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The family of a client diagnosed with a myocardial infarction complicated by cardiogenic shock is visibly anxious and upset about the client's condition. Which should the nurse plan to implement to provide support to the family?
- A. Offer them coffee and other beverages on a regular basis.
- B. Insist that they go home to sleep at night to keep up their own strength.
- C. Ask the hospital chaplain to sit with them until the client's condition stabilizes.
- D. Provide flexible visiting times according to the client's condition and family needs.
Correct Answer: D
Rationale: The use of flexible visiting hours meets the needs of both the client and family for reducing the anxiety levels of both. Offering the family beverages does not provide support. Insisting that the family go home is nontherapeutic. Although the chaplain may provide support, it is unrealistic for the chaplain to stay until the client stabilizes.
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Which comment made by the parents of a male infant who will have a surgical repair of a hernia indicates a need for further teaching by the nurse?
- A. I understand that surgery will repair the hernia.'
- B. I don't know if he will be able to father a child when he grows up.'
- C. The day nurse told me to give him sponge baths for a few days after surgery.'
- D. I'll need to buy extra diapers because we need to change them frequently now.'
Correct Answer: B
Rationale: The anatomical location of a hernia frequently causes more psychological concern to the parents than does the actual condition or treatment. The remaining options all indicate accurate understanding associated with the surgery. The correct option is an incorrect comment requiring follow-up.
A client diagnosed with hyperaldosteronism has developed kidney failure and states to the nurse, 'This means that I will die very soon.' Which is the most appropriate therapeutic response for the nurse to make to the client?
- A. You will do just fine.
- B. What are you thinking about?
- C. You sound discouraged today.
- D. I read that death is a beautiful experience.
Correct Answer: B
Rationale: The therapeutic response encourages the client to express their thoughts and feelings about their prognosis, facilitating open communication. Option 1 provides false reassurance, which can block communication. Option 3 labels the client's emotions without encouraging further exploration. Option 4 is inappropriate and does not address the client's specific concerns about their condition.
A client who is quadriplegic frequently makes lewd sexual suggestions and uses profanity. The nurse concludes that the client is inappropriately using displacement. Which concern should the nurse identify as being appropriate for this client?
- A. Disuse syndrome
- B. Lack of coping skills
- C. Negative body image
- D. Lack of awareness of surroundings
Correct Answer: B
Rationale: Lack of coping skills is evident when the client demonstrates an impaired ability to adapt to meeting life's demands and roles. This client is displacing feelings onto the environment instead of using them in a constructive fashion. Option 3 may be appropriate, but it has nothing to do with the displacement that the client is currently using. Options 1 and 4 have no relation to this situation.
A young female client hospitalized on the inpatient psychiatric unit receives treatment for anorexia nervosa. Which statement made by the client to the nurse best indicates improvement?
- A. The client states, 'I realize I am too thin and that it is not good for me, but I do not know how to eat more without getting fat.'
- B. The client requests a sanitary pad, saying, 'I did not think to bring anything with me. I have not had a period for months.'
- C. The client states, 'Either the food here is getting better or my appetite is coming back, but lately I find myself looking forward to meals.'
- D. The client asks for her discharge date to be delayed and says, 'I do not feel ready yet to deal with the tension in my family and their demands for perfection.'
Correct Answer: C
Rationale: Looking forward to meals indicates improved appetite and a positive shift in attitude toward eating, a key sign of progress in anorexia treatment. Other statements reflect awareness, physical changes, or anxiety, but do not directly indicate improved eating behavior.
The nurse is preparing a client for a parathyroidectomy when the client states, 'I guess I'll have to wear a scarf after this surgery.' Considering this statement, which concern should the nurse address?
- A. Denial that the surgery is necessary
- B. Trouble coping with the need for surgery
- C. Issues with potential changes to body image
- D. Anxiety about postsurgical altered function
Correct Answer: C
Rationale: The client's statement reflects a psychosocial concern regarding his or her appearance after surgery, so option 3 is the correct option. The remaining options identify unsuitable problems that are not supported by the provided client data.