A client is fearful and reluctant to talk after a traumatic event. Which technique will the nurse employ that is most effective when trying to engage the client in interaction?

Silence

Giving information

Focusing

Broad opening

Answer and Explanation

The Correct Answer is A

Choice A reason: Silence allows the client to process trauma at their own pace, creating a safe, non-pressurized environment. Fearful clients may need time to feel secure before speaking. This technique fosters trust, encourages emotional expression, and is particularly effective in trauma, where verbalization can be challenging due to psychological distress.

Choice B reason: Giving information provides facts but may overwhelm a fearful client, who may not be ready to process details post-trauma. This technique is less effective for engagement, as it does not address emotional barriers or encourage self-expression, which are critical for therapeutic interaction in trauma recovery.

Choice C reason: Focusing directs the conversation to specific topics, which can feel intrusive for a traumatized client. It assumes readiness to discuss, potentially increasing anxiety or withdrawal. This technique is less effective than silence, which allows the client to initiate dialogue when emotionally prepared, fostering trust.

Choice D reason: Broad opening encourages the client to choose topics but may be too vague for a fearful, traumatized client, who may feel overwhelmed by the lack of structure. Silence is more effective, as it provides space for emotional processing without pressuring the client to verbalize prematurely.

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Correct Answer is D

Explanation

Choice A reason: Left-sided flank pain may suggest kidney stones or infection but is not specific to AKI. Pain can occur in various conditions, including pyelonephritis or ureteral obstruction, and does not directly indicate reduced glomerular filtration or oliguria, which are hallmarks of AKI, making it less urgent.

Choice B reason: Blood pressure of 138/86 mm Hg and heart rate of 92 bpm are within normal ranges and not specific to AKI. While hypertension can occur in AKI due to fluid overload, these values do not strongly suggest AKI without other signs like oliguria or lab abnormalities.

Choice C reason: Cloudy urine with sediment and foul odor suggests a urinary tract infection, not necessarily AKI. Infections can coexist with AKI but are not diagnostic. AKI is characterized by reduced urine output and elevated creatinine, not primarily by urine appearance, making this finding less indicative.

Choice D reason: Urine output of 150 mL in 8 hours (450 mL/day) indicates oliguria, a key sign of AKI, where kidneys fail to filter adequately, reducing urine production. This can lead to fluid overload and toxin accumulation, necessitating urgent provider notification to evaluate and manage potential AKI complications like hyperkalemia.

A. Allow the client to leave with community resources for follow-up care B. Contact the client’s family to request they convince the client to stay C. Initiate a 302 commitment D. Call security and ask them to detain the client

Correct Answer is C

Explanation

Choice A reason: Allowing a client with suicidal comments to leave against medical advice is unsafe, as it risks self-harm without immediate intervention. Providing resources does not address acute suicide risk, which requires inpatient stabilization to ensure safety, making this action inappropriate in the context of expressed suicidal ideation.

Choice B reason: Contacting family to persuade the client to stay does not address immediate suicide risk. While family support may be helpful, it lacks legal authority to prevent discharge and does not ensure safety, making it less effective than initiating a commitment for a client with suicidal intent.

Choice C reason: A 302 involuntary commitment is appropriate for a client expressing suicidal ideation, indicating imminent danger to self. This legal action ensures safety through inpatient evaluation and treatment, preventing self-harm. Mental health laws prioritize protection in such cases, making this the most appropriate nursing action.

Choice D reason: Calling security to detain the client is coercive and lacks legal basis without a formal commitment process. It may escalate agitation and violate autonomy. A 302 commitment is the proper legal mechanism to ensure safety for a suicidal client, making detention by security inappropriate.

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A client is fearful and reluctant to talk after a traumatic event. Which technique will the nurse employ that is most effective when trying to engage the client in interaction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for an acutely ill client. Which assessment finding should prompt the nurse to inform the healthcare provider that the client may be exhibiting signs of acute kidney injury (AKI)?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

When is a nurse legally obligated to breach confidentiality?

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The nurse is caring for a client who is in the oliguric phase of acute kidney injury (AKI). During this phase of AKI, the nurse might anticipate which of the following findings?

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