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An overweight patient who enjoys active outdoor activities develops arthritis in the knees. Which action by the nurse is most appropriate to assist the patient in coping with the diagnosis?
- A. Ask the patient to discuss feelings about the diagnosis.
- B. Have the patient practise frequent relaxation breathing.
- C. Educate the patient on the use of imagery to decrease pain and decrease stress.
- D. Encourage the patient to think about how weight loss might improve symptoms.
Correct Answer: D
Rationale: For problems that can be changed or controlled, problem-focused coping strategies, such as encouraging the patient to lose weight, are most helpful. The other strategies also may assist the patient in coping with the diagnosis, but they will not be as helpful as a problem-oriented strategy.
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The nurse is teaching a hospitalized patient to use imagery as a relaxation technique. Which statement by the nurse is appropriate?
- A. Place your stress in the image of a form you can destroy.
- B. Think of a place where you feel peaceful and comfortable.
- C. Bring what you hear and sense in your present environment into your image of the scene.
- D. If your scene is stressful to you, continue visualizing until you can overcome the distress.
Correct Answer: B
Rationale: When using imagery for relaxation, the patient should visualize a comfortable and peaceful place. The goal is to offer a relaxing retreat from the actual patient environment. Imagery may be used to target a disease or pathology, but this type of imagery will not lead to relaxation.
The nurse is caring for a patient who has been hospitalized following a heart attack and tells the nurse, 'I didn't sleep last night because I worried about missing work and losing my insurance coverage.' Which nursing diagnosis is appropriate to include in the plan of care?
- A. Anxiety
- B. Defensive coping
- C. Ineffective denial
- D. Risk prone-health behaviour
Correct Answer: A
Rationale: The information about the patient indicates that anxiety is an appropriate nursing diagnosis. The patient data do not support defensive coping, ineffective denial, or risk-prone health behaviour as problems for this patient.
The nurse is assisting with a breast biopsy for an alert patient who has a lump in the right breast. Which relaxation technique will be best to use at this time?
- A. Massage
- B. Meditation
- C. Guided imagery
- D. Relaxation breathing
Correct Answer: D
Rationale: Relaxation breathing is the easiest of the relaxation techniques to use. It will be difficult for the nurse to provide massage while assisting with the biopsy. Meditation and guided imagery require more time to practise and learn.
When choosing music to help relax a patient who is having a painful dressing change, which action is best for the nurse to take?
- A. Use music composed by Mozart.
- B. Ask the patient about music preferences.
- C. Select music that has 60-80 beats/minute.
- D. Encourage the patient to use music without words.
Correct Answer: B
Rationale: Although music with 60-80 beats/minute, music without words, and music composed by Mozart are frequently recommended to reduce stress, each patient responds individually to music and personal preferences are important.
The nurse is preparing a health-promotion session on meditation for older persons at a community centre. Which of the following points should the nurse include in the session?
- A. Have patients bring earphones to the session.
- B. Breathing pattern to slowly increase speed.
- C. Allow a 10-20 minute time frame for meditation.
- D. Practise two to three times per week.
Correct Answer: C
Rationale: Guidelines for basic mediation include continuing it for 10-20 minutes, although even 5 minutes can be helpful. Patients won't bring earphones as the guideline is to find a quiet place with no distractions. The breathing pattern is to breathe slowly and consistently, relaxation breathing, not to speed up the rate. Meditation guidelines suggest that this be done once or twice a day.