A patient diagnosed with schizophrenia had an exacerbation of hallucinations and delusions related to medication non-adherence and was hospitalized for 10 days. The patient is stabilized and discharge is planned. The patient’s family is concerned that the patient’s symptoms will return after discharge. Acting as an advocate for the patient’s rights, the nurse’s best response is:

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.

Choice A reason: Prolonged silences may cause withdrawal in some patients, as anxiety from serotonin or GABA imbalances can heighten discomfort. However, this does not guide silence’s use. Silence is therapeutic when timed appropriately, not avoided due to potential withdrawal, making this principle incorrect.

Choice B reason: Nurses breaking silences assumes discomfort, ignoring therapeutic benefits. Silence allows processing, potentially calming amygdala hyperactivity in anxiety. The nurse’s role is to use silence strategically, not to interrupt it routinely, making this principle misaligned with effective interview techniques.

Choice C reason: Silence facilitates reflection, allowing patients to process emotions, reducing stress via hypothalamic calming. In disorders like depression, it supports cognitive restructuring by giving time to integrate thoughts. This principle guides therapeutic silence, aligning with neurobiological benefits of reflective pauses in interviews.

Choice D reason: Silence does not inherently confirm understanding. It may allow emotional processing, but assuming it signals comprehension risks miscommunication. In conditions like anxiety, silence supports reflection, not validation, making this principle less accurate than reflection for guiding its therapeutic use.