Nokea
An older couple was emotionally despondent when their home was severely damaged by flooding. When planning for the couple's initial needs, what intervention should the community health nurse implement?
- A. Contacting their families
- B. Attending to their emotional needs
- C. Arranging for the repair of their home
- D. Attending to their basic physiological needs
Correct Answer: D
Rationale: The question asks about the first thing that the nurse needs to consider when planning for the rescue and relocation of these older residents. The initial concerns of community health are always attending to people's basic needs of food, shelter, and clothing. Contacting family, addressing emotional needs, and arranging for home repairs are needs that may be addressed as needed after physiological needs are met.
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A community health nurse is caring for a group of homeless people. What is the most immediate concern when planning for the potential needs of this group?
- A. Finding affordable housing for the group
- B. Setting up a 24-hour crisis center and hotline
- C. Providing peer support through structured support groups
- D. Ensuring that adequate food, shelter, and clothing are available
Correct Answer: D
Rationale: The question asks about the situation's most immediate concern. The initial community health concern is always attending to people's basic physiological needs of food, shelter, and clothing. Finding affordable housing and providing crisis intervention and peer support are meaningful interventions that may be completed at a later time.
The nurse has an established relationship with the family of a client whose death is imminent. Which intervention should the nurse focus on in order to help the family most effectively cope with this experience?
- A. Limiting time in the client's room to promote privacy
- B. Providing education regarding coping mechanisms to use
- C. Identifying spiritual measures that work best for dying clients
- D. Answering questions clearly and providing resources as requested
Correct Answer: D
Rationale: Maintaining effective and open communication among family members affected by death and grief is important to facilitate decision making and effective coping. The nurse maintains and enhances communication and preserves the family's sense of self-direction and control effectively by answering questions clearly and providing information and resources for decision making as requested by the family. Isolating the family from the client by limiting time in the client's room is inappropriate. The nurse should not provide education about coping mechanisms for family members to use because coping mechanisms directed by the nurse are unlikely to be as effective as the methods that the individuals choose for themselves. Identifying spiritual measures that work best for the dying client generalizes and does not reflect individualized care.
The nurse is bathing a client when the client begins to cry. Which action by the nurse is therapeutic at this time?
- A. Continue bathing the client and say nothing.
- B. Stop the bath, cover the client, and sit with the client.
- C. Stop the bath, cover the client, and allow the client private time.
- D. Call the primary health care provider to report the signs of depression.
Correct Answer: B
Rationale: If a client begins to cry, the nurse should stay with the client and let the client know that it is all right to cry. The nurse should ask the client what the client is thinking or feeling at the time. By continuing the bath or by leaving the client, the nurse appears to be ignoring the client's feelings. Crying alone is not necessarily an indication of depression, and calling the primary health care provider is a premature action.
A client diagnosed with incurable cancer has a life expectancy of a few weeks. Which response indicates that the client's partner is reacting with an expected coping response?
- A. Refusing to visit the client
- B. Expresses anger with his God
- C. Not allowing the death to occur at home
- D. Sending the children to live with relatives
Correct Answer: B
Rationale: Anger is a normal stage of the grieving process and is an expected coping response when facing the imminent loss of a loved one. Expressing anger toward a spiritual entity, such as God, is a common way for individuals to process their grief. Refusing to visit the client indicates avoidance or denial, which may not be constructive. Not allowing the death to occur at home or sending children to live with relatives may reflect practical decisions but do not directly indicate an expected emotional coping response related to grief.
The nurse admits a client who is demonstrating right-sided weakness, aphasia, and urinary incontinence. The woman's daughter states, 'If this is a stroke, it's the kiss of death.' What initial response should the nurse make?
- A. Why would you think like that?'
- B. You feel your mother is dying?'
- C. These symptoms are reversible.'
- D. A stroke is not the kiss of death.'
Correct Answer: B
Rationale: Option 2 allows the daughter to verbalize her feelings, begin coping, and adapt to what is happening. By restating, the nurse seeks clarification of the daughter's feelings and offers information that potentially helps ease some of the fears and concerns related to the client's condition and prognosis. Option 1 is a disapproving comment that is likely to interfere with communication. Option 3 is potentially misleading and offers false hope. The nurse could reflect back the statement in option 4 to the daughter to promote communication. However, as it stands, option 4 is a barrier to communication that contradicts the daughter's feelings.