A client who is having burn debridement states, "You are the worst nurse I have ever seen. All you do is hurt me." Which of the following responses should the nurse make?

"That's a hurtful thing to say."

"Why would you say such a thing?"

"Well, that's your opinion."

"Tell me more about that."

Answer and Explanation

The Correct Answer is D

Choice A Reason: This choice is incorrect because it reﬂects the nurse's feelings rather than focusing on the client's needs. Saying "That's a hurtful thing to say" may make the client feel guilty or defensive, and it does not address the underlying cause of the client's anger or frustration.

Choice B Reason: This choice is incorrect because it sounds accusatory and confrontational rather than empathetic and supportive. Asking "Why would you say such a thing?" may make the client feel judged or criticized, and it does not explore the client's feelings or concerns.

Choice C Reason: This choice is incorrect because it dismisses the client's feelings rather than acknowledging them. Saying "Well, that's your opinion" may make the client feel ignored or invalidated, and it does not show respect or compassion for the client.

Choice D Reason: This choice is correct because it invites the client to express their feelings and concerns rather than shutting them down. Saying "Tell me more about that" may make the client feel heard and understood, and it may help to identify the source of their anger or frustration. The nurse can then use therapeutic communication skills such as active listening, reﬂecting, clarifying, or validating to establish rapport and trust with the client.

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Correct Answer is C

Explanation

Choice A Reason: This choice is incorrect because it indicates respiratory alkalosis, not AKI. Respiratory alkalosis is a condition in which the lungs eliminate too much carbon dioxide (CO2) from the blood, resulting in a low level of CO2 (PaCO2) and a high level of pH. A normal PaCO2 range is 35 to 45 mm Hg, and a normal pH range is 7.35 to 7.45, so a value of 30 mm Hg and 7.49 indicate respiratory alkalosis.

Choice B Reason: This choice is incorrect because it indicates respiratory acidosis, not AKI. Respiratory acidosis is a condition in which the lungs cannot eliminate enough CO2 from the blood, resulting in a high level of CO2 (PaCO2) and a low level of pH. A value of 46 mm Hg and 7.26 indicate respiratory acidosis.

Choice C Reason: This choice is correct because it indicates metabolic acidosis, which is a common complication of AKI. Metabolic acidosis is a condition in which the body produces too much acid or loses too much base, resulting in a low level of bicarbonate (HCO3) and a low level of pH. A normal HCO3 range is 22 to 26 mEq/L, so a value of 14 mEq/L indicates metabolic acidosis. The low PaCO2 value (30 mm Hg) is due to the respiratory compensation mechanism that tries to restore the acid-base balance by increasing the ventilation and eliminating more CO2.

Choice D Reason: This choice is incorrect because it indicates metabolic alkalosis, not AKI. Metabolic alkalosis is a condition in which the body loses too much acid or gains too much base, resulting in a high level of bicarbonate (HCO3) and a high level of pH. A value of 30 mEq/L and 7.49 indicate metabolic alkalosis.

A. Systolic blood pressure is increased B. Radial heart rate is increased C. Cardiac output is reduced D. Urine output is reduced

Correct Answer is A

Explanation

Choice A Reason: This is correct because dopamine is a vasopressor that increases the contractility and stroke volume of the heart, which results in an increased systolic blood pressure.

Choice B Reason: This is incorrect because dopamine can cause tachycardia as a side eﬀect, but this does not indicate a therapeutic eﬀect. An increased radial heart rate can also indicate other conditions, such as anxiety, fever, or dehydration.

Choice C Reason: This is incorrect because dopamine does not reduce cardiac output, but rather increases it by improving the pumping function of the heart.

Choice D Reason: This is incorrect because dopamine does not reduce urine output, but rather increases it by stimulating the renal blood vessels and enhancing renal perfusion.

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A client who is having burn debridement states, "You are the worst nurse I have ever seen. All you do is hurt me." Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is A

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