PNLE 2025–2026 Psychiatric Nursing & Therapeutic Communication Techniques (High-Yield Flipbook Reviewer)

Defense Mechanisms & Therapeutic Rules: GOLDEN RULES OF THERAPEUTIC COMMUNICATION: 1. Never ask "WHY?" (Accusatory and provokes defensiveness). 2. Never give false reassurance ("Everything will be okay"). 3. Never pass judgment or agree/disagree with hallucinations. 4. Acknowledge the client's underlying feeling, then orient to reality: "I don't see the spiders on the wall, but I understand that seeing them is terrifying for you." 5. Explore and clarify: "Tell me more about what you are experiencing." ---------------------------------------- PRACTICE BOARD QUESTION & RATIONALE: Q: A client diagnosed with paranoid schizophrenia tells the nurse, 'The FBI has placed a microphone in my water pitcher to record my thoughts.' Which response by the nurse is most therapeutic? A. 'You know that is impossible; hospitals do not allow microphones in rooms.' B. 'Why do you believe the government is spying on you?' C. 'It must feel very frightening to think you are being recorded, but there are no microphones here.' D. 'I will change your water pitcher so you feel safer.' Correct Answer: C. This response validates the client's emotional state ('It must feel very frightening') without validating the delusional belief, and calmly presents reality without arguing.