A client has been on the nursing unit for a few weeks because of complications after surgery, including the need for extensive wound care. During the last dressing change before discharge to home with home health services, the client becomes angry and says, “You don’t have to be so careful. I’m being sent home anyway!” Which response, if made by the nurse WOULD NOT be therapeutic? Select one answer
“I hear frustration or perhaps anger in your voice. Could you tell me more about how you are feeling right now?”
“It sounds as though you are nervous about going home, but the wound care nurse who will see you also uses excellent technique I am sure your wound will continue to heal.”
“Do you have any concerns about what will happen after discharge that you would like to talk about?”
“Many people who have been in the hospital for an extended period have mixed feelings about going home. Can you tell me how you are feeling about discharge?”
The Correct Answer is B
Choice A reason: “I hear frustration or perhaps anger in your voice. Could you tell me more about how you are feeling right now?” is a therapeutic response, not a non-therapeutic one. This response shows active listening, which is a communication skill that involves hearing, understanding, and responding to the client’s verbal and nonverbal messages. It also shows empathy, which is the ability to understand and share the feelings of another person. It acknowledges and validates the client’s emotions, and invites them to express their concerns or fears. Therefore, this choice is incorrect.
Choice B reason: “It sounds as though you are nervous about going home, but the wound care nurse who will see you also uses excellent technique I am sure your wound will continue to heal.” is a non-therapeutic response, not a therapeutic one. This response shows false reassurance, which is a communication technique that involves minimizing or dismissing the other person’s feelings or situation. It also shows assumption, which is a communication barrier that involves making judgments or guesses about what the other person thinks or feels. It does not address the client’s emotions or needs, and may sound vague or insincere. Therefore, this choice is correct.
Choice C reason: “Do you have any concerns about what will happen after discharge that you would like to talk about?” is a therapeutic response, not a non-therapeutic one. This response shows open-ended questioning, which is a communication technique that involves asking questions that require more than a yes or no answer. It also shows support, which is a communication technique that involves providing emotional or practical assistance to the client, and helping them cope with their situation or problem. It encourages the client to share their thoughts and feelings, and shows that the nurse is interested, supportive, and empathetic. Therefore, this choice is incorrect.
Choice D reason: “Many people who have been in the hospital for an extended period have mixed feelings about going home. Can you tell me how you are feeling about discharge?” is a therapeutic response, not a non-therapeutic one. This response shows generalization, which is a communication technique that involves using statements that apply to most people in similar situations. It also shows reflection, which is a communication technique that involves restating or paraphrasing what the client has said to show understanding and clarify meaning. It helps the client to feel less alone or isolated, and to explore their own feelings or thoughts. Therefore, this choice is incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: “Where do you hurt?” is not the best response to the PN’s observations. This response shows closed-ended questioning, which is a communication technique that involves asking questions that require a yes or no answer or a specific piece of information. It also shows confrontation, which is a communication technique that involves challenging or opposing the other person’s statements or behaviors. It may make the client feel defensive, pressured, or misunderstood, and may discourage further communication. Therefore, this choice is incorrect.
Choice B reason: "I am glad you are feeling beter and have no discomfort.” is not the best response to the PN’s observations. This response shows false reassurance, which is a communication technique that involves minimizing or dismissing the other person’s feelings or situation. It also shows inconsistency, which is a communication barrier that involves giving contradictory or conflicting messages. It may make the client feel confused, ignored, or invalidated, and may undermine the trust or rapport between the client and the PN. Therefore, this choice is incorrect.
Choice C reason: "What you are saying and what I am observing don’t seem to match.” is the best response to the PN’s observations. This response shows reflection, which is a communication technique that involves restating or paraphrasing what the client has said to show understanding and clarify meaning. It also shows congruence, which is a communication skill that involves using consistent verbal and nonverbal cues to reinforce the message and avoid confusion or misunderstanding. It helps the client to recognize and explore their own feelings or thoughts, and shows that the PN is atentive, respectful, and empathetic. Therefore, this choice is correct.
Choice D reason: "It makes me uncomfortable when you are not honest with me.” is not the best response to the PN’s observations. This response shows self-disclosure, which is a communication technique that involves sharing personal information or feelings with the other person. It also shows accusation, which is a communication barrier that involves blaming or criticizing the other person for their statements or behaviors. It may make the client feel
guilty, ashamed, or angry, and may damage the relationship or communication between the client and the PN. Therefore, this choice is incorrect.
Correct Answer is C
Explanation
Choice A reason: Be silent as a sign of compassion is not an appropriate action for the nurse to take when a client bursts into tears. Silence can be misinterpreted as indifference, disapproval, or rejection, and it can make the client feel more isolated or uncomfortable. Therefore, this choice is incorrect.
Choice B reason: Continue with the physical preparation of the client is not an appropriate action for the nurse to take when a client bursts into tears. Continuing with the task without acknowledging the client’s emotional state can be perceived as insensitive, uncaring, or disrespectful, and it can increase the client’s anxiety or distress. Therefore, this choice is incorrect.
Choice C reason: Ask the client to share what she is feeling is an appropriate action for the nurse to take when a client bursts into tears. Asking open-ended questions can encourage the client to express her emotions, concerns, or fears, and it can show that the nurse is interested, supportive, and empathetic. It can also help the nurse to identify the source of the client’s distress and provide appropriate interventions or referrals. Therefore, this choice is correct.
Choice D reason: Pull the curtain and leave the area to provide privacy is not an appropriate action for the nurse to take when a client bursts into tears. Leaving the client alone can make her feel abandoned, ignored, or unimportant, and it can prevent the nurse from providing emotional support or assistance. Therefore, this choice is incorrect.
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