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Difficulty: MediumTherapeutic Communication

During a morning assessment, a client with newly diagnosed end-stage liver disease refuses their prescribed oral medications. The client crosses their arms, looks away, and states, "I am not swallowing another pill. My body is shutting down anyway, so delaying the inevitable is just a waste of everyone's time." Which response by the nurse demonstrates the most appropriate therapeutic communication technique?

  1. A
    Your healthcare provider prescribed these specifically to manage your symptoms and keep you comfortable.
  2. B
    Why have you decided that the medical plan is no longer worth pursuing?
  3. You feel that taking these medications is pointless because of the progression of your illness.Answer
  4. D
    Refusing your treatment plan will only cause you to experience more discomfort in the coming days.

Answer

The response that restates the client's feeling that taking the medications is pointless due to the illness progression.
The correct response utilizes reflection, a powerful therapeutic technique that directs the client's ideas, feelings, and thoughts back to them. By restating the client's core message without adding new information or judgment, the nurse validates the client's feelings of hopelessness and encourages them to continue sharing their emotional experience.

Step-by-Step Solution

1
Analyze the client's statement to identify the core emotional message.
The client is expressing feelings of hopelessness, despair, and powerlessness regarding their terminal prognosis.
Recognizing the underlying emotional context is essential for selecting a response that addresses the client's actual psychological needs.
2
Evaluate the nursing responses for therapeutic communication techniques.
The reflective statement accurately mirrors the client's expressed feelings of pointlessness back to them.
Reflection validates the client's emotional state, demonstrates active listening, and opens the door for further exploration of their feelings.
3
Identify non-therapeutic communication barriers in the remaining options.
The other options use non-therapeutic techniques such as providing logical explanations (ignoring feelings), asking 'why' (causing defensiveness), or highlighting negative consequences (subtle threatening).
Eliminating responses that block communication ensures the selection of the most therapeutic approach.

Key Concept

Therapeutic Communication
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Topics

Therapeutic Communication

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