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NCLEX · Therapeutic Communication

A teenager with a new type 1 diabetes diagnosis says: 'I don't care about this stupid disease — it won't change anything.' What does the nurse recognise?

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Correct answer

This statement may indicate denial or minimisation as a coping mechanism — adolescents with new chronic illness diagnoses often use denial to manage the psychological threat; the nurse should explore the statement without confrontation

  1. A This is normal and requires no response
  2. B This statement may indicate denial or minimisation as a coping mechanism — adolescents with new chronic illness diagnoses often use denial to manage the psychological threat; the nurse should explore the statement without confrontation
  3. C The teenager is ready for discharge
  4. D The teenager is medically compliant and healthy

Why this is the answer

Adolescent coping with chronic illness:

Developmental context: Adolescents are establishing identity and peer belonging — a diagnosis of a chronic, visible disease (requiring injections, diet management, medical equipment) threatens both; denial and minimisation protect against the full psychological weight of the diagnosis.

Therapeutic approach: Do NOT confront denial aggressively — this triggers defensiveness and shuts down communication.

Explore: 'It sounds like this has a lot to manage. What parts feel most overwhelming?'; 'What questions do you have about how this affects your daily life?'.

Assess: Is the denial preventing essential self-care (not testing blood sugar, not giving insulin)? If so, it moves from adaptive to dangerous.

Education approach: Start with the client's concerns and questions rather than a lecture; involve the client in care planning; connect with peer support (other teens with T1DM); family involvement as appropriate.

Long-term: Adolescent non-compliance is the highest-risk period for T1DM complications — therapeutic relationship that doesn't alienate is critical.

Source: NCLEX-RN Psychosocial — Therapeutic Communication, Adolescent Denial of Chronic Illness

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About this topic: Therapeutic Communication

Therapeutic communication questions ask for the nurse's best response — reflecting, clarifying, open-ended, silence — and test the non-therapeutic responses to avoid. This is one of 14 RN: Psychosocial Integrity questions on therapeutic communication, each with a full explanation on a single study page.

New to this exam? Our NCLEX exam guide explains the format, scoring, and how to prepare.

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