AIIMS BBSR SNO - 2019
Nursing Foundation
Medium
Choose the most therapeutic response to Mr. Shyam's question: 'Am I going to die?'
Appeared in: AIIMS BBSR SNO - 2019
Explanation
- This response uses an open-ended question, which is a core technique in therapeutic communication.
- It validates the patient's concern by opening a dialogue about their condition and prognosis, rather than shutting down the conversation.
- It empowers the patient by giving them control over the conversation, asking if they 'would like to talk' about it.
- This approach demonstrates empathy and a willingness to listen, which helps build trust and rapport with the patient.
Why Other Options Were Wrong
- Option A: This response is a cliché that dismisses and minimizes the patient's immediate and personal fear. It closes communication by offering a philosophical statement instead of addressing the patient's feelings.
- Option B: This response deflects the question and shifts responsibility to the doctor. While the doctor's information is important, the nurse's role is to address the patient's emotional response, which this option avoids.
- Option C: This is a leading question that uses denial. It presumes the patient's feelings and actively discourages them from talking about the very topic they brought up. It is a significant communication barrier.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Therapeutic Communication in Nursing as background academic context rather than a clinical decision trigger.
- A nurse's ability to communicate therapeutically is crucial, especially in end-of-life care. It directly impacts the patient's psychological well-being and their ability to cope with a difficult prognosis.
- Failing to address a patient's fears can lead to increased anxiety, depression, and a breakdown of the nurse-patient relationship.
- What if the patient responds 'No, I don't want to talk about it'? The nurse should respect their wishes but leave the door open by saying something like, 'That's perfectly okay. I want you to know I'm here for you if you change your mind or want to talk about anything else.' This respects autonomy while still offering support.
How to Approach the Question
- First, identify the core of the question: it's asking for the 'most therapeutic' response. This signals a focus on communication principles, not just medical facts.
- Read the patient's statement: 'Am I going to die?' Recognize this as a direct expression of fear that requires an empathetic and open response.
- Evaluate each option against the principles of therapeutic communication. Ask yourself: Does this response encourage the patient to talk more? Does it show empathy? Does it block communication?
- Eliminate options that are clear communication blocks. Option A is a cliché, B deflects, and C uses denial.
- Identify the option that opens up conversation. Option D is an open-ended question that validates the patient's concern and invites them to share more.
- Confirm that the chosen answer aligns with the goal of providing patient-centered emotional support.
Concept Tested & Keywords
- Concept Tested: Therapeutic Communication in Nursing
- Stem keywords: therapeutic response, Am I going to die
- Lead-in keywords: Choose the most
- Clinical cues: Patient expressing existential fear
- Negative lead-in flag: false
Question ID
QfEGzhBNUkrEgVM8gypb9k
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
Practise the full AIIMS BBSR SNO - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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