The nurse is asking a diagnosed schizophrenic patient how they slept and they respond, "This is a new day in May and I can't wait to play." Which communication pattern does the nurse identify?

The correct answer is Choice B.

Choice A rationale: Phase IV is not a recognized phase in the cycle of battering. Typically, the cycle of battering consists of three phases: tension-building, acute battering, and honeymoon phase. Each phase has distinct characteristics.

Choice B rationale: Phase I, the tension-building phase, is characterized by increased tension, irritability, and frustration in the abuser. The victim may sense the abuser's declining tolerance for frustration, leading them to try to avoid confrontation by staying out of the abuser's way.

Choice C rationale: Phase III is the honeymoon phase, where the abuser may apologize, show remorse, and be affectionate. The victim may feel hopeful for change. However, this does not match the described behavior of increasing frustration and anger with quick apologies.

Choice D rationale: This is a duplicate of Choice B. As previously stated, Phase I, the tension-building phase, involves the buildup of tension and irritability in the abuser, leading the victim to try to stay out of the abuser's way to avoid conflict.

The correct answer is choice A: Set limits for the relationship.

Choice A rationale:

Setting limits for the therapeutic relationship (Choice A) is an essential nursing action. Boundaries help create a safe and structured environment, ensuring that both the nurse and client maintain appropriate roles. Limits prevent overstepping boundaries that could compromise the therapeutic alliance.Setting limits for the relationship is an essential part of establishing a therapeutic relationship in a mental health setting. This helps to maintain professional boundaries and ensures that the relationship remains focused on the client’s needs and therapeutic goals.

Choice B rationale:

Engaging in affectionate interactions with the client (Choice B) is not appropriate in a therapeutic relationship. Professionalism and maintaining appropriate boundaries are crucial in psychiatric nursing. Affectionate interactions could blur the lines between the therapeutic relationship and personal relationships, potentially harming the client's progress.

Choice C rationale:

Promoting the use of transference by the client (Choice C) is not a suitable approach. Transference occurs when a client projects feelings and emotions onto the nurse based on past experiences. While it can be valuable to explore transference, actively promoting it could lead to confusion and misunderstandings in the therapeutic relationship.

Choice D rationale:

Instructing the client on how they should behave (Choice D) is contrary to the principles of a therapeutic relationship. The therapeutic relationship is client-centered, where the nurse supports the client's self-discovery and growth. Directing the client's behavior undermines their autonomy and inhibits their progress.