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A nurse is caring for a client whose partner is requesting to bring the client food from home that is not allowed in the client's dietary plan. Which of the following responses should the nurse make?
- A. "Why would you want to put your partner's health at further risk?"
- B. "You will need to discuss your concerns about your partner's diet with the provider."
- C. "Everyone likes food from home, but it can delay your partner's recovery."
- D. "Let's try to find ways to incorporate your partner's favorite food into her diet plan."
Correct Answer: D
Rationale: The correct answer is D: "Let's try to find ways to incorporate your partner's favorite food into her diet plan." This response acknowledges the partner's desire to bring food from home while also emphasizing the importance of adhering to the client's dietary plan for recovery. By suggesting a compromise to incorporate the favorite food within the diet plan, the nurse is promoting collaboration and patient-centered care. It shows understanding and empathy towards the partner's concerns while prioritizing the client's health and recovery.
Choice A is incorrect as it may come off as judgmental and dismissive. Choice B is not the most appropriate response as it doesn't address the partner's request directly. Choice C is incorrect as it may sound like a blanket statement and could potentially create tension between the nurse and the partner.
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A nurse is caring for a client who is hospitalized for the treatment of severe depression. Which of the following nursing approaches is therapeutic to include in the client's plan of care?
- A. Encouraging decision-making
- B. Playing a game of chess with the client
- C. Giving the client choices of activities
- D. Spending time sitting with the client
Correct Answer: D
Rationale: The correct answer is D: Spending time sitting with the client. This approach is therapeutic as it promotes a sense of companionship, support, and comfort for the client. By being present and engaged in the moment, the nurse can establish trust and demonstrate empathy towards the client, which are crucial in the treatment of severe depression. This approach also provides an opportunity for the client to express their feelings and thoughts in a safe and non-judgmental environment.
Choice A, encouraging decision-making, may overwhelm the client who is dealing with severe depression and may exacerbate their feelings of helplessness. Choice B, playing a game of chess, may be too stimulating or competitive for the client in this vulnerable state. Choice C, giving the client choices of activities, may add unnecessary pressure and decision-making burden on the client. Overall, spending time sitting with the client is the most appropriate and therapeutic nursing approach in this scenario.
A nurse is caring for a client who is to start chemotherapy for advanced breast cancer. She tells the nurse she is worried about the adverse effects of the treatment. Which of the following responses should the nurse make?
- A. "I will have your provider discuss the adverse effects with you before the treatment begins."
- B. "Someone from the American Cancer Society will be here soon to answer your questions."
- C. "What is it about the adverse effects that concern you?"
- D. "I agree. Sometimes the adverse effects can be worse than the disease."
Correct Answer: C
Rationale: Correct Answer: C
Rationale: The nurse should respond with "What is it about the adverse effects that concern you?" This response shows empathy, encourages open communication, and allows the nurse to address the client's specific fears or concerns. It also promotes a patient-centered approach to care, enhancing trust and rapport between the nurse and the client. This response demonstrates active listening and provides an opportunity for individualized education and support.
Incorrect Answers:
A: This response defers the responsibility to the provider and does not address the client's concerns directly.
B: This response does not address the client's specific concerns and may not provide the necessary support.
D: This response dismisses the client's concerns and does not address the root of her worries, potentially increasing anxiety.
E, F, G: No information provided.
A nurse is caring for a client who has bipolar disorder and is in the manic phase. The client says he is bored. Which of the following activities is appropriate for the nurse to suggest to this client?
- A. Watching a video with a group in the day room
- B. Walking with the nurse in the courtyard
- C. Participating in a basketball game in the gym
- D. Joining a group discussion about a local election
Correct Answer: B
Rationale: The correct answer is B: Walking with the nurse in the courtyard. During the manic phase, individuals with bipolar disorder may have high energy levels and increased impulsivity. Walking in the courtyard with the nurse provides a safe outlet for physical activity and helps to channel excess energy in a constructive manner. This activity also allows for one-on-one interaction, which can help the client focus and reduce boredom. Other options like watching a video with a group or participating in a basketball game may be too stimulating and could exacerbate manic symptoms. Joining a group discussion about a local election might be overwhelming and less effective in managing the client's energy level and attention.
A nurse is caring for an older adult client whose provider will discharge him to an extended-care nursing facility. The client asks the nurse why he has to go "to that place." Which of the following responses should the nurse make?
- A. "Your doctor feels that this is the best place for you right now."
- B. "Why don't you ask your doctor about that when she comes in to see you?"
- C. "Did your doctor or anyone else talk to you about going to the nursing home?"
- D. "Your family can't take care of you at home, so you will need to go there."
Correct Answer: C
Rationale: Encouraging discussion allows the client to express concerns and ensures they are informed about their care plan.
A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell the family to expect?
- A. Decreased auditory and visual acuity
- B. Decreased display of emotions
- C. Personality traits that are opposite of original traits
- D. Forgetfulness gradually progressing to disorientation
Correct Answer: D
Rationale: Dementia typically presents with progressive forgetfulness and eventual disorientation.