Which nursing intervention is most appropriate to promote healing in a client with a nonhealing surgical wound?

Choice A rationale

Motivational counseling is designed to help clients change specific behaviors, such as smoking cessation or adherence to a new exercise regimen. It focuses on resolving ambivalence and finding internal drive. The client’s concern about pet care is a situational stressor related to hospitalization rather than a deep-seated behavioral issue. Therefore, motivational techniques are not the primary approach needed to solve the immediate logistical problem of finding a temporary caregiver for a pet.

Choice B rationale

Short-term counseling is appropriate for clients experiencing situational stress or a temporary crisis that has a clear beginning and end. The client's worry about his pet is a specific, immediate problem triggered by his hospitalization. This type of counseling focuses on problem-solving and finding resources to manage the current situation. Once a solution is found for the pet, the stressor is resolved, making this the most fitting approach for the nurse to utilize.

Choice C rationale

Long-term counseling is generally utilized for chronic psychological issues, personality disorders, or deep-seated emotional patterns that require extensive therapy over months or years. A client’s concern about pet care during a hospital stay is an acute, situational matter that does not require an extended therapeutic relationship. Applying long-term counseling models to this scenario would be inappropriate as the goal is to find a quick, practical resolution to an immediate logistical need.

Choice D rationale

Crisis intervention is used when a person’s usual coping mechanisms fail during a sudden, overwhelming event, such as a natural disaster or a major trauma. While the client is stressed, the pet care issue is a manageable logistical problem rather than a total psychological breakdown. Short-term counseling is a better fit for this level of stress, as it provides the support needed to address the specific concern without the intensive protocols of crisis intervention.

Choice A rationale

Changing the subject involves the nurse moving the conversation away from the client's expressed concern to a different topic. In this scenario, the nurse is still addressing the client's anxiety and the upcoming surgery, so they have not changed the subject. However, the way they addressed the concern was dismissive. Instead of shifting to a new topic like the weather or hospital food, the nurse gave a response that minimized the client's current emotional state.

Choice B rationale

Summarizing is a therapeutic communication technique where the nurse briefly states the main points of the discussion to ensure mutual understanding. It helps the client feel heard and organizes the information shared during the interaction. The nurse's statement in the question does not reflect the client's feelings or consolidate the conversation. Instead, it provides a generic statement that ignores the specific nature of the client's fears, failing to demonstrate the clarifying purpose of a summary.

Choice C rationale

False reassurance occurs when a nurse gives a clichéd or superficial response that minimizes the client's concerns and implies there is no cause for worry. Telling an anxious client they will be asleep and that everyone feels this way devalues the client's unique experience. This communication style can block further expression of feelings and damage the therapeutic bond because the client may feel that their very real fears are being dismissed as unimportant or easily resolved.

Choice D rationale

Premature advice happens when the nurse offers a solution or a course of action before fully exploring the client's feelings or the details of the situation. In this case, the nurse is not necessarily telling the client what to do, but rather telling them how they should feel or why their feelings are unnecessary. This shuts down the opportunity for the nurse to understand why the client is anxious, which prevents the development of a tailored and effective intervention.