A nurse is assisting with an in-service to a group of newly licensed nurses about the definition of nursing developed by the American Nurses Association (ANA). Which of the following information should the nurse include in the teaching? (Select all that apply.)

A. Quaternary prevention focuses on preventing unnecessary interventions or overmedicalization. It aims to protect patients from harm and ensure that they receive only the necessary care. Administering insulin does not fit this definition.
B. Primary prevention involves measures taken to prevent the onset of disease or injury before it occurs. This includes health education, vaccinations, and lifestyle changes to prevent diseases. Administering insulin does not fall under this category, as it does not prevent diabetes but rather manages it.
C. Secondary prevention aims to detect and treat diseases early to reduce their impact. This includes screenings and interventions that occur after a disease has developed but before significant symptoms appear. Administering insulin is not a preventive measure in this context.
D. Tertiary prevention involves managing and reducing the impact of an existing disease. It focuses on rehabilitation and maintaining quality of life. Administering insulin to a client with type 1 diabetes is an example of tertiary prevention, as it is part of the management and treatment of a chronic condition to prevent complications.

A. Offering approval or disapproval can create a judgmental atmosphere, potentially making clients feel defensive or unsupported. Therapeutic communication should focus on understanding and empathizing with the client rather than evaluating their feelings or actions.
B. This technique can be problematic in therapeutic communication. Asking clients to explain their feelings or behaviors may come off as interrogative or dismissive, which can hinder open dialogue. It’s often more effective to explore the client’s feelings without requiring justification.
C. While offering sympathy may seem caring, it can shift the focus from the client’s feelings to the nurse's emotions. Sympathy often implies pity and can create a power imbalance, whereas therapeutic communication should aim for empathy—understanding and validating the client's experiences without imposing one's own feelings.
D. This is a key technique in therapeutic communication. Open-ended questions encourage clients to express themselves freely, providing more information and facilitating deeper conversations. They invite exploration and help build rapport, making clients feel heard and understood.