Therapeutic Comm Q 17
A client on an in-patient psychiatric unit tells the nurse, “I should have died because I am totally worthless.” In order to encourage the client to continue talking about feelings, which should be the nurse’s initial response?
A. "How would your family feel if you died?"
B. "You feel worthless now, but that can change with time."
C. "You've been feeling sad and alone for some time now?"
D. "It is great that you have come in for help."
Correct Answer: C. “You’ve been feeling sad and alone for some time now?”
This nursing statement is an example of the therapeutic communication technique of reflection. When reflection is used, questions and feelings are referred back to the client so that they may be recognized and accepted.
Option A: Testing is appraising the client’s degree of insight. These types of questions force the client to try to recognize his problems. The client’s acknowledgment that he doesn’t know these things may meet the nurse’s needs but it is not helpful for the client.
Option B: False reassurance refers to indicating there is no reason for anxiety or other feelings of discomfort. Attempts to dispel the client’s anxiety by implying that there is not sufficient reason for concern completely devalue the client’s feelings. Vague reassurances without accompanying facts are meaningless to the client.
Option D: Saying what the client thinks or feels is “good” implies that the opposite is “bad”. Approval, then, tends to limit the client’s freedom to think, speak, or act in a certain way. This can lead to the client’s acting in a particular way just to please the nurse.