A nurse is caring for an older adult client who had a cerebrovascular accident and has right-sided paralysis and aphasia. The client's son tells the nurse it is his fault because he did not insist that his mother live with him. Which of the following responses should the nurse make?

Choice A Reason:

"If it weren't for you and the hours we've spent talking, I don't think I would be on my way to getting my anxiety under control." While this statement acknowledges the importance of the nurse-patient relationship in helping with anxiety, it might imply a somewhat dependent stance. The ideal therapeutic relationship encourages patients to gain skills and tools to manage their issues independently.

Choice B Reason:

"I appreciate the time you spent with me. I have a better understanding of what I can do to manage my problem." This statement reflects the patient's acknowledgment of the nurse's support and guidance, resulting in a positive impact on the patient's understanding and ability to manage their concerns. It emphasizes the constructive nature of the nurse-patient relationship and the effectiveness of the interactions in addressing the patient's needs.

Choice C Reason:

"I really need to talk with you. You always give me good advice about how to address my anger issues." While seeking support and advice from the nurse is positive, the emphasis on always receiving good advice might suggest a more directive approach rather than collaborative exploration and problem-solving, which is often a goal in therapeutic relationships.

Choice D Reason:

"You've been kind to me when I was at a low point. Knowing you've had low points too was such a help. “While mutual understanding and empathy are crucial in the nurse-patient relationship, the statement may focus more on the nurse's experiences rather than the patient's progress or understanding. The primary focus should be on the patient's needs and growth.

Choice A Reason:

"How many in the group feel that Jack is ready to be discharged?” This response focuses on the group's opinion rather than addressing Jack's concerns directly. It may not provide the emotional support Jack needs.

Choice B Reason:

"Maybe others in the group have similar feelings.” This response acknowledges Jack's concerns, normalizes his feelings by suggesting that others might share similar concerns, and creates an opportunity for group members to express their thoughts and provide support. It fosters an open and empathetic group dynamic.

Choice C Reason:

"Jack, you ought to be happy that you are leaving." This response is dismissive of Jack's feelings and may invalidate his concerns. It lacks empathy and may hinder open communication.

Choice D Reason:

“Jack maybe you're not ready to be discharged.” While this response acknowledges Jack's fears, it assumes he is not ready without exploring his specific concerns. It might not encourage a constructive discussion about his readiness for discharge.