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？

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。

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 Option C incorrectly implies that consent cannot be withdrawn after signing, when in fact the client has the right to withdraw consent at any time.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.

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。