A client with end-stage alcoholic cirrhosis of the liver is hesitant to talk about the illness and the impending loss of life from their alcohol use disorder. Which action by the nurse can promote the client's ability to express their feelings?
Ask the client if they are in denial regarding the seriousness of their illness.
Be an active listener and use silence to facilitate communication.
Refer the client to the chaplain for religious counseling.
Inform the client that since it is too late to change, acceptance is inevitable.
The Correct Answer is B
Using active listening techniques and providing a supportive and non-judgmental environment can promote the client's ability to express their feelings. Many clients facing end-stage illnesses, such as alcoholic cirrhosis, may experience a range of emotions and find it difficult to talk about their illness or impending loss of life. By being present, attentive, and using silence when appropriate, the nurse allows the client the space and time they need to process their thoughts and emotions and feel comfortable expressing their feelings when they are ready.
Incorrect:
Option A may come across as confrontational and judgmental, which can hinder the client's willingness to share their feelings.
Option C may be appropriate if the client requests spiritual or religious support, but it should not be assumed as the primary intervention for promoting emotional expression.
Option D can be seen as dismissive and insensitive to the client's emotional needs, and it may not be helpful in encouraging the client to open up about their feelings.
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Correct Answer is D
Explanation
Explanation: This response demonstrates the use of therapeutic communication, specifically offering the client an opportunity to express their feelings and concerns in a non-confrontational manner. By suggesting a private and quiet area to talk to, the nurse provides a safe and supportive environment for the client to explore and process their emotions. This approach can help the client feel heard, validated, and understood, which may reduce their need to act out or engage in argumentative behaviors to express their feelings.
The other responses are not as effective or therapeutic:
A. Threatening the client with seclusion is an aggressive approach and may escalate the client's behavior or cause them to feel cornered and defensive, leading to further acting out.
B. Telling the client they have to take medication to stop their behavior does not address the underlying issues that may be causing their behavior. It can also come across as dismissive of the client's feelings and concerns.
C. Saying "I don't know what set you off today but you have to get along with others" may be perceived as dismissive and does not offer the client an opportunity to express their emotions or address their concerns.
In summary, offering a private space to talk and explore the client's feelings in a non-judgmental and supportive manner is the most beneficial therapeutic response to help the adolescent client decrease acting out behaviors and promote positive communication and coping skills.
Correct Answer is C
Explanation
The correct answer is c. Beneficence.
Choice A: Autonomy
Autonomy refers to the right of individuals to make decisions about their own lives and bodies. In the context of nursing, it means respecting a patient’s right to make their own healthcare decisions. However, in the case of seclusion due to loud and intrusive behavior, the primary concern is not about the patient’s decision-making capacity but rather the safety and well-being of the patient and others on the unit.
Choice B: Justice
Justice is the ethical principle that emphasizes fairness and equality. It involves ensuring that patients are treated fairly and that resources are distributed equitably. While justice is important in healthcare, it does not directly address the appropriateness of seclusion in response to disruptive behavior.
Choice C: Beneficence
Beneficence is the ethical principle that focuses on doing good and acting in the best interest of the patient. It involves taking actions that promote the well-being of patients and prevent harm. In the context of seclusion, beneficence guides the nurse to consider whether secluding the patient will prevent harm to the patient and others, thereby promoting overall safety and well-being.
Choice D: Veracity
Veracity refers to the principle of truth-telling and honesty. It involves providing accurate and truthful information to patients. While veracity is crucial in building trust between healthcare providers and patients, it does not directly relate to the decision of whether to use seclusion for managing disruptive behavior.
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