A client being discharged appears angry with the nurse when the nurse attempts to review discharge instructions with the client. The nurse can best assist the client in this stage of the relationship with which response?

In the termination phase of the nurse-client relationship, patients often experience a resurgence of anxiety, sadness, or anger as they prepare to transition away from the structured, supportive environment of the hospital. Anger is frequently used as a defense mechanism to mask the fear of self-management or the pain of saying goodbye. The nurse assists the client best by validating the emotion and providing an opportunity for the client to verbalize their feelings, which de-escalates the tension and allows for effective learning to occur. Rationale: A. This response is authoritarian and dismissive. By focusing solely on the task ("We have to go over these"), the nurse ignores the patient's emotional state. This approach often increases the patient's resistance and ensures they will not retain the critical health information needed for a safe discharge. B. This is a judgmental and belittling statement. Telling a patient they should be able to regulate their feelings is a non-therapeutic communication technique that shames the patient. It creates a power struggle and damages the therapeutic alliance, making the patient less likely to cooperate with the discharge process. C. This is the correct therapeutic response since it uses the technique of sharing observations ("I can sense you are angry") followed by an open-ended question ("Tell me how you feel..."). This acknowledges the patient's reality without judgment and helps identify if the anger is directed at the nurse, the illness, or the fear of going home. D. This is a passive-aggressive or sarcastic response. It poses a closed-ended, "yes/no" question that does not address the underlying emotion. It may be perceived by the patient as a threat to withhold their discharge, which further exacerbates their anxiety and anger.