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The nurse counsels the spouse of a client diagnosed with generalized anxiety disorder about how to cope with the client's anxiety. Which statement, made by the spouse, indicates that teaching is successful?
- A. Anxiety is a conscious means of resolving conflict.
- B. Anxiety represents an unconscious conflict of needs.
- C. I should confront my spouse when I notice signs of anxiety.
- D. Defense mechanisms increase anxiety.
Correct Answer: B
Rationale: Recognizing anxiety as an unconscious conflict of needs demonstrates understanding of its psychological basis, indicating successful teaching. Other statements are incorrect or promote unhelpful actions like confrontation.
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The nurse is caring for a client diagnosed with bipolar disorder. During the morning assessment, the client tells the nurse that she hears people in the room behind her bed talking about her. Which response by the nurse best reflects therapeutic communication?
- A. What do you hear them saying?
- B. I will see if we can move you to another room.
- C. I will notify your doctor in case he wants to change your medications.
- D. I understand that the voices seem real to you, but I don't see or hear anyone else in here.
Correct Answer: D
Rationale: This response validates the client's experience without reinforcing the hallucination and promotes trust by acknowledging their perception.
The nurse is caring for a client diagnosed with left-sided Bell's palsy. Which statement by the client shows a need for further teaching by the nurse?
- A. My left eye is tearing a lot.'
- B. I have trouble closing my left eyelid.'
- C. I don't know how I'll live with this stroke.'
- D. I can't feel anything on the left side of my face.'
Correct Answer: C
Rationale: Bell's palsy is an inflammatory condition that involves the facial nerve (cranial nerve VII). Although it results in facial paralysis, it is not the same as a stroke. Many clients fear that they have had a stroke when the symptoms of Bell's palsy appear, and they commonly believe that the paralysis is permanent. Symptoms resolve, although it may take several weeks. The remaining options are expected assessment findings of the client with Bell's palsy.
A perinatal home care nurse has just assessed the fetal status of a client with a diagnosis of partial placental abruption of 20 weeks' gestation. The client is experiencing new bleeding and reports less fetal movement. The nurse informs the client that the primary health care provider will be contacted for possible hospital admission. The client begins to cry quietly while holding her abdomen with her hands. She murmurs, 'No, no, you can't go, my little man.' The nurse should recognize the client's behavior as an indication of which psychosocial reaction?
- A. Fear of hospitalization
- B. Fear of loss and the death of the fetus
- C. Grief due to potential loss of the fetus
- D. Cognitive confusion as a result of shock
Correct Answer: C
Rationale: Grief occurs when a client has knowledge of an impending loss, such as when signs of fetal distress accelerate. The first stages of grieving may be characterized by shock; emotional numbness; disbelief; and strong emotions such as tears, screaming, or anger. The remaining options are not focused on the mother's expressed concerns.
The family of a client diagnosed with a myocardial infarction complicated by cardiogenic shock is visibly anxious and upset about the client's condition. Which should the nurse plan to implement to provide support to the family?
- A. Offer them coffee and other beverages on a regular basis.
- B. Insist that they go home to sleep at night to keep up their own strength.
- C. Ask the hospital chaplain to sit with them until the client's condition stabilizes.
- D. Provide flexible visiting times according to the client's condition and family needs.
Correct Answer: D
Rationale: The use of flexible visiting hours meets the needs of both the client and family for reducing the anxiety levels of both. Offering the family beverages does not provide support. Insisting that the family go home is nontherapeutic. Although the chaplain may provide support, it is unrealistic for the chaplain to stay until the client stabilizes.
A preschooler has just been diagnosed with impetigo. The child's mother tells the nurse, 'But my children take baths every day.' Which therapeutic response should the nurse make to the mother?
- A. You are concerned about how your child got impetigo?'
- B. There is no need to worry. We will not tell your day care provider why your child is absent.'
- C. Not only do you have to do a better job of keeping your children clean, you must also wash your hands more frequently.'
- D. You should have seen the doctor before the wound became infected, and then you would not have had to worry about the child having impetigo.'
Correct Answer: A
Rationale: By paraphrasing what the parent tells the nurse, the nurse is addressing the parent's thoughts. Option 1 demonstrates the therapeutic technique of paraphrasing. The remaining options are blocks to communication because they make the parent feel guilty for the child's illness.