GMCH Chandigarh - 2019
Nursing Foundation
Medium
Choose the most therapeutic response to Mr. Shyam's question: "Am I going to die?"
Appeared in: GMCH Chandigarh - 2019
Explanation
- This response uses an open-ended question ('Would you like to talk...?'), which encourages the patient to share their feelings and thoughts.
- It is patient-centered, giving the patient control over the conversation and respecting their autonomy.
- It directly and gently acknowledges the patient's underlying concern about their 'condition and prognosis' without making false promises or deflecting.
- This approach validates the patient's question as important and shows the nurse is present and willing to listen to difficult topics.
Why Other Options Were Wrong
- Option A: This is a generalized, cliché response that minimizes and invalidates the patient's specific, personal fear. It acts as a communication block.
- Option B: This deflects the question and shifts the focus away from the patient's immediate emotional needs. It can make the patient feel that the nurse is unwilling to talk.
- Option C: This is a closed-ended, judgmental question that makes a negative assumption about the patient's willingness to talk. It is likely to shut down communication.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Therapeutic communication techniques in response to a patient's fear of death as background academic context rather than a clinical decision trigger.
- Using therapeutic communication builds trust and rapport, which is essential for providing holistic care, especially in end-of-life situations.
- Failure to respond therapeutically can cause patient distress, anxiety, and a feeling of isolation, hindering the nurse-patient relationship.
- What if? If the patient had said, 'My doctor told me everything is fine, but I don't believe him,' the best response would shift to exploring the discrepancy, such as, 'It sounds like you're feeling uncertain about what you've been told. Can you tell me more about that?'.
How to Approach the Question
- First, identify the core of the question: it's asking for the 'most therapeutic' response, which means the one that best promotes communication and supports the patient emotionally.
- Analyze the patient's statement: 'Am I going to die?' This is a direct expression of fear and a request for an honest conversation.
- Evaluate each option against the principles of therapeutic communication: Is it open-ended? Is it non-judgmental? Does it focus on the patient's feelings? Does it block or encourage conversation?
- Eliminate options that are clear communication blocks (clichés, judgmental questions, deflections).
- Select the option that opens the door for further discussion and empowers the patient, which is typically an open-ended, empathetic question.
Concept Tested & Keywords
- Concept Tested: Therapeutic communication techniques in response to a patient's fear of death.
- Stem keywords: therapeutic response, Mr. Shyam, Am I going to die?
- Lead-in keywords: Choose the most
- Clinical cues: Patient directly asking about death, indicating fear and a need for discussion.
Question ID
Q7juwVrvkorPkW3B64WBfI
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 7677-7679
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2696-2698
E6 Medicine Harrison 22e Part 1 p. 118-120
Practise the full GMCH Chandigarh - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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