NCLEX · Therapeutic Communication

A client just received a new terminal diagnosis and begins crying. The nurse should:

Correct answer

Remain with the client; offer tissues; allow them to cry without rushing to stop the tears; place a hand on their arm if culturally appropriate and welcomed; say quietly 'Take your time. I'm here.'

  1. A Leave to give them privacy
  2. B Quickly change the subject to something positive
  3. C Remain with the client; offer tissues; allow them to cry without rushing to stop the tears; place a hand on their arm if culturally appropriate and welcomed; say quietly 'Take your time. I'm here.'
  4. D Say 'Everything will be okay'

Why this is the answer

THERAPEUTIC PRESENCE in grief: The most therapeutic response to tears is PRESENCE and PERMISSION — allowing the grief without rushing to stop it or fix it. WHY STAYING IS CORRECT: Leaving 'to give privacy' communicates that the nurse is uncomfortable with their grief — the client is already alone with a devastating diagnosis; TISSUES: Practical comfort without interrupting the emotional process; GENTLE TOUCH: When culturally appropriate and welcomed; some clients find touch comforting, others do not — read cues; SILENCE: Crying clients do not need words; quiet reassurance ('I'm here') is sufficient; FALSE REASSURANCE: 'Everything will be okay' when the client has a terminal diagnosis is a lie — it destroys trust; SUBJECT CHANGE: Communicates that the nurse cannot tolerate the client's feelings — shuts down future disclosure. The therapeutic role in grief is to witness and accompany — not to fix, cheer, or rush.
Source: NCLEX-PN Test Plan: Psychosocial — Therapeutic Communication, Presence in Grief