The nurse is caring for a patient who refuses to participate in physical therapy (PT) and states, "I really don't like to exercise.". Which response by the nurse is most likely to help engage the pa-tient in PT?

Question

a. "It makes the pain worse, doesn't it?"
b. "What don't you like about exercise?"
c. "You really should do these exercises.".
d. "Do you like to do any other activities?"

Answer 1

B
The nurse asks an open-ended question using the patient's words to uncover information about the patient's refusal to participate in PT by asking what the patient dislikes about exercise. Using the patient's words conveys acceptance and value because the nurse listened closely enough to repeat what the patient said; in addition, the nurse is asking the patient to continue describing his or her pain to uncover factors that can be resolved or other issues requiring follow-up care and ultimately result in patient participation. Asking the patient a yes-or-no question such as, "It makes the pain worse, doesn't it?" is unlikely to promote further discussion. Telling the patient to do the exercises is giving advice; rather the nurse can tell the patient the reason for the therapy and the benefits of doing it or the risks of not doing it. Asking about other activities moves the focus away from the patient's need for physical therapy.