Which individual is demonstrating the highest level of resilience?

Choice A reason: Dismissing the patient’s feelings by saying they will leave is non-therapeutic, as it invalidates their emotions. Therapeutic communication requires empathy and exploration of feelings, not reassurance that may feel dismissive, as it fails to address the patient’s underlying concerns, making this choice incorrect.

Choice B reason: Encouraging effort with a promise of discharge is overly optimistic and may pressure the patient, ignoring their emotional state. Therapeutic responses focus on understanding feelings, not conditional reassurance, which can undermine trust in psychiatric care, making this response non-therapeutic and incorrect.

Choice C reason: Generalizing the patient’s feelings as common minimizes their unique experience, reducing therapeutic engagement. It fails to explore the patient’s specific concerns or foster a trusting nurse-patient relationship, which is critical in mental health care, making this response non-therapeutic and incorrect.

Choice D reason: Reflecting the patient’s statement by exploring perceived lack of progress demonstrates active listening and empathy, key to therapeutic communication. It encourages the patient to elaborate on feelings, fostering trust and insight, aligning with psychiatric nursing principles, making this the most therapeutic and correct

Choice A reason: Trust versus mistrust, Erikson's first psychosocial stage (0–1 year), focuses on developing trust in caregivers for basic needs. Failure leads to fear and suspicion, not feelings of worthlessness or insignificance. These symptoms do not align with the adult’s statements about opinions not counting, making this choice scientifically inaccurate for the described crisis.

Choice B reason: Autonomy versus shame and doubt, Erikson’s second stage (1–3 years), involves gaining independence in actions like self-care. Failure results in shame and self-doubt about autonomy, not a broader sense of worthlessness or lack of influence. This stage is unrelated to the adult’s expressed feelings, rendering this choice incorrect.

Choice C reason: Initiative versus guilt, the third stage (3–6 years), centers on initiating activities and asserting control. Failure leads to guilt over actions, not a diminished sense of self-worth or influence. The adult’s statements reflect identity struggles, not guilt from initiative, so this choice does not fit the psychosocial crisis described.

Choice D reason: Identity versus role confusion, Erikson’s fifth stage (12–18 years), involves forming a cohesive self-identity. Failure leads to role confusion, low self-esteem, and feelings of insignificance, directly aligning with the adult’s statements about having no answers and opinions not counting. This unresolved crisis persists into adulthood, making this the correct choice.