A nurse is caring for a client who has a new diagnosis of diabetes mellitus and is refusing to learn how to self-administer insulin. Which of the following responses should the nurse make?

A. “I’d like to hear your thoughts about giving yourself this medication.”: This response uses open-ended, therapeutic communication that invites the client to express concerns, fears, or misconceptions. It demonstrates respect for autonomy and helps build trust while allowing the nurse to assess readiness to learn. Understanding the client’s perspective is essential before providing education or problem-solving. B. “You will suffer serious health issues if you don't take your medication.”: This response uses fear and threats, which can increase anxiety and resistance rather than promote cooperation. It does not encourage dialogue or address the client’s underlying concerns. C. “Why don't you want to learn how to give yourself your medication?”: Questions beginning with “why” can feel accusatory or judgmental, causing the client to become defensive. Although the nurse needs to understand the client’s reluctance, this phrasing may inhibit open communication. A more neutral approach is preferred. D. “Have you considered how your decision to refuse medication will affect your family?”: This response applies guilt and shifts the focus away from the client’s feelings and autonomy. It does not promote therapeutic communication or support informed decision-making. Using guilt can undermine trust and collaboration.