A nurse is teaching a newly licensed nurse about pain. Which of the following is an example of acute pain?

Choice A rationale

Asking why questions often sounds accusatory or judgmental to the patient. This can cause the client to become defensive or shut down, which hinders the therapeutic relationship. In a crisis or after an injury, the patient may not know the cause of the fall, and being pressured for an explanation can increase anxiety. Effective communication focuses on open-ended inquiries rather than seeking justifications. The nurse should avoid language that implies the patient is at fault.

Choice B rationale

This statement provides false reassurance and minimizes the patient's concerns. Telling a patient not to stress or that everything will resolve itself is dismissive of their current physical and emotional pain. It shuts down further communication by implying that the patient's feelings are not valid. While involving family is helpful, the nurse cannot guarantee specific outcomes or total resolution. Therapeutic communication requires acknowledging the patient's reality and providing honest, empathetic support throughout the evaluation process.

Choice C rationale

This is an open-ended, therapeutic inquiry that encourages the patient to provide a detailed narrative of the event. By asking for the sequence before, during, and after the fall, the nurse gathers essential clinical data for diagnosis while showing interest in the patient's perspective. It allows the patient to express their experience without feeling rushed or judged. This approach helps identify potential causes like syncope or environmental hazards. It fosters a collaborative environment and validates the patient's experience.

Choice D rationale

Comparing the patient to other clients is unprofessional and violates the principle of individualized care. It minimizes the patient's specific trauma by suggesting their situation is common or routine for the staff. This can make the patient feel like just another number in a busy emergency department. Therapeutic communication should remain focused entirely on the individual patient currently being treated. Discussing other cases is a breach of privacy and distracts from the immediate clinical needs of the falling victim.

Choice A rationale

Suggesting an antidepressant is inappropriate because wanting to die at home during the terminal stage of lung cancer is a rational preference for comfort and autonomy, not necessarily a sign of clinical depression. Pathologizing a client's end of life wishes ignores their right to self-determination. Furthermore, antidepressants take weeks to reach therapeutic levels, which may not align with the client's immediate terminal prognosis and the urgent need for a discharge plan focused on comfort.

Choice B rationale

Informing a patient that their wish to go home is not in their best interest is a paternalistic approach that violates the ethical principle of autonomy. A nurse's role is to support the client's informed decision-making process rather than imposing personal or professional biases. In end stage lung cancer, the focus shifts from curative care to quality of life. Denying the client's request can cause moral distress and prevent a peaceful death in their preferred environment.

Choice C rationale

Transferring a client to a long term care facility does not honor the client's specific request to go home. While long term care provides nursing assistance, it is still an institutional setting and may not provide the specialized end of life care required for a terminal diagnosis. This action bypasses the client's expressed wish for a home environment. The nurse should focus on resources that facilitate the client's transition to their own residence with appropriate medical support.

Choice D rationale

Discussing hospice services is the most important action because hospice provides palliative care for clients with a terminal illness and a life expectancy of six months or less. Hospice focuses on pain management, symptom control, and emotional support for both the client and family in the home setting. By coordinating this referral, the nurse ensures the client's wish to die at home is honored while maintaining safety and professional care standards during the dying process.