When using cognitive behavioral theory with an anxious, withdrawn patient, interventions should focus on which of the following?

Choice A reason: Direct questions like "Did you feel angry?" may elicit specific information but can feel confrontational, limiting open dialogue. They focus on the nurse’s agenda rather than signaling attentive listening, which is critical for therapeutic communication in mental health, making this choice less effective.

Choice B reason: Asking "Why did you do that?" can seem judgmental, causing defensiveness and hindering open communication. It shifts focus to justification rather than fostering a safe space for the patient to share feelings, making it non-therapeutic and incorrect for showing listening interest.

Choice C reason: Maintaining eye contact and nodding are nonverbal cues that demonstrate active listening and empathy, encouraging patients to share openly. These align with therapeutic communication principles in psychiatric nursing, creating a supportive environment and fostering trust, making this the correct choice for showing interest.

Choice D reason: Offering advice based on personal experience shifts focus to the nurse, undermining the patient’s perspective. It risks blurring professional boundaries and is non-therapeutic, as it does not prioritize the patient’s feelings or encourage open dialogue, making this choice incorrect.

Choice A reason: Discussing patient history with staff during care planning is permissible under HIPAA for treatment purposes. It ensures coordinated care within the healthcare team, not violating privacy, as it is limited to professional need-to-know, making this choice incorrect.

Choice B reason: Documenting daily behavior is standard practice in medical records for treatment continuity and legal documentation. It is protected under confidentiality laws and does not breach privacy when restricted to authorized personnel, making this choice incorrect for a privacy violation.

Choice C reason: Releasing information to an employer without consent violates HIPAA, which mandates patient authorization for disclosures outside treatment, payment, or operations. This breaches confidentiality, compromising the patient’s right to privacy, making this the correct choice for a privacy violation.

Choice D reason: Asking family for pre-hospitalization information is appropriate if done with patient consent or legal justification, such as assessing history for treatment. Without evidence of unauthorized disclosure, this does not inherently breach privacy, making this choice incorrect.