The nurse is speaking with the spouse of a client following a family discussion with the healthcare provider about the client’s terminal condition and eligibility for hospice care. The spouse states, "I don't think I can make this decision right now. What would you do?" How should the nurse respond?
"I find it helpful to investigate the options. I will get you a pamphlet about hospice care."
"You seem overwhelmed. I’ll contact a chaplain to come and talk with you about the options."
"It’s hard to say what the best decision is, but know hospice provides wonderful care."
"These decisions are challenging. Tell me your spouse’s beliefs about end-of-life."
The Correct Answer is D
Choice A reason: Offering information is supportive, but this does not address the spouse’s emotional needs or encourage discussion about the client’s values.
Choice B reason: Calling a chaplain might be supportive later, but it avoids addressing the spouse’s statement directly and risks shifting responsibility away from the nurse.
Choice C reason: Reassurance without exploring the client’s and family’s values minimizes the spouse’s need for deeper reflection and personal decision-making.
Choice D reason: Encouraging the spouse to reflect on the client’s beliefs and values promotes autonomy and supports decision-making that honors the client’s wishes, making it the most therapeutic response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Redirecting the focus back to the patient in a therapeutic and nonjudgmental way ensures the conversation remains centered on the client’s needs. This maintains professional boundaries while being supportive.
Choice B reason: Stating that nurses direct interviews is authoritative and may come across as rigid. It does not encourage patient openness.
Choice C reason: Responding with a prohibition sounds harsh and judgmental. It could damage rapport and shut down communication.
Choice D reason: Asking "why" can make the patient feel defensive, which is not therapeutic. It shifts the focus to justification rather than reflection.
Correct Answer is C
Explanation
Choice A reason: While silence may sometimes convey understanding, its primary therapeutic purpose in communication is to allow the patient time to think or reflect, not simply to indicate understanding.
Choice B reason: Prolonged silence may cause withdrawal in some patients, but this is not the guiding principle in therapeutic communication. The focus should be on the value of reflection.
Choice C reason: Silence provides the patient with opportunities for reflection and processing of thoughts and emotions. It encourages deeper expression and supports therapeutic dialogue.
Choice D reason: The nurse is not always responsible for breaking silence. Sometimes allowing the patient to break the silence themselves is more therapeutic and empowering.
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