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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.
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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.
Which action should the nurse take to monitor the effects of an acute stressor on a hospitalized patient?
- A. Assess for bradycardia.
- B. Ask about gastrointestinal pain.
- C. Observe for decreased appetite.
- D. Check for elevated blood glucose levels.
- E. Monitor for a decrease in respiratory rate.
Correct Answer: B,C,D
Rationale: The physiological changes associated with the acute stress response can cause changes in appetite, increased gastrointestinal upset, and elevation of blood glucose. Stress causes an increase in respiratory and heart rates.
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.
A hospitalized patient whose wife describes him as usually well organized and calm is receiving diabetic teaching after being newly diagnosed with diabetes. He states, 'I'm feeling distracted because I'm just getting used to my new diagnosis'. Which action should the nurse take?
- A. Ask the health care provider for a psychiatric referral.
- B. Administer the PRN sedative medication every 4 hours.
- C. Suggest the use of a home caregiver to the patient's family.
- D. Plan to reinforce and repeat teaching about diabetes management.
Correct Answer: D
Rationale: Since behavioural responses to stress include temporary changes such as irritability, changes in memory, and poor concentration, patient teaching will need to be repeated. Psychiatric referral or home caregiver referral will not be needed for these expected short-term cognitive changes. Sedation will decrease the patient's ability to learn the necessary information for self-management.
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.