An adult who is terminally ill asks the nurse, "Am I going to die soon?" What is the best response for the nu… - UPUMS Nsg.Officer-2024

UPUMS Nsg.Officer-2024

Nursing Foundation

Hard

Appeared in: UPUMS Nsg.Officer-2024

Explanation

This response uses the therapeutic technique of reflection, which paraphrases or restates the patient's concern to show that the nurse is actively listening and understands.
It is an open-ended statement that validates the patient's feelings and creates a safe, non-judgmental space for them to elaborate on their thoughts.
This approach encourages the patient to explore the emotions behind their question, which could be fear, anxiety about unfinished business, or concern for their family.
By reflecting the question, the nurse avoids making assumptions and allows the patient to lead the conversation, fostering a trusting nurse-patient relationship.

Option A: This is a non-therapeutic response that uses a cliché. It minimizes the patient's personal feelings and dismisses their concern, effectively blocking further communication.
Option C: This is a closed-ended question that makes an assumption that the patient's primary emotion is fear. It limits the patient's response to a simple 'yes' or 'no' and may prevent them from discussing other significant concerns.
Option D: While factually accurate, this statement is a conversation-blocker. It fails to address the emotional need behind the patient's question and shuts down the opportunity for therapeutic dialogue.

Clinical Relevance

Nursing practice connection: Knowing Therapeutic Communication in End-of-Life Care helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
In end-of-life care, the nurse's role extends beyond physical symptom management to providing crucial psychosocial and spiritual support. Effective therapeutic communication is the primary tool for this.
Using reflective and open-ended techniques helps build a trusting relationship, allowing the nurse to accurately assess the patient's fears, wishes, and needs, which is essential for patient-centered care planning.
What if? If the patient confirms their concern by saying, 'Yes, I am worried,' the nurse's next best response would be another open-ended prompt, such as, 'Tell me more about what is on your mind,' to continue exploring their feelings.

How to Approach the Question

This is a clinical communication question, which requires selecting the most therapeutic response.
First, identify the core of the patient's question. The patient is expressing anxiety and seeking information about their prognosis.
Evaluate each option against the principles of therapeutic communication. The goal is to encourage the patient to express their feelings.
Look for the option that is open-ended, non-judgmental, and patient-centered. Techniques like reflection, restating, and asking broad, open questions are ideal.
Eliminate options that block communication. These include giving advice, providing false reassurance, using clichés, making assumptions, or asking closed-ended ('yes/no') questions.
The best response often validates the patient's feelings and invites them to share more, as seen in the correct option.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 pp. 92-94, 91-93