(Select all that apply): A nurse is establishing a therapeutic relationship with a patient at risk for suicide. Which of the following skills should the nurse use to build rapport and trust with the patient? 

Choice B:

Encouraging active patient involvement.

Choice D:

Reflecting the patient's feelings and thoughts.

Choice A rationale:

Closed-ended questions often limit conversation and do not encourage deeper exploration of feelings or thoughts. In a therapeutic relationship with a patient at risk for suicide, the focus should be on open communication and building trust, which is not achieved through the use of closed-ended questions. Therefore, this choice is not suitable for building rapport and trust.

Choice B rationale:

Encouraging active patient involvement is crucial for establishing a therapeutic relationship. It empowers the patient to share their thoughts, concerns, and feelings openly. This choice promotes a sense of collaboration and trust between the nurse and the patient, creating a safe space for discussing sensitive topics like suicidal thoughts.

Choice C rationale:

Imposing personal opinions can create a power imbalance and hinder the therapeutic relationship. Patients should feel that their thoughts and feelings are respected and valued. Imposing personal opinions could alienate the patient and undermine the trust-building process.

Choice D rationale:

Reflecting the patient's feelings and thoughts involves active listening and showing empathy. This technique validates the patient's emotions and experiences, fostering a sense of understanding and trust. Reflecting feelings and thoughts demonstrates that the nurse is genuinely engaged and interested in the patient's perspective.

Choice E rationale:

Disregarding the patient's preferences goes against the principles of patient-centered care and building a therapeutic relationship. The patient's preferences and needs should be acknowledged and respected to establish trust and rapport. Disregarding preferences can lead to feelings of invalidation and hinder the development of a meaningful connection.

The correct answer is B. Reflecting back the patient’s feelings and thoughts and D. Encouraging patient involvement in decision making.

Choice A rationale:

Asking close-ended questions is not effective in building rapport and trust. Close-ended questions can limit the patient’s ability to express their feelings and thoughts, which is crucial in understanding their mental state and providing appropriate support.

Choice B rationale:

Reflecting back the patient’s feelings and thoughts helps in validating their emotions and shows that the nurse is actively listening and empathetic. This technique fosters trust and encourages the patient to open up more about their feelings.

Choice C rationale:

Imposing personal views and opinions can be detrimental to the therapeutic relationship. It can make the patient feel judged or misunderstood, which can hinder open communication and trust.

Choice D rationale:

Encouraging patient involvement in decision making empowers the patient and promotes a sense of control over their situation. This collaborative approach can enhance the therapeutic relationship and support the patient’s autonomy.

Choice E rationale:

Disregarding patient preferences is counterproductive in establishing a therapeutic relationship. It can lead to feelings of disrespect and neglect, which can further isolate the patient and exacerbate their risk.