# Situation: A 29-year-old man with schizophrenia was admitted voluntarily to the psychiatric ward of a provincial hospital 3 days ago. He hears voices, stays in his room most of the day, and speaks a regional language at home; he is also fluent in Filipino and English. A nursing student is assigned to him and writes a process recording of each interaction. In the process recording, the client says, "Everyone here avoids me." The student replies, "You're saying you feel lonely because your family does not visit." The student labels this response as reflecting. Which analysis by the clinical instructor is accurate?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630049  
> language: ko  
> subject: Nursing Practice V — Care of Clients with Maladaptive Patterns of Behavior; Care of Clients with Life-Threatening Conditions, Acute Multi-Organ Problems, High Acuity and Emergency Situations

## 문제

Situation: A 29-year-old man with schizophrenia was admitted voluntarily to the psychiatric ward of a provincial hospital 3 days ago. He hears voices, stays in his room most of the day, and speaks a regional language at home; he is also fluent in Filipino and English. A nursing student is assigned to him and writes a process recording of each interaction.

In the process recording, the client says, "Everyone here avoids me." The student replies, "You're saying you feel lonely because your family does not visit." The student labels this response as reflecting. Which analysis by the clinical instructor is accurate?

## 보기

1. It is clarifying, as it checks what he means by everyone
2. It is interpreting, as it adds a cause that he never stated **✔ 정답**
3. It is reflecting, as it names his feeling of loneliness
4. It is presenting reality, as it names the real cause of his view

**정답: 2**

## 해설

Interpreting imposes the nurse's own meaning on what the client said and is nontherapeutic. The client spoke only of others avoiding him; the student added a feeling he did not express and a cause (his family not visiting) that he never mentioned. Reflecting returns a feeling the client actually conveyed, and clarifying asks the client to explain, so the student should ask rather than tell.

## 심화 해설

The reply adds what the client never said
The client says, "Everyone here avoids me." The student replies, "You're saying you feel lonely because your family does not visit," and labels this as reflecting. The reply supplies both a feeling the client did not express and a cause he never mentioned, which makes it interpreting, a nontherapeutic response. Interpreting imposes the nurse's own meaning on the client's words and can leave the client feeling misunderstood or pushed toward the nurse's view.

Why it is not reflecting
Reflecting returns a feeling that the client actually conveyed, through words or nonverbal cues, so that he can examine it. For example, if the client looked sad and said everyone avoids him, a reflecting response might be, "You sound hurt that people here avoid you." The student went further: the idea of loneliness and the explanation about the family both came from the student. Once the nurse adds content the client did not give, the response is no longer reflection.

| Response | Technique | Therapeutic? |
| --- | --- | --- |
| "You feel lonely because your family does not visit." | Interpreting | No |
| "You sound hurt that people avoid you." | Reflecting | Yes, if the feeling was conveyed |
| "Who do you mean by everyone?" | Clarifying | Yes |
| "I see staff and others talking with you each day." | Presenting reality | Yes, if factual |

Why the other analyses are wrong
Clarifying is a question that asks the client to explain a vague word such as "everyone"; the student made a statement, not a request. Presenting reality offers observable facts about the environment without arguing; the student offered an unverified cause, not a fact about the ward. A better response would ask, "Who has been avoiding you?" or "Tell me more about that," letting the client supply his own meaning.

Watch out! With a client who has schizophrenia and may be suspicious, interpreting is especially risky. It can feel intrusive and increase distrust. Ask rather than tell.

Exam takeaway
Key point! If the nurse's reply adds a meaning, feeling, or cause the client did not express, it is interpreting, which is nontherapeutic. Reflecting returns only what the client conveyed; clarifying asks the client to explain.

## 임상 시나리오

Interpreting Versus ReflectingAnalyzing a student's response
"You're saying you feel lonely because your family does not visit" adds a feeling and a cause the client never gave. This is interpreting, which is nontherapeutic.

Reflecting returns only the feeling the client conveyed. Clarifying asks him to explain, for example, "Who has been avoiding you?"

Ask rather than tell, so the client supplies his own meaning.

CautionInterpreting can feel intrusive to a suspicious client and increase distrust.

## 핵심 개념

- **Interpreting** — A nontherapeutic response that imposes the nurse's meaning or explanation on the client's words.
- **Reflecting** — Returning a feeling the client actually expressed so he can examine it.
- **Clarifying** — Asking the client to explain a vague or unclear statement.
- **Presenting reality** — Offering observable facts about the environment without arguing with the client.

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