Nokea
A young mother who fractured her leg is sobbing with her face hidden behind her hands. She says to the nurse, "I will not be able to work for at least 2 months. Without my job, I cannot pay my bills or take care of my baby. I am alone and do not have anyone to help me.= Which response by the nurse accurately conveys empathy?
- A. "Why do you think that no one cares about you or will refuse to help you?=
- B. "I can see that you are hesitant about relying on others because of low self-esteem.=
- C. "You seem worried about how you will be able to take care of yourself and your baby.=
- D. "I am sorry that you are uncomfortable with asking others for help right now.=
Correct Answer: C
Rationale: The correct answer is C because it reflects active listening and understanding the mother's concerns without making assumptions or judgments. The nurse accurately acknowledges the mother's worries about taking care of herself and her baby, showing empathy and validation. Choice A assumes the mother feels uncared for, choice B presumes low self-esteem, and choice D focuses on discomfort with asking for help rather than addressing the mother's specific concerns. Hence, choice C is the most empathetic and appropriate response in this scenario.
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The first-semester nursing student tells the team leader that her clinical assignment for the day is to take vital signs and obtain a client history that will take about 1 or 2 hours to complete. Which clients would the leader recommend that she approach to fulfill her assignment? (Select all that apply.)
- A. Mr. N (non-Hodgkin lymphoma)
- B. Mr. L (tracheostomy and partial laryngectomy)
- C. Mr. B (bladder cancer)
- D. Ms. C (bowel resection and colostomy)
Correct Answer: B
Rationale: The correct answer is B because Mr. L, who has a tracheostomy and partial laryngectomy, will likely require vital signs monitoring and a detailed client history due to his complex respiratory and communication needs. This assignment will provide the student with valuable experience in caring for clients with specialized needs.
Incorrect choices:
A: Mr. N (non-Hodgkin lymphoma) - While Mr. N may require vital signs monitoring, his condition does not necessarily involve complex care needs that would warrant a 1-2 hour history-taking session.
C: Mr. B (bladder cancer) - Vital signs monitoring and history-taking for a client with bladder cancer may not require as much time as the scenario suggests, as the care needs may not be as complex as those of a client with a tracheostomy and laryngectomy.
D: Ms. C (bowel resection and colostomy) - While Ms. C may require vital signs monitoring and history-taking
Ms. C (bowel resection and colostomy) is receiving epoetin alfa. Which laboratory test will the nurse check to see if the medication should be discontinued?
- A. Hemoglobin
- B. White cell count
- C. Potassium level
- D. Blood glucose level
Correct Answer: A
Rationale: The correct answer is A: Hemoglobin. Epoetin alfa is a medication that stimulates red blood cell production. Monitoring hemoglobin levels is crucial to assess the effectiveness of the medication. If hemoglobin levels rise too high, it can lead to complications like blood clots. Checking hemoglobin levels helps determine if the dose of epoetin alfa should be adjusted or discontinued.
Summary:
B: White cell count - Monitoring white cell count is not directly related to epoetin alfa therapy.
C: Potassium level - Monitoring potassium level is important for other medications like diuretics or ACE inhibitors, not specifically for epoetin alfa.
D: Blood glucose level - Monitoring blood glucose level is important for diabetic patients but not directly related to epoetin alfa therapy.
To convey the intervention of active listening, the nurse would:
- A. maintain eye contact by staring at the patient.
- B. prompt the patient when the patient stops talking for a moment.
- C. make a conscious effort to block out other sounds in the immediate environment.
- D. write down remarks on a clipboard to facilitate later topics of conversation. An active listener maintains eye contact without staring, gives the patient full attention, and makes a conscious effort to block out other sounds and distractions.
Correct Answer: C
Rationale: The correct answer is C because active listening involves making a conscious effort to block out other sounds in the immediate environment, demonstrating full focus on the speaker. This allows the nurse to truly understand the patient's perspective and feelings. Maintaining eye contact (A) is important but staring can be intimidating. Prompting the patient (B) may disrupt their train of thought. Writing down remarks (D) can be perceived as disengagement. In summary, active listening requires focused attention and empathy, which choice C exemplifies.
The nurse cares for elderly clients in an assisted living center. Which action by the nurse would best show respect for these clients?
- A. Patronize clients who share ideas or voice concerns.
- B. Identify healthcare needs by listening to the clients.
- C. Address the clients formally by their last names.
- D. Limit the clients' opportunities to express opinions.
Correct Answer: B
Rationale: The correct answer is B because listening to the elderly clients to identify their healthcare needs demonstrates respect by valuing their input and autonomy. This approach fosters a collaborative and client-centered care environment. Choice A is incorrect as patronizing clients undermines their dignity. Choice C may be seen as impersonal and distant. Choice D is disrespectful as it restricts clients' autonomy and diminishes their voice. Listening and considering clients' needs is crucial in providing respectful care to the elderly population.
The nurse is reviewing Mr. N's (non-Hodgkin lymphoma) medication administration record and sees that the combination therapy aprepitant, dexamethasone, and ondansetron was administered during the last shift. What is the nurse most likely to ask to determine efficacy of the therapy?
- A. "On a scale of 1 to 10, with 1 being the least and 10 being the worst, what number is your pain? Where is the pain located?"
- B. "Have the medications improved your appetite? Are there special foods that you would prefer?"
- C. "Are you having any feelings of nausea right now? When was the last time you vomited?"
- D. "After taking the medications, have you experienced any improvement in your energy level? Do you feel fatigued?"
Correct Answer: C
Rationale: The correct answer is C. The nurse would ask about feelings of nausea and vomiting to determine the efficacy of the antiemetic therapy. Nausea and vomiting are common side effects of chemotherapy, which Mr. N would receive for non-Hodgkin lymphoma. Improvement in these symptoms indicates the effectiveness of the antiemetic regimen. Choices A, B, and D are not directly related to the medications administered and would not provide valuable information on the efficacy of the therapy for managing chemotherapy-induced nausea and vomiting. Option A focuses on pain assessment, B on appetite and food preferences, and D on energy levels and fatigue, which are not the primary outcomes to evaluate in this context.