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Question

Difficulty: MediumEnd of Life Care

During morning hygiene care at an inpatient hospice facility, a young adult client with terminal melanoma begins to cry and states to the practical nurse, 'My children are still in elementary school. I cannot stand the thought of missing their graduations.' Which response by the nurse is the most therapeutic?

  1. This must be an incredibly heavy thought to carry. Would you like to tell me more about your children?Answer
  2. B
    Let's focus on getting you comfortable right now. I can ask the social worker to arrange a special visit with your kids.
  3. C
    It is expected to feel angry and try to bargain during this stage, but finding a way to accept the situation will eventually bring you peace.
  4. D
    Try to stay positive; researchers are developing new treatments every day that might give you more time to spend with them.

Answer

The most therapeutic response is to acknowledge the heavy burden of the thought and invite the client to talk more about their children.
The correct response directly addresses the client's emotional pain with empathy and uses an open-ended question to encourage further sharing. This active listening technique validates the client's feelings of loss and provides a safe space for them to process their anticipatory grief without judgment.

Step-by-Step Solution

1
Analyze the client's statement to identify the core psychosocial need.
The client is expressing deep anticipatory grief and distress over premature separation from their young children.
Understanding the underlying emotion is essential to selecting a response that provides empathy and validation.
2
Evaluate the nursing responses against principles of therapeutic communication.
Identify which options use active listening and validation versus those that rely on communication blocks like false reassurance or changing the subject.
Therapeutic communication at the end of life must focus on the client's current feelings rather than minimizing their pain or enforcing a specific grieving process.
3
Select the option that best supports the client's emotional expression.
The response that validates the heavy thought and asks an open-ended question about the children is selected.
This approach demonstrates empathy, maintains a patient-centered focus, and facilitates healthy processing of grief.

Key Concept

Therapeutic Communication in End of Life Care
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Topics

End of Life Care

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