A nurse is caring for a client who is scheduled for a bronchoscopy. The client states, "I no longer wish to have this procedure." Which of the following responses should the nurse make?

Rationale:

A. "Why have you changed your mind about the procedure?": Asking “why” can feel confrontational and may pressure the client to justify their decision rather than respecting their autonomy. It’s better to acknowledge their feelings without judgment.

B. "You have the right to refuse the procedure.": Affirming the client’s right to refuse respects their autonomy and legal rights. It opens the door for further discussion and ensures informed consent is voluntary and ongoing.

C. "Have you had any troubles with swallowing?": This question is unrelated to the client’s decision to refuse the bronchoscopy and does not address their expressed concern or right to refuse.

D. "Your doctor wants you to have this procedure.": Emphasizing the provider’s wishes may pressure the client and undermine their autonomy. The nurse’s role is to support informed decision-making, not to coerce.

Rationale:

A. "You will need to report any temperature above 98 Fahrenheit after discharge.": Reporting a temperature above 98°F is unnecessary, as this is within the normal range. Fever is typically defined as a temperature over 100.4°F and may indicate infection if it occurs postoperatively.

B. "I'm sure you know that clients have self-esteem issues after having surgery.": Generalizing the client’s emotional response can be dismissive and discourages open communication. Emotional reactions to hysterectomy vary, so individual concerns should be explored respectfully.

C. "Your kidneys should produce about 20 milliliters of urine each hour after surgery.": Stating a urine output of 20 mL/hour reflects an inaccurate understanding of kidney function. Normal renal output is at least 30 mL/hour, and anything less may indicate hypoperfusion or renal impairment.

D. "Let me know if you would like to hear about non-sexual ways to connect with a partner after surgery.": Offering information while allowing the client to guide the discussion respects emotional boundaries and promotes holistic recovery. This also acknowledges the impact surgery may have on intimacy without making assumptions.