An agitated 80 year old patient states, 'I'm having trouble with my bowels.' Which response by the nurse incorporates the interviewing skill of reflection?

An agitated 80 year old patient states, 'I'm having trouble with my bowels.' Which response by the nurse incorporates the interviewing skill of reflection?

• A. It's common to have problems with the bowels at your age.
• B. You seem distressed about your bowels.
• C. You're having trouble with your bowels?
• D. When did you first notice having trouble with your bowels.

Answer: (B)

Reflective listening is the skill being tested: you acknowledge and name the patient’s emotion to show you understand and to invite them to share more. Saying, “You seem distressed about your bowels,” validates how the patient feels and opens the door for them to express fears or concerns behind the agitation (such as pain, embarrassment, or worry about a serious problem). This approach builds trust, calms agitation, and encourages more detailed communication. The other responses miss that empathetic acknowledgment. Telling the patient it’s common at their age shifts the focus to a general fact and can feel dismissive. Restating the symptom with a question asks for information but doesn’t reflect the emotional state. Probing when the issue began is useful for history-taking, but it doesn’t validate the patient’s feelings or de-escalate the situation.

Reflective listening is the skill being tested: you acknowledge and name the patient’s emotion to show you understand and to invite them to share more. Saying, “You seem distressed about your bowels,” validates how the patient feels and opens the door for them to express fears or concerns behind the agitation (such as pain, embarrassment, or worry about a serious problem). This approach builds trust, calms agitation, and encourages more detailed communication.

The other responses miss that empathetic acknowledgment. Telling the patient it’s common at their age shifts the focus to a general fact and can feel dismissive. Restating the symptom with a question asks for information but doesn’t reflect the emotional state. Probing when the issue began is useful for history-taking, but it doesn’t validate the patient’s feelings or de-escalate the situation.