A nurse is speaking with the parents of a 4-year-old child who has a terminal illness.
The parents tell the nurse they have taken their son's name off the list for little league baseball next season. Which of the following responses should the nurse make?
"Why did you feel you needed to do that at this time?"
"It must be frustrating for you to have to cancel an activity your son enjoyed."
"You never know. He could be ready for baseball by the spring."
"Baseball can be a dangerous sport for children anyway.".
The Correct Answer is B
Choice A rationale:
Judgmental and challenging: Asking "Why did you feel you needed to do that at this time?" implies that the parents' decision may not have been the best one. It puts them on the defensive and could make them feel like they need to justify their actions.
Not empathetic: This response does not acknowledge the parents' feelings of sadness, disappointment, or loss. It focuses on the decision itself rather than on the emotional impact it has had on the family.
Not supportive: The nurse's role is to provide support and understanding, not to the parents' decisions. This response does not offer any emotional support or validation.
Choice B rationale:
Empathetic and validating: This response acknowledges the parents' feelings and shows that the nurse understands how difficult it must have been to cancel their son's baseball registration. It also validates their decision, which can be helpful in coping with difficult situations.
Opens up communication: By expressing empathy, the nurse encourages the parents to share their feelings and experiences. This can help them to process their emotions and feel more supported.
Facilitates understanding: By recognizing the parents' frustration, the nurse can better understand their perspective and provide more tailored support. This can help to strengthen the nurse-client relationship and promote trust.
Choice C rationale:
False hope: While it is possible that the child's condition could improve, it is not realistic to offer false hope to the parents. This response could make it more difficult for them to accept the reality of their child's illness and could lead to disappointment and frustration in the future.
Dismissive of feelings: This response does not acknowledge the parents' current feelings of sadness and loss. It focuses on the future, which can be overwhelming and anxiety-provoking for parents who are facing a terminal illness.
Choice D rationale:
Irrelevant and insensitive: The dangers of baseball are not relevant to the parents' decision to cancel their son's registration. This response is dismissive of their feelings and does not offer any support or understanding.
Potentially offensive: This response could be interpreted as suggesting that the parents are being overprotective or that they are making a decision based on fear rather than on their child's best interests.
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Correct Answer is D
Explanation
Choice A rationale:
This statement is accusatory and blaming, rather than promoting understanding and problem-solving. It focuses on the negative behavior of the sibling and seeks external validation for the speaker's feelings, rather than attempting to address the underlying issue directly with the sibling.
It uses "should" language, which can come across as judgmental and critical, potentially escalating conflict.
It does not express the speaker's own feelings or needs, making it difficult for the other person to understand and respond effectively.
Choice B rationale:
While this statement demonstrates a willingness to take responsibility for actions, it does not directly address the communication between the family members. It focuses on redirecting the father's anger rather than exploring the underlying reasons for the conflict.
It could be interpreted as silencing the children's voices and potentially reinforcing a hierarchical dynamic within the family, where one parent holds authority over the others.
Choice C rationale:
This statement is manipulative and threatening, using a fear of exposure to control the other person's behavior. It undermines trust and safety within the family, making it difficult to have open and honest communication.
It does not address the core issue at hand and instead escalates conflict by using a "tit-for-tat" approach.
Choice D rationale:
This statement effectively demonstrates several key principles of effective communication: It expresses curiosity and a genuine desire to understand the other person's perspective.
It avoids accusations or assumptions, instead inviting open dialogue.
It focuses on specific behaviors and events ("each time you go to the mall") rather than making sweeping generalizations about the person's character.
It uses "I" language to express the speaker's own feelings and concerns, inviting empathy and understanding.
It creates an opportunity for the other person to share their perspective and work towards a resolution together.
Correct Answer is B
Explanation
Choice A rationale: Dissociation is a defense mechanism where a person disconnects from reality, memory, identity, or perception. It is often a response to trauma and can result in a detachment from emotional and physical experiences. The client’s behavior does not indicate a disconnection from reality or self.
Choice B rationale: Regression is a defense mechanism where an individual reverts to an earlier stage of development in response to stress or anxiety. In this case, the client’s behavior of wanting someone to take care of them can be seen as a regression to a childlike state of dependency, which is a common response to overwhelming stress or anxiety.
Choice C rationale: Introjection is a defense mechanism where a person internalizes the ideas or voices of other people- often authority figures. This is not evident in the client’s behavior.
Choice D rationale: Repression is a defense mechanism where a person unconsciously blocks out distressing thoughts or feelings. In this scenario, the client is expressing their feelings of stress rather than repressing them.
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