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Which approach is best to use with a client who is angry and agitated?
- A. Confront the client about the behavior.
- B. Turn on the television to distract the client.
- C. Maintain a calm, consistent approach with the client.
- D. Explain to the client why the behavior is unacceptable.
Correct Answer: C
Rationale: When dealing with an angry and agitated client, it is crucial to maintain a calm and consistent approach. Consistency allows the client to predict the caregiver's behavior, which can help reduce their anxiety and agitation. Confronting the client about their behavior may escalate the situation and increase their anger. Using distractions like turning on the television is not addressing the underlying issue and may not be effective in calming the client. Explaining to the client why their behavior is unacceptable is not suitable in the moment of agitation, as the client may not be in a state to attend to logical explanations and perceived criticisms should be avoided to prevent further escalation.
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The parents tell the nurse that their preschooler often awakes from sleep screaming in the middle of the night. The preschooler is not easily comforted and screams if the parents try to restrain the child. What should the nurse instruct the parents to do?
- A. Always read a story to the child before bedtime.
- B. Intervene only if necessary to protect the child from injury.
- C. Discuss counseling options with the primary health care provider.
- D. Try to wake the child and ask the child to describe the dream.
Correct Answer: B
Rationale: Waking up screaming from sleep at night indicates sleep terrors. The nurse would advise the parents to observe the child and intervene only if there is a risk for injury. Reading a story before bedtime helps calm the child before sleeping, but it does not ensure that the child will not have a sleep terror. There is no need for professional counseling because sleep terrors are a common phenomenon in preschool-age children. Trying to wake the child and asking the child to describe the dream is not appropriate as the child is not aware of anybody's presence during a sleep terror, and this may cause the child to scream and thrash more.
After a mastectomy or a hysterectomy, a client may feel incomplete as a woman. Which statement would alert the nurse to this feeling in a client who has undergone a total hysterectomy?
- A. "I don't know who can help me during my recovery."
- B. "I feel washed out; there isn't much left."
- C. "I'm scared about the pain in recovery."
- D. "I can't wait to get home; I so want to see my grandchild."
Correct Answer: B
Rationale: The correct answer is "I feel washed out; there isn't much left." This statement suggests a feeling of emptiness or incompleteness after the surgical procedure. Concern about who can assist during recovery, fear of pain, or excitement to go home and see a grandchild are not indicative of feeling incomplete as a woman after a hysterectomy. These other statements focus on practical concerns, physical discomfort, and positive emotions, respectively.
A client has just died, and their son states, 'She was the most wonderful mother. There was no one who was a better mother than she was. She was perfect.' Which stage of grief is this son experiencing?
- A. Denial
- B. Anger
- C. Idealization
- D. Shock
Correct Answer: C
Rationale: The son is experiencing the idealization stage of grief. During this stage, individuals tend to idealize the deceased person and remember them in a highly positive light, overlooking any negative aspects. This idealization serves as a coping mechanism to deal with the loss. Choice A, Denial, is incorrect as denial involves refusing to accept the reality of the loss. Choice B, Anger, is incorrect as it involves feelings of resentment and frustration. Choice D, Shock, is incorrect as shock is the initial reaction to the loss and is different from idealizing the deceased individual.
A 30-year-old woman is scheduled for a total abdominal hysterectomy due to noninvasive endometrial cancer. The nurse anticipates the client may have difficulty adjusting emotionally to this type of surgery. Which concern would be the cause of this anticipated difficulty?
- A. Change in femininity
- B. Body image changes
- C. Diminished sexual desire
- D. Slow recovery
Correct Answer: A
Rationale: The correct answer is 'Change in femininity.' The removal of the uterus can lead to changes in how some women perceive themselves sexually as it is a reproductive organ. In this young client, there may be heightened feelings of loss of femininity and reproductive potential. Body image changes could occur but are more likely with surgeries involving obvious external changes. Diminished sexual desire is unlikely in a premenopausal woman unless she has specific concerns. Slow recovery is not expected in an otherwise healthy 30-year-old woman undergoing this surgery.
Which statement regarding an interpreter is correct?
- A. Relatives or friends of the client cannot serve as interpreters.
- B. The interpreter should aim to convey meaning rather than provide literal translations.
- C. Interpreting not only the language but also the culture is important.
- D. The interpreter should be available only during client-provider communication.
Correct Answer: C
Rationale: The correct answer is that interpreting not only the language but also the culture is important. Health care facilities should provide professional interpreters to ensure accurate communication with clients who do not speak English proficiently. It is crucial for interpreters to understand and convey cultural nuances to prevent misunderstandings. Relatives or friends of the client should not serve as interpreters as they may not be impartial or adequately skilled. Providing literal word-for-word translations is not always effective as it may not capture the intended meaning. Interpreters should be available throughout the client's care process, not just during direct communication, to ensure effective and culturally sensitive care.