Which therapeutic communication technique is being used when the nurse says, 'Tell me more about what you are feeling right now'?

Correct Answer: D

Rationale: The correct answer is D: Exploration. This therapeutic communication technique encourages the patient to expand on their feelings, promoting exploration of thoughts and emotions. By asking the patient to elaborate on their feelings, the nurse facilitates deeper understanding. Restating (A) involves repeating the patient's words back to them. Clarification (B) is seeking to understand the patient's meaning. Reflection (C) involves mirroring the patient's emotions. In this scenario, the nurse is prompting the patient to delve further into their emotions, making exploration the most appropriate technique.

Correct Answer: C

Rationale: The correct answer is C: Difficulty sleeping. This finding is most concerning because it can indicate severe depression or potential suicidal ideation. Insomnia is a common symptom of major depressive disorder and can exacerbate the patient's condition. It is important to address sleep disturbances promptly to prevent further deterioration. Rationale for why other choices are incorrect: A: Decreased interest in activities is a common symptom of major depressive disorder but may not necessarily indicate immediate risk. B: Feelings of worthlessness are also common in depression but may not be as urgent as sleep disturbances. D: Changes in appetite can be a symptom of depression, but difficulty sleeping poses a more immediate concern for potential harm to the patient's well-being.

Correct Answer: B

Rationale: The correct answer is B: Duloxetine. Duloxetine is a serotonin-norepinephrine reuptake inhibitor used to treat both major depressive disorder and neuropathic pain by increasing the levels of these neurotransmitters in the brain. Gabapentin (A) is primarily used for neuropathic pain, Amitriptyline (C) is a tricyclic antidepressant used for depression and neuropathic pain, and Tramadol (D) is an opioid analgesic used for pain management but not typically for major depressive disorder.

Correct Answer: D

Rationale: The correct answer is D: Nausea. Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat OCD. Nausea is a common side effect of SSRI medications due to their impact on serotonin levels in the gastrointestinal tract. This can lead to stomach upset and feelings of nausea. Increased appetite (A) and weight gain (C) are more commonly associated with other types of medications, such as antipsychotics or mood stabilizers. Dry mouth (B) is a side effect seen with some antidepressants, but it is not a common side effect of fluvoxamine.

Correct Answer: D

Rationale: The correct answer is D, developing a safety plan with the patient. This intervention is crucial for addressing self-harm behaviors in patients with borderline personality disorder. A safety plan helps the patient identify triggers, warning signs, coping strategies, and support networks to prevent self-harm. It also outlines specific steps to take in a crisis situation. This intervention is more direct and practical compared to the other options. A: Keeping a journal may be helpful for self-reflection but may not provide immediate strategies to prevent self-harm. B: Setting boundaries is important but may not directly address self-harm behaviors. C: Providing coping skills is beneficial, but a safety plan is more specific and tailored to managing self-harm risks. In summary, developing a safety plan is the most effective intervention for addressing self-harm behaviors in patients with borderline personality disorder.