護理師正在照護一位準備接受選擇性手術的病人。病人說：「我改變主意了，我不確定我是否還想做這個手術。」護理師最好的回應為何？
A nurse is caring for a client who is being prepared for an elective surgery. The client says, 'I changed my mind. I am not sure if I want this surgery anymore.' Which is the best response by the nurse?
- AI will call the surgeon to explain the procedure to you again.我會呼叫外科醫師再向您說明手術程序。
- BDo not worry, the surgeon is very experienced and you will be fine.別擔心，外科醫師經驗豐富，您會沒事的。
- CYou have already signed the consent form, so we must proceed.您已經簽署了同意書，所以我們必須進行手術。
- DTell me more about your concerns regarding the surgery.請告訴我您對手術的擔憂。正確答案
- D請告訴我您對手術的擔憂。
此題考驗護理師在知情同意（Informed Consent）中的角色以及與病人的治療性溝通。護理師的首要任務是充當病人的擁護者（Advocate）並評估其不安全感或知識缺失的原因。選項 D 是一個開放式問題，能引導病人表達恐懼或疑慮，這是解決問題的第一步。在 NCLEX 的邏輯中，『評估（Assessment/Communication）』通常優先於『行動（Action）』。選項 B 屬於虛假的保證（False assurance），是不專業的溝通。選項 C 錯誤地暗示簽署同意書後就不能撤回，實際上病人隨時有權撤回同意。選項 A 雖然在某些情況下是必要的（如果病人對手術本身不理解），但在護理層面，應先透過溝通了解病人的心理狀態。護理師必須尊重病人的自主權（Autonomy），確保其決定是基於充分理解而非壓力。透過傾聽，護理師能判斷病人是需要心理支持還是需要更多醫療資訊，從而採取最適當的後續行動。
- A我會呼叫外科醫師再向您說明手術程序。
如果病人對手術流程有誤解，確實需由醫師再次說明，但護理師應先釐清病人是不安、害怕還是真的缺乏資訊，而非直接推給醫師。
- B別擔心，外科醫師經驗豐富，您會沒事的。
虛假的保證會忽視病人的真實擔憂，並阻斷進一步的溝通，這是不利於建立護病關係且無助於解決問題的回應。
- C您已經簽署了同意書，所以我們必須進行手術。
知情同意是一個持續的過程，病人有法律權利在手術前的任何時刻撤銷同意，醫護人員必須尊重此項權利。
- D · 正確答案請告訴我您對手術的擔憂。
這是一種治療性溝通技巧，藉由開放式提問讓病人抒發疑慮，護理師才能針對病人的具體不安點進行後續介入或轉介。
在美國，病人自主權受法律嚴格保護，護理師在手術前確認病人意願是標準作業程序；在台灣，病人改變主意時，醫療團隊往往會花更多時間與家屬溝通，有時家屬的決定會給病人帶來壓力，護理師在台灣的角色更常是在病人、家屬與醫師之間進行多方協調。實際要求可能受聯邦法、州法、州護理委員會規則與機構政策影響；本題依題幹所示護理原則作答。
English explanation
This item examines the nurse's role in informed consent and therapeutic communication with the client. The nurse's primary responsibilities are to serve as the client's advocate and to assess the reason for any insecurity or knowledge deficit. Option D is an open-ended statement that invites the client to express fear or concerns and is the first step in problem solving. In NCLEX logic, assessment/communication generally precedes action. Option B is false reassurance and is unprofessional communication. Option C incorrectly implies that consent cannot be withdrawn after signing, when in fact the client has the right to withdraw consent at any time. Option A may sometimes be necessary (if the client does not understand the procedure itself), but at the nursing level the nurse should first explore the client's psychological state through communication. The nurse must respect the client's autonomy and ensure that the decision is based on adequate understanding rather than pressure. By listening, the nurse can determine whether the client needs emotional support or more medical information and then take the most appropriate follow-up action.
最近修訂：2026-08-25