A terminally ill client tells the nurse. "I cannot sleep at night. I keep thinking about what is going to happen to me." How should the nurse respond?

Terminal illness often triggers anticipatory anxiety, existential distress, and sleep disturbances due to heightened cognitive arousal, fear of death, and impaired emotional regulation. These symptoms commonly interfere with rest through persistent rumination and activation of the sympathetic nervous system. Rationale: A. Directive advice to use relaxation techniques dismisses the client’s expressed emotional distress and does not explore underlying anxiety. It may feel minimizing and non-therapeutic. Therefore instructional response fails to validate the client’s emotional experience. B. Positive reframing about support systems shifts focus away from the client’s anxiety and may invalidate their current emotional state. It does not address sleep disturbance or fear of dying. Thus inappropriate reassurance reduces therapeutic effectiveness. C. Therapeutic reflection acknowledges the client’s emotional experience and encourages further exploration of anxiety related to illness. It validates feelings without judgment and facilitates open communication. Therefore empathetic clarification is the most appropriate nursing response. D. False reassurance and offering comfort measures like warm beverages do not address the underlying psychological distress. It minimizes the seriousness of existential anxiety. Thus non-therapeutic reassurance fails to support effective emotional processing.