RN Nursing · Therapeutic Communication · Practice question
A nurse is caring for a client who states during a counseling session, "I am sliding off a cliff." Which of the following statements should the nurse make?
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"How are things going at your job?"
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"You must be feeling very frightened right now."
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"Don't worry. Everything will be okay."
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"I don't think that is really what is happening to you."
Answer & explanation
Correct: "You must be feeling very frightened right now."
Responding with "You must be feeling very frightened right now" is the best therapeutic communication technique in this situation because it reflects the client's feelings and demonstrates empathic understanding. When a client uses a metaphor such as "sliding off a cliff," the nurse should recognize the emotional content being conveyed — likely fear, loss of control, or desperation — and reflect that emotion back to validate the client's experience. This opens the conversation, invites the client to elaborate, and builds therapeutic rapport. Asking "How are things going at your job?" introduces an unrelated topic and redirects away from the emotional distress the client just expressed, which is non-therapeutic and dismissive. Saying "Don't worry, everything will be okay" is a false reassurance that invalidates the client's feelings and closes down further communication by minimizing their experience. Telling the client "I don't think that is really what is happening to you" is an outright dismissal of the client's perception and is countertherapeutic because it undermines trust and may cause the client to disengage from care. Therapeutic communication requires the nurse to meet clients where they are emotionally, and reflecting feelings is a foundational technique to achieve this goal.
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