Interesting case. I am curious about your thoughts on counseling a patient such as the one in your scenario. Client Challenges- The client who is reluctant to answer question Client Challenges- The client who is reluctant to answer question What guidance do you think you should provide to support this individual? What education would you prioritize at this visit?

The client who is reluctant to answer question

Hypothetical Scenario

In an urgent care clinic, Nurse Practitioner (NP) Taylor Smith finds herself faced with a challenging scenario involving an adolescent client who is reluctant to answer questions. The client, a 15-year-old named Alex, presents with lesions to his genital area. The client was accompanied by his mother and father.  The client’s parents reported that they are strictly religious and requested to be in the room during the examination because of assessing the private region. NP asked the client if it was okay for his parents to come to the examination room. He looked at his parents and stated with hesitancy, “I guess it is okay.”

The encounter takes place in a well-lit examination room, and Taylor senses Alex’s immediate reluctance to engage in the conversation. Taylor explained the necessity of examining the client’s genital area for appropriate treatment. During inspection, Taylor noted multiple sores on the anterior and lateral portions of his penis. Upon palpation, Taylor found that the lesions were firm and round and not painful to touch. NP suspected sexually transmitted disease and asked him if he had been sexually active within the past 2-3 months. Alex took a long pause, and without making eye contact, he stated, “ I am strictly religious, and I would never do that before marriage”. Alex avoided eye contact during further assessment questions. NP performed some research and found out that in California, the Miners’ consent law allows miners under the age of 12 and above to give consent to receive sexually transmitted disease-related diagnosis, treatment, and prevention (National Center of Youth Law, 2023). NP asked the client’s parents if she could speak to Alex alone for the best treatment plan. The client’s parents accepted the request.

Taylor discussed with the patient that all his healthcare information and anything said by the client would be kept confidential, and if he would not like her to share it with his parents. NP discussed sexually transmitted diseases rate in adolescents and explained the deadly consequences if these diseases were left untreated. Upon repeating the question of being sexually active within 2-3 months, Alex reported that he is sexually active, anally, with 14 year old in his religious community. The client wishes to keep this information private as his parents do not approve of being sexually active before marriage and homosexuality. Alex consents to draw blood for the STI panel. Lab results reveal positive for syphilis. NP has Alex back to the clinic for a penicillin G single dose (CDC, 2022).

Client’s Challenging Behaviors

The above scenario is challenging for NP  because she is aware that Alex’s parents are very strict with their religion and want him to uphold their religious beliefs of not having sex before marriage, but Alex’s symptoms are congruent with sexually transmitted diseases. Alex felt shame or fear of being punished and did not admit to having a sexual relationship in the presence of his parents. As healthcare professionals, it is our job to build rapport with the client and to provide the best possible treatment for him for his healthy life.

Potential Impact on the Client-Provider Relationship

This challenging behavior can significantly impact the client-provider relationship. The lack of information may hinder accurate assessment and diagnosis, potentially compromising the quality of care (Molina-Mula & Gallo-Estrada, 2020). Additionally, a strained relationship may impede trust-building, making it difficult for Alex to feel comfortable seeking healthcare in the future.

Techniques to Enhance Communication

In this scenario, the techniques to utilize to enhance communication should be a nonjudgemental attitude, compassion, and clinician counseling with the client interview. It is very important for NP to speak to the client’s level of understanding.NP should use open-ended questions, such as, Tell me about your new sexual partner?

Further, Taylor can demonstrate a keen awareness of the profound importance of active listening, diligently attending to both the explicit and implicit signals conveyed through spoken and non-verbal communication (Tennant et al., 2023). The noun phrase effectively affirms the validity of Alex’s emotions, thereby demonstrating a profound sense of empathy and comprehension. Through the process of normalizing the inherent reticence exhibited by Alex in divulging personal information, Taylor can effectively establish an environment that fosters a diminished sense of scrutiny, thereby cultivating a greater propensity within Alex to engage