An old patient on chemotherapy begins to cry as the nurse discusses hair loss. The best response would be?

NHM MP Staff Nurse - 2015

Medical & Surgical Nursing

Hard

Appeared in: NHM MP Staff Nurse - 2015

Explanation

This option correctly uses therapeutic communication by first validating the patient's feelings of distress ('I know this will be difficult for you').
It demonstrates empathy, which helps to build a trusting nurse-patient relationship and encourages the patient to express their concerns.
It follows the empathetic statement with factual, hopeful information ('your hair will grow back after the completion of therapy'), which provides reassurance without being dismissive.
This combination of emotional validation and factual information is the most supportive and effective approach in this scenario.

Option A: This response offers false reassurance ('Don't worry') which minimizes the patient's current, valid feelings of sadness and fear.
Option B: This response is judgmental, insensitive, and confrontational. It invalidates the patient's feelings and can create a hostile environment, shutting down communication.
Option C: This is an insincere and inappropriate comment that completely misses the emotional context. The patient is grieving a loss of body image, and this response trivializes their distress.

Clinical Relevance

Nursing practice connection: Use the key finding related to Therapeutic Communication in Oncology Nursing to guide bedside assessment, documentation, and the next nursing action.
A nurse's ability to communicate therapeutically directly impacts a patient's psychosocial well-being, coping ability, and adherence to treatment.
Hair loss is a major assault on body image for many cancer patients. Acknowledging this distress is a critical nursing responsibility.
What if the patient's hair loss was likely to be permanent (e.g., after high-dose radiation to the head)? The nurse's response would shift from reassuring about regrowth to exploring coping mechanisms for a permanent change, such as 'This is a difficult and permanent change. Let's talk about how you're feeling and explore resources that can help.'.

How to Approach the Question

First, identify the question type: This is a clinical scenario question testing your knowledge of therapeutic communication.
Analyze the situation: A patient is showing clear signs of emotional distress (crying) related to a side effect of treatment (hair loss).
The goal is to find the response that is most supportive and helpful. Evaluate each option against the principles of therapeutic communication.
Ask yourself for each option: Does this response validate the patient's feelings? Does it show empathy? Does it block or encourage further communication?
Eliminate options that are communication blockers, such as giving false reassurance, being judgmental, or making inappropriate comments.
Select the option that acknowledges the patient's feelings and provides support or helpful, factual information.

Concept Tested & Keywords

Concept Tested: Therapeutic Communication in Oncology Nursing
Stem keywords: patient on chemotherapy, cry, hair loss, best response
Lead-in keywords: best response
Clinical cues: Patient crying is a key cue indicating emotional distress that requires an empathetic response.
Negative lead-in flag: false

q1jPYT4QVNjgmeDqiYp-A

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 pp. 32-34, 19-21

E6 Pharmacology Nursing Lilley 11e Part 3 p. 95-97