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Difficulty: EasyCoping Mechanisms

An ambulatory care nurse is speaking with a client who was just informed they have early-stage Alzheimer's disease. The client laughs and says, "The doctor doesn't know what he's talking about. I just have a little trouble remembering names sometimes, like anyone my age." Which of the following is the most therapeutic response by the nurse?

  1. A
    Why do you think the doctor's assessment is incorrect?
  2. B
    Do not worry, many people experience memory loss and still live normal lives.
  3. It sounds like you are finding it difficult to believe the doctor's diagnosis.Answer
  4. D
    I know this is upsetting, but you need to accept the diagnosis to start treatment.

Answer

The most therapeutic response is to reflect the client's feelings by stating, "It sounds like you are finding it difficult to believe the doctor's diagnosis."
The correct response uses the therapeutic technique of reflection and validation. By acknowledging the client's difficulty in accepting the news, the nurse keeps the lines of communication open and allows the client to explore their feelings without feeling judged or confronted. This safely addresses the client's use of denial.

Step-by-Step Solution

1
Identify the client's current coping mechanism based on their statement.
The client is using denial, a defense mechanism to protect themselves from the overwhelming stress of a new, life-altering diagnosis.
Recognizing the coping mechanism is essential to formulating an appropriate and therapeutic nursing response.
2
Evaluate the nursing response options against therapeutic communication principles.
The correct response must acknowledge the client's feelings without arguing, probing, or offering false reassurance.
Therapeutic communication builds trust and helps the client process their emotions at their own pace without destroying their necessary coping mechanism prematurely.

Key Concept

Coping Mechanisms and Therapeutic Communication
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Topics

Coping Mechanisms

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