A nurse is caring for a client who has breast cancer and is postoperative following a bilateral mastectomy. Which of the following statements indicates the client has an altered body image?

Rationale:

A. "Your family disagrees with your decision?": This open-ended response reflects therapeutic communication by encouraging the client to express her feelings without judgment. It invites further discussion and shows the nurse’s support for the client’s autonomy and emotional well-being.

B. "Did you tell your provider that your family doesn't agree with your decision?": This response shifts focus away from the client's emotional conflict and places it on the provider. It may dismiss the client’s current need for support and hinder further emotional exploration.

C. "You are making the same decision I would make.": Personalizing the conversation undermines client autonomy. The nurse’s role is to support the client’s decision-making process, not impose personal opinions or make assumptions about what is best.

D. "You should get your family to agree with your decision before signing the consent.": This response suggests the client must yield to family opinions, which contradicts the principle of informed consent. The decision is ultimately the client’s, and family agreement is not a legal or ethical requirement.

Rationale:

A. "Tell me how you are feeling about your mom dying.": This encourages the daughter to express her emotions, which is an important first step in processing grief and finding the right words to support her mother. It shows empathy and opens a therapeutic conversation.

B. "You sound like you have questions about your mom dying. Let's talk about it.": This response invites the daughter to engage in a meaningful discussion about her concerns. It provides emotional support and creates a safe space for her to ask questions and gain clarity.

C. "Let's talk about your mom's cancer and how things will progress from here.": Educating the daughter about the disease process and what to expect during hospice care can reduce anxiety and help her feel more prepared to have honest conversations with her mother.

D. "Tell her not to worry. She still has plenty of time left.": This response offers false reassurance and avoids the reality of the situation. It can prevent the daughter from addressing important emotional or end-of-life discussions with her mother.

E. "Hospice will take good care of your mom, so I wouldn't worry about that.": Although hospice provides excellent care, this response shifts the focus away from the daughter’s emotional needs and discourages open communication about death and dying.