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A nurse is caring for an older adult client who expresses feelings of grief for his earlier life. Which of the following actions should the nurse take to help the client cope with his feelings of loss?
- A. Let the client know that this is a common problem of the aging population.
- B. Provide the client with activities to perform so he won't have time to dwell on the past.
- C. Listen attentively when the client talks about the past.
- D. Tell the client about some of the younger clients in the hospital who have experienced loss.
Correct Answer: C
Rationale: The correct answer is C. Listening attentively when the client talks about the past is essential in helping the older adult cope with feelings of grief. By actively listening, the nurse validates the client's feelings and provides a supportive environment for the client to express and process their emotions. This approach shows empathy and understanding, which can help the client feel heard and respected.
Choice A is incorrect because simply stating that it is a common problem does not address the client's individual feelings and may diminish the significance of their grief. Choice B is incorrect as it suggests avoidance rather than addressing the client's emotions directly. Choice D is incorrect as comparing the client's experience to that of younger clients may not be relevant or helpful.
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A nurse is collecting data from a client. Which of the following findings should the nurse report to the charge nurse as an indicator of dehydration?
- A. Red mucous membranes
- B. Jugular vein distention
- C. Skin tenting
- D. BP 178/90 mm Hg
Correct Answer: C
Rationale: Skin tenting is a hallmark sign of dehydration due to decreased skin elasticity. Jugular vein distention and high BP indicate fluid overload.
A 46-year-old African-American man is in an outpatient clinic for a physical examination. His BP is 126/84 mm Hg, his BMI is 24, and he reports no previous medical problems. Which of the following actions should the nurse take?
- A. Schedule his next appointment for 1 year from now.
- B. Provide information about how to reduce risk factors of hypertension.
- C. Schedule an appointment for a prostate-specific antigen (PSA) test.
- D. Provide information for a weight loss plan that includes increasing physical activity.
Correct Answer: B
Rationale: The correct answer is B: Provide information about how to reduce risk factors of hypertension. The rationale is as follows: The patient is at risk for developing hypertension based on his age, ethnicity, and BP reading. Providing information on reducing risk factors such as maintaining a healthy diet, regular exercise, stress management, and avoiding tobacco and excess alcohol can help prevent the development of hypertension. This proactive approach aligns with preventive healthcare measures.
Choices A, C, and D are incorrect because scheduling the next appointment for 1 year from now does not address the potential risk of hypertension, a PSA test is unrelated to the patient's current presentation, and weight loss is not indicated as the patient's BMI is within the normal range.
A nurse is caring for a client who is 2 days postoperative following a right hemicolectomy. When the nurse enters the client's room, he states that, following a bout of coughing, 'something popped in my belly.' The nurse lifts the sheets and sees that the client's gown is bloody. After sending a coworker to get the charge nurse and call the surgeon, which of the following actions should the nurse take next?
- A. Position the client supine with his hips and knees bent.
- B. Prepare to administer an IV infusion of 0.9% sodium chloride.
- C. Cover the wound with moist sterile gauze.
- D. Measure the client's vital signs.
Correct Answer: C
Rationale: Evisceration requires immediate covering of the wound with a sterile, moist dressing to prevent infection and tissue damage.
A nurse is planning to collect data about the abdomen of a client who reports 'stomach pain.' Which of the following actions should the nurse take first?
- A. Auscultate.
- B. Percuss.
- C. Inspect.
- D. Palpate.
Correct Answer: C
Rationale: Inspection is always the first step in an abdominal assessment to observe for any abnormalities before auscultation and palpation.
A nurse is caring for several clients at various developmental stages. The nurse understands that according to Erikson, acceptance of death occurs at which of the following stages of psychosocial development?
- A. Autonomy vs. Shame and Doubt
- B. Generativity vs. Stagnation
- C. Identity vs. Role Diffusion
- D. Integrity vs. Despair
Correct Answer: D
Rationale: The correct answer is D: Integrity vs. Despair. According to Erikson's psychosocial development theory, acceptance of death occurs during the final stage of life, which is Integrity vs. Despair. In this stage, individuals reflect on their lives and come to terms with their mortality, finding a sense of fulfillment and wisdom. Option A (Autonomy vs. Shame and Doubt) focuses on developing a sense of independence in early childhood. Option B (Generativity vs. Stagnation) pertains to middle adulthood and concerns contributing to society and future generations. Option C (Identity vs. Role Diffusion) relates to adolescence and the formation of a sense of self. These stages do not specifically address acceptance of death.