Nokea
A client who has a femur fracture states, 'I can't stay in this bed any longer. I need to get home so I can take care of my family.' The nurse responds by saying, 'You have talked about your family. Can you tell me more about your specific concerns?' Which of the following therapeutic communication techniques is the nurse using?
- A. Summarizing
- B. Empathizing
- C. Focusing
- D. Clarifying
Correct Answer: C
Rationale: Focusing helps the client explore concerns in more detail, allowing for appropriate support and planning.
You may also like to solve these questions
A nurse is preparing an in-service presentation about preventing health care-associated infections (HAIs). The nurse should include which of the following as a common cause of these infections?
- A. Chlorhexidine washes
- B. Urinary catheterization
- C. Malnutrition
- D. Multiple caregivers
Correct Answer: B
Rationale: The correct answer is B: Urinary catheterization. This is a common cause of HAIs due to the introduction of bacteria into the urinary tract. Catheters provide a direct pathway for bacteria to enter the body, leading to infections such as urinary tract infections. The other choices are incorrect because:
A: Chlorhexidine washes are actually used to prevent infections by killing bacteria on the skin.
C: Malnutrition can weaken the immune system and make individuals more susceptible to infections, but it is not a direct cause of HAIs.
D: Multiple caregivers can increase the risk of infections if proper hygiene practices are not followed, but it is not a specific cause of HAIs like urinary catheterization.
A nurse is caring for a client who requires a clear liquid diet. Which of the following foods should the nurse allow the client to have?
- A. Grape juice
- B. Lemon sherbet
- C. Skim milk
- D. Carrot juice
Correct Answer: A
Rationale: The correct answer is A: Grape juice. A clear liquid diet includes transparent liquids like water, broth, tea, and clear juices without pulp. Grape juice fits this criteria as it is a clear liquid that is easily digestible. Lemon sherbet (B) contains dairy and solid components, not suitable for a clear liquid diet. Skim milk (C) is a dairy product and not transparent. Carrot juice (D) has pulp and is not considered a clear liquid.
A nurse is discussing pressure ulcer staging with a newly licensed nurse. Which of the following statements should the nurse use to describe a stage 3 pressure ulcer?
- A. Unbroken skin with un-blancheable erythema
- B. Full-thickness tissue loss extending to underlying support structures
- C. A shallow, ruptured or intact skin blister without slough
- D. A deep crater without visible bone, tendon, or muscle
Correct Answer: D
Rationale: Stage 3 ulcers involve full-thickness skin loss with damage to subcutaneous tissue but without exposed bone or muscle.
A nurse is completing a client's history and physical examination. Which information should the nurse consider subjective data?
- A. Blood pressure
- B. Cyanosis
- C. Nausea
- D. Petechiae
Correct Answer: C
Rationale: Subjective data are information reported by the client, such as symptoms or feelings. Nausea is subjective because the client experiences and reports it. Blood pressure, cyanosis, and petechiae are objective data that can be measured or observed directly by the nurse. Blood pressure is a vital sign, cyanosis is a physical finding, and petechiae are skin manifestations. Therefore, they are not subjective data. By understanding the distinction between subjective and objective data, the nurse can accurately assess and document the client's health status.
A nurse is preparing a client for ambulation. Which of the following actions should the nurse take to determine the client's level of strength?
- A. Ask the client how strong she feels today.
- B. Ask the client if she has been out of bed today.
- C. Check the client's pedal pulses and feet for edema.
- D. Ask the client to push her legs and feet against the nurse's palms.
Correct Answer: D
Rationale: The correct answer is D. Asking the client to push her legs and feet against the nurse's palms is a direct assessment of the client's muscle strength. This action provides a more objective measure of strength compared to subjective responses (A) or general activity level (B). Checking pedal pulses and feet for edema (C) assesses circulation and fluid status, not strength. Asking the client to perform a physical task (D) allows for a practical evaluation of strength level.