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NCLEX · Therapeutic Communication

A client says: 'My doctor never explains anything to me. I don't understand what's happening.' The nurse's BEST response is:

Correct answer

'What specifically has been confusing or unclear for you? Let me help you understand what I can, and we can identify what questions you want to ask your doctor.'

  1. A 'Your doctor is very busy. I'm sure they explained it.'
  2. B 'What specifically has been confusing or unclear for you? Let me help you understand what I can, and we can identify what questions you want to ask your doctor.'
  3. C 'I'll tell the doctor to explain better.'
  4. D 'Would you like me to arrange a patient advocate?'

Why this is the answer

THERAPEUTIC COMMUNICATION for expressed confusion: The best response: (1) VALIDATES the experience without dismissing or defending the physician; (2) EXPLORES the specific concern ('What specifically has been confusing') — this opens productive conversation rather than making assumptions; (3) OFFERS DIRECT HELP within the nurse's scope ('help you understand what I can'); (4) EMPOWERS the client ('questions you want to ask your doctor') — teaching patient advocacy skills; What's wrong with the other responses: 'Your doctor is very busy' — minimizes and dismisses the concern; 'I'll tell the doctor' — patronizing and not addressing the client's immediate confusion; 'Patient advocate' — may be appropriate eventually but immediately offering this avoids the therapeutic relationship the nurse should be providing.
Source: NCLEX-RN Test Plan: Psychosocial — Therapeutic Communication, Client Information Concerns

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