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:

Making an evaluation about the patient's problem is incorrect. Making an evaluation may involve the nurse imposing their judgment on the patient's situation, which can hinder effective communication.

Choice B Reason:

Restating the main feelings or thoughts the patient has expressed is correct. Restating the main feelings or thoughts the patient has expressed is a therapeutic communication technique known as paraphrasing. This technique demonstrates active listening and shows the patient that the nurse is paying attention to their concerns. It allows the nurse to reflect back to the patient what has been said, confirming understanding and encouraging further communication.

Choice C Reason:

Saying "I understand what you're saying" is incorrect. While expressing understanding is important, simply stating "I understand" might be perceived as superficial if not accompanied by concrete examples or restatement of the patient's expressed thoughts and feelings.

Choice D Reason:

Offering a leading question such as "And then what happened?", is incorrect. Asking a leading question can be perceived as directive and may steer the conversation in a particular direction. It might not convey the same level of active listening as restating the patient's own words and feelings.

Choice A Reason:

Engaging in friendly interactions with the client is correct. Developing a therapeutic relationship involves creating a supportive and empathetic connection with the client. Engaging in friendly interactions helps build trust and rapport. This approach fosters a positive environment for communication and collaboration.

Choice B Reason:

Instructing the client on how he should behave is incorrect. Instructing the client on how to behave can be perceived as directive and may hinder the development of a collaborative and trusting relationship.

Choice C Reason:

Setting limits for the relationship is incorrect. While setting boundaries is important, using the term "limits" can convey a sense of restriction. It's crucial to establish appropriate boundaries, but the term "limits" may not promote the openness needed in a therapeutic relationship.

Choice D Reason:

Promoting the use of transference by the client is incorrect. Promoting transference involves encouraging the client to project feelings from past relationships onto the nurse. This is generally not considered a therapeutic approach and may lead to misunderstandings in the therapeutic relationship.