driven to promote autonomy, aligning with neurobiological and psychological recovery principles, making this the correct description of the therapeutic dynamic.

Choice D reason: Shifting focus and mutual advice blur professional boundaries, resembling social relationships. Therapeutic relationships prioritize patient needs, like serotonin stabilization, with nurse guidance, not reciprocal advice. This option misrepresents the patient-centered, evidence-based nature of psychiatric therapeutic relationships.

Choice A reason: This question verifies the nurse’s interpretation, ensuring accurate understanding of concerns linked to emotional dysregulation, possibly from serotonin imbalances. It promotes therapeutic communication, engaging prefrontal cortex processing to clarify patient emotions, reducing miscommunication and fostering trust in psychiatric interactions.

Choice B reason: Asking for common elements seeks patterns, not clarification of specific concerns. Emotional concerns, tied to amygdala hyperactivity, require precise understanding. This question is too vague, risking misinterpretation of neurobiological emotional cues, making it less effective for therapeutic clarification in psychiatric care.

Choice C reason: Requesting a full recount is inefficient and may overwhelm patients with anxiety or cognitive deficits, like those from dopamine dysregulation. Clarification needs targeted questions to confirm specific concerns, not a broad restart, making this approach inappropriate for effective therapeutic communication.

Choice D reason: Asking to repeat experiences may frustrate patients and fail to clarify specific points. Emotional concerns, linked to stress-induced cortisol spikes, need focused verification. This vague request risks missing neurobiological nuances, making it less effective than direct confirmation for therapeutic clarification.