病人對護理師說：「我是美國總統，我需要召集內閣會議。」護理師的哪項回應具有治療性？
A client tells the nurse, 'I am the President of the United States, and I need to call a meeting of my cabinet.' Which response by the nurse is therapeutic?
- AI understand you believe you are the President, but I am your nurse.✓ 正解我了解您認為自己是總統，但我是您的護理師。
- BYou are not the President; you are in a hospital.您不是總統；您在醫院裡。
- CWait until the other clients hear this; they won't believe you.等其他病友聽到這個，他們不會相信你的。
- DIf you are the President, why are you wearing a hospital gown?如果你是總統，你為什麼穿著病號服？
在精神科護理中，當病人出現妄想（delusions）時，護理師的回應方式對建立治療關係和確保病人安全至關重要。妄想對病人而言是真實的，直接反駁或嘲笑病人的信念會破壞信任，加劇病人的焦慮和退縮，甚至可能導致激動或暴力行為。治療性溝通的目標是既要尊重病人的感受，又要溫和地引導他們回到現實，同時避免激化矛盾。 正確答案 A：「我理解您相信您是總統，但我是您的護理師（I understand you believe you are the President, but I am your nurse.）」是最具治療性的回應。這種回應首先承認了病人的感受和信念（「我理解您相信您是總統」），這是一種驗證（validation）而非認同（agreement），讓病人感到被傾聽和尊重。接著，護理師溫和而堅定地重申現實（「但我是您的護理師」），將對話拉回當下的情境和護病關係，這稱為「呈現現實（presenting reality）」。這種方式避免了直接爭辯，同時也避免了認同妄想，有助於維護治療性關係，並逐步幫助病人與現實建立連結。
In psychiatric nursing, when a client experiences delusions, the nurse's response is critical to establishing a therapeutic relationship and ensuring client safety. Delusions are real to the client, and directly contradicting or ridiculing them undermines trust, increases anxiety and withdrawal, and may even provoke agitation or violent behavior. The goal of therapeutic communication is to respect the client's feelings while gently guiding them back to reality, without escalating the conflict. Correct answer A, 'I understand you believe you are the President, but I am your nurse,' is the most therapeutic response. It first acknowledges the client's feelings and beliefs ('I understand you believe you are the President'), which is validation rather than agreement, helping the client feel heard and respected. The nurse then gently but firmly restates reality ('but I am your nurse'), bringing the conversation back to the current situation and the nurse-client relationship; this is called presenting reality. This approach avoids direct argument and avoids endorsing the delusion, helping to preserve the therapeutic relationship and gradually re-establishing the client's connection with reality.