A nurse is conducting a health history interview with a client who has rheumatoid arthritis. The nurse notices that the client is grimacing and rubbing their hands. Which of the following statements by the nurse is appropriate at this time?
"You seem to be in pain. Would you like some medication?"
"How long have you had rheumatoid arthritis? What treatments have you tried?"
"Let's take a break from the interview. I will come back later when you are feeling better."
"How does your pain affect your daily activities? How do you cope with it?"
The Correct Answer is D
The nurse uses an appropriate statement that acknowledges the client's pain and explores its impact on their quality of life and coping strategies. This helps to assess the client's physical, emotional, and social needs, as well as provide support and education.
Incorrect options:
A) "You seem to be in pain. Would you like some medication?" - This is an inappropriate statement that assumes that the client wants medication without assessing their pain level, preference, or history of medication use.
B) "How long have you had rheumatoid arthritis? What treatments have you tried?" - This is an inappropriate statement that ignores the client's pain and continues with the interview without addressing their comfort or needs.
C) "Let's take a break from the interview. I will come back later when you are feeling better." - This is an inappropriate statement that terminates the interview prematurely and may make the client feel dismissed or abandoned.
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Correct Answer is D
Explanation
The nurse demonstrates therapeutic communication by using an open-ended statement that invites the client to express their feelings and concerns. The nurse also shows empathy, respect, and genuineness by offering to listen attentively.
Incorrect options:
A) "You should be more optimistic. Things could be worse." - This is a nontherapeutic response that minimizes the client's feelings and implies that the client is wrong or ungrateful for feeling depressed and hopeless.
B) "Why do you feel depressed and hopeless? You have a lot to live for." - This is a nontherapeutic response that uses a closed-ended question that can make the client feel defensive or guilty for feeling depressed and hopeless. The nurse also makes an assumption about the client's life without exploring their perspective.
C) "I understand how you feel. I have a family member who has diabetes too." - This is a nontherapeutic response that uses false reassurance and self-disclosure that can shift the focus away from the client and their feelings.
Correct Answer is B
Explanation
The nurse should use gestures and nonverbal cues, such as nodding, smiling, and eye contact, to supplement verbal communication with the client who has dyspnea. This helps to convey empathy, understanding, and interest, as well as reduce the need for the client to speak excessively.
Incorrect options:
A) Ask open-ended questions that require detailed responses. - This is an incorrect action, as asking open-ended questions that require detailed responses can increase the client's dyspnea and anxiety, as well as decrease the client's oxygenation.
C) Speak loudly and clearly to ensure the client can hear the nurse. - This is an incorrect action, as speaking loudly and clearly can be perceived as shouting or aggressive by the client, which can impair the therapeutic relationship and increase the client's stress level.
D) Interrupt the client frequently to save time and energy. - This is an incorrect action, as interrupting the client frequently can be disrespectful and rude, which can damage the rapport and trust between the nurse and the client.
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