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An 85-year-old has difficulty walking after a knee replacement. The patient tells the nurse, “It’s awful to be old. Every day is a struggle. No one cares about old people.” Select the nurse’s best response.
- B. It sounds like you’re having a difficult time. Tell me about it.
- C. Let’s not focus on the negative. Tell me something good.
- D. You are still able to get around, and your mind is alert.
Correct Answer: B
Rationale: The correct answer is B because it shows empathy and active listening. By encouraging the patient to share their feelings, the nurse validates their emotions and builds a therapeutic relationship. This approach helps the nurse understand the patient's perspective and provides an opportunity for emotional support.
Choice A does not actively invite the patient to share their feelings and may come off as dismissive. Choice C ignores the patient's emotional distress and may seem invalidating. Choice D, while positive, fails to address the patient's emotional concerns and misses an opportunity for meaningful communication.
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After undergoing two of nine electroconvulsive therapy (ECT) procedures, a client states, "I can’t even remember eating breakfast, so I want to stop the ECT." Which is the most appropriate nursing reply?
- A. After you begin the course of treatments, you must complete all of them.
- B. You’ll need to talk with your doctor about what you’re thinking
- C. It is within your right to discontinue the treatments, but let’s talk about your concerns.
- D. Memory loss is a rare side effect of the treatment. I don’t think it should be a concern.
Correct Answer: C
Rationale: The correct answer is C. It acknowledges the client's autonomy while also addressing their concerns. First, it recognizes the client's right to discontinue treatment. Second, it opens the door for a discussion to explore the client's worries and provide support. This response shows empathy and respects the client's decision-making.
Choice A is incorrect because it dismisses the client's autonomy and fails to address their concerns. Choice B is not as appropriate as it suggests only talking to the doctor, missing the opportunity for the nurse to provide immediate support. Choice D is incorrect as it invalidates the client's experience of memory loss and fails to address their concerns.
Which statement best explains how a mother of several children should prepare to help them cope with the loss of a dear aunt?
- A. Each child will grieve in a unique way and on their own timetable
- B. Children are resilient and simply need love as they grieve.
- C. People regardless of age or gender experience stages of grief.
- D. Extreme reactions are more commonly observed in the young griever
Correct Answer: A
Rationale: The correct answer is A because each child will indeed grieve in a unique way and on their own timetable. This approach recognizes the individuality of each child's emotions and coping mechanisms. By understanding and respecting their differences, the mother can provide tailored support and comfort. Option B oversimplifies the grieving process and ignores the complexity of individual responses. Option C generalizes the stages of grief for all people and does not account for variations in how children may process loss. Option D incorrectly suggests that extreme reactions are more common in young children, which is not necessarily true as grief responses can vary widely among children.
A teenage boy has lost his best friend as a result of a hunting accident. His parents report that he is eating and sleeping very little and expresses little interest in school. They are concerned that he talks about the accident repeatedly. These behaviors are generally seen as:
- A. Expressing responsibility for his friends death
- B. Attempts to avoid dealing with his pain
- C. Expressions of a normal grief reaction
- D. Indications of a risk for self-harm
Correct Answer: C
Rationale: The correct answer is C: Expressions of a normal grief reaction. The teenage boy's behaviors of poor appetite, insomnia, lack of interest in school, and repetitive discussions about the accident are common manifestations of grief. This grief reaction is a normal response to losing a close friend in a traumatic manner like a hunting accident. It is important to acknowledge and validate his emotions during this difficult time.
Incorrect Choices:
A: Expressing responsibility for his friend's death - This choice suggests guilt or blame on the part of the boy, which is not evident in the scenario.
B: Attempts to avoid dealing with his pain - The boy's behaviors indicate he is processing his grief rather than avoiding it.
D: Indications of a risk for self-harm - While it is important to monitor for signs of self-harm, the behaviors described are more indicative of grief rather than immediate self-harm risk.
Select the best outcome for a patient with the nursing diagnosis: "Impaired social interaction related to sociocultural dissonance as evidenced by stating, 'Although I’d like to, I don’t join in because I don’t speak the language very well.'” Patient will:
- A. Show improved use of language.
- B. Demonstrate improved social skills.
- C. Become more independent in decision-making.
- D. Select and participate in one group activity per day.
Correct Answer: D
Rationale: The correct answer is D: Select and participate in one group activity per day. This outcome directly addresses the nursing diagnosis of impaired social interaction by encouraging the patient to engage in a specific social activity daily. This goal promotes social interaction, helps the patient overcome language barriers, and gradually enhances their social skills. It provides a structured approach to improve the patient's sociocultural integration.
A: Show improved use of language - This choice focuses solely on language skills but does not directly address the social interaction issue.
B: Demonstrate improved social skills - While this choice is related to the nursing diagnosis, it is too broad and lacks specificity compared to choice D.
C: Become more independent in decision-making - This choice is not directly related to addressing impaired social interaction caused by language barriers.
When a hospitalized patient dies, his wife stares blankly and states, "It can’t be." This indicates:
- A. Despair and protest
- B. Shock and disbelief
- C. Anger and hostility
- D. Disorganization and confusion
Correct Answer: B
Rationale: Correct Answer: B (Shock and disbelief)
Rationale:
1. The wife's blank stare and statement "It can’t be" suggest a state of disbelief and being stunned by the news of her husband's death, indicating shock.
2. Shock is a common initial reaction to unexpected and distressing events, such as the sudden death of a loved one.
3. This choice is the most fitting based on the wife's reaction of disbelief and being unable to accept the reality of the situation.
Summary:
A: Despair and protest - Despair involves a sense of hopelessness, not evident in the wife's initial reaction. Protest implies a more active response, while the wife's reaction is passive.
C: Anger and hostility - There is no indication of anger or hostility in the wife's initial response; rather, it is characterized by disbelief.
D: Disorganization and confusion - While the wife may feel disorganized and confused later, her initial response reflects more shock and disbelief than disorganization