The nurse is caring for a patient with chronic lung disease. The ...

[ss2343]

The nurse is caring for a patient with chronic lung disease. The patient demands a cigarette after eating breakfast. The nurse responds, If that was me, I wouldn't be asking for a cigarette. That is what has made you so sick in the first place.
 
  This nontherapeutic communication response is an example of:
  a.
  changing the subject.
  b.
  giving advice.
  c.
  a stereotypical response.
  d.
  defensiveness.

Question 2

A patient with an inoperable brain tumor says to the nurse, I just want to die now. It's going to happen soon anyway. Which of the following would be the most appropriate response?
 
  a. Don't worry about that right now. It'll be OK.
  b. I disagree with what you just said
  c. Honey, now don't you talk like that.
  d. Tell me why you are saying that.

[pallen55]

Answer to Question 1

ANS: B
Giving advice implies that the patient cannot make his or her own decisions and the nurse accepts the responsibility for the action. Changing the subject ignores the patient's concerns. Stereotypical or generalized responses such as, Don't cry over spilled milk may be seen as judgmental. A defensive response such as, The nurses work very hard to take care of you moves the focus of the conversation from the patient and limits further discussion.

Answer to Question 2

ANS: D
Using open-ended questions or comments gives the patient the opportunity to share freely on a subject, avoids interjection of feelings or assumptions by the nurse, and provides for patient elaboration on important topics when the nurse wants to collect a breadth of information. Giving false reassurance discounts the patient's feelings, cuts off conversation about legitimate concerns of the patient, and demonstrates a need by the nurse to fix something that the patient just wants to discuss. Showing agreement or disagreement discontinues patient reflection on an introduced topic, and implies a lack of value for the thoughts, feelings, or concerns of patients. Using personal terms of endearment, such as Honey, demonstrates disrespect for the individual, diminishes the dignity of a unique patient, and may indicate that the nurse did not take the time or care enough to learn or remember the patient's name