A 55-year-old client on a medical-surgical unit has just received a diagnosis of pancreatic cancer. The client says to the nurse, "Is this disease going to kill me?" What is the best response by the nurse? A)"Hearing this diagnosis must have been difficult for you. What are your thoughts?" B)"We will do everything possible to prevent that from happening." C)"Well, we're all going to die sometime." D)"You should concentrate on getting better rather than thinking about death."

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Quizplus · Accepted Answer

The stress of receiving a life-threatening diagnosis often causes clients to feel very vulnerable. There is a tendency to keep feelings and concerns closed off; clients may not be able to express how distressed they feel or find the right words to express feelings and concerns. In asking, "Is this disease going to kill me?," the client is most likely not looking for a direct "yes" or "no" answer. This would immediately close off the conversation and create a missed opportunity for a meaningful engagement and communication with the nurse. It is more likely that this question is being asked to provide an opening for further discussion about the meaning of this devastating diagnosis as well as the client's thoughts and feelings. The nurse can facilitate a sense of trust, connection, and collaboration by the following: Providing empathy - acknowledging the distressing nature of the diagnosis Providing situations (eg, broad opening for discussion) in which the client can share thoughts and feelings in a safe environment Active listening - being very attentive to what the client is saying and trying to understand what the client is thinking and feeling Focusing - going beyond words and explanations to attain new awareness of a client's concerns Communicating effectively will assist the client in coping with difficult situations, reducing stress, and developing approaches for making necessary life changes (Option B) This response attempts to give reassurance but does not address the client's thoughts and concerns. (Option C) This is a very trite response and will close down any opportunity for further discussion. (Option D) This response gives advice to the client and is non-therapeutic; it does not acknowledge the client's current concerns. Educational objective: Clients with devastating conditions or situations may have difficulty expressing their concerns, thoughts, and feelings. A nurse who is skilled in using effective communication techniques such as active listening, providing broad openings for discussion, and focusing can help clients cope with and reduce the stress of difficult situations.

A 55-Year-Old Client on a Medical-Surgical Unit Has Just Received