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Difficulty: MediumTherapeutic Communication

A nurse is completing the preoperative checklist for an adult client scheduled for a bilateral mastectomy the following morning. The client is crying quietly and states, "I do not know who I am going to be after this surgery. My partner says it does not matter, but I just cannot believe them."

Which response by the nurse is the most therapeutic?

  1. A
    You should not worry about that right now; the most important thing is that the surgery will remove the disease.
  2. B
    Why are you questioning your partner's sincerity when they have been by your side every day?
  3. You are experiencing a lot of fear about how this physical change will impact who you are and your relationship.Answer
  4. D
    It is completely normal to feel this way, and these negative thoughts will pass once the surgery is over.

Answer

The most therapeutic response reflects the client's feelings and validates their fear regarding their identity and relationship without offering false reassurance or judgment.
The correct response utilizes the therapeutic communication technique of reflection and validation. By restating the client's implicit concerns about identity and relationship security, the nurse acknowledges the client's emotional pain without judgment, encouraging further exploration of these profound fears.

Step-by-Step Solution

1
Analyze the client's statement and underlying emotional message.
The client is expressing deep-seated fears regarding loss of identity and relationship insecurity following a major body-altering surgery.
Therapeutic communication requires addressing the underlying emotional message rather than just the spoken words.
2
Evaluate the options for therapeutic communication techniques.
Look for responses that validate feelings, use open-ended exploration, or reflect the client's emotional state.
Effective therapeutic communication facilitates expression and helps the client process complex emotions.
3
Identify non-therapeutic barriers in the distractors.
Eliminate options that minimize feelings, offer false reassurance, give unwanted advice, or ask aggressive 'why' questions.
Non-therapeutic responses invalidate the client's experience and abruptly close the channels of communication.

Key Concept

Therapeutic Communication
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Topics

Therapeutic Communication

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