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Difficulty: HardTherapeutic Communication

A practical nurse is caring for a client who is scheduled for a bilateral mastectomy in the morning. The client is pacing the room, wringing their hands, and suddenly states, "I look in the mirror and I just don't know who I will be tomorrow. Maybe I should just cancel the whole thing." What is the most therapeutic response for the practical nurse to make?

  1. A
    It is completely normal to have cold feet before a major surgery, but everything will be okay.
  2. It sounds like you are feeling overwhelmed about how this surgery will change you. Tell me more about what you are feeling.Answer
  3. C
    You should try to get some sleep now because you are going to need your strength for the procedure tomorrow.
  4. D
    Why are you thinking about canceling the surgery when it is necessary to treat your breast cancer?

Answer

The correct answer is the response that reflects the client's feelings about the upcoming surgery and uses an open-ended prompt to encourage further discussion.
The correct response utilizes the therapeutic techniques of reflection ('It sounds like you are feeling overwhelmed...') and open-ended questioning ('Tell me more...'). This approach validates the client's specific fears regarding body image changes and encourages them to verbalize their anxiety, which is essential for processing their emotions before a major surgery.

Step-by-Step Solution

1
Analyze the client's behavior and statement.
The client is pacing, wringing hands (signs of anxiety), and expressing fear of altered body image and doubt about the surgery.
To identify the underlying emotional need that requires a therapeutic response.
2
Evaluate the communication techniques used in each option.
Identify which options use non-therapeutic blocks (false reassurance, giving advice, asking 'why') versus therapeutic techniques (reflection, open-ended questioning).
To differentiate between therapeutic and non-therapeutic communication.
3
Select the response that best addresses the client's emotional state.
The response that reflects the feeling of being overwhelmed and asks the client to tell more is the most appropriate.
Therapeutic communication aims to validate feelings and encourage the client to express their concerns without judgment.

Key Concept

Therapeutic Communication: Responding to Anxiety and Body Image Alteration
Estimated Time:1m 15s
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Topics

Therapeutic Communication

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