A client's spouse has just learned of the client's terminal illness. The spouse is sitting in the corner of the client's room crying, and says to the nurse, "I feel as if I'm already so alone." Which action should the nurse take first?

Explain that alternative treatment options may be helpful.

Remind the spouse that the client may still live a long time.

Offer reassurance that the spouse is not alone.

Encourage the spouse to share their feelings.

Answer and Explanation

The Correct Answer is C

C. The first action the nurse should take is to offer reassurance to the spouse that they are not alone. This statement acknowledges the spouse's emotional distress and provides comfort and support during a difficult time. It also validates the spouse's feelings of loneliness and acknowledges the importance of their presence and support for the client.

A and B focus on the client's illness or prognosis, which may not be the immediate concern for the spouse at this moment.

D, while valuable, may come after the initial reassurance to create a supportive environment for the spouse to share their feelings when they feel ready.

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Correct Answer is B

Explanation

B. Smoking is a significant risk factor for the development of cardiovascular disease, as it contributes to the narrowing and hardening of the arteries, increases blood pressure, reduces oxygen supply to tissues, and promotes the formation of blood clots.

A. Chronic stress can contribute to cardiovascular disease by raising blood pressure, increasing heart rate, and promoting inflammation.

C. Regular physical activity is crucial for cardiovascular health. It helps strengthen the heart muscle, lower blood pressure, improve cholesterol levels, control weight, and reduce stress.

D. A low-fat diet, particularly one that is high in fruits, vegetables, whole grains, and lean proteins, can help lower cholesterol levels, reduce blood pressure, and manage weight, all of which are important for heart health.

Although A, C, D play a role in preventing cardiovascular disease, smoking is the major risk factor for cardiovascular disease.

A. Increase the lighting in the room. B. Obtain a new catheter. C. Clean the catheter with providone-iodine. D. Reposition the legs before reinsertion.

Correct Answer is B

Explanation

B. If the tip of the urinary catheter reemerges from the insertion site during insertion, it means that the catheter has become contaminated with microorganisms from the urethra or surrounding area. Continuing to insert the same catheter can introduce these microorganisms into the urinary tract, increasing the risk of urinary tract infection (UTI).

A. Increasing the lighting in the room allows for optimal visualization during the procedure, but it is not the priority action when the catheter has become contaminated.

C. Cleaning the catheter with providone-iodine is not sufficient to sterilize the catheter and eliminate the risk of introducing pathogens into the urinary tract.

D. Repositioning the legs before reinsertion does not address the contamination of the catheter and does not mitigate the risk of introducing pathogens into the urinary tract.

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A client's spouse has just learned of the client's terminal illness. The spouse is sitting in the corner of the client's room crying, and says to the nurse, "I feel as if I'm already so alone." Which action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a family history of cardiac disease is seeking information to control risk factors. Which lifestyle modification is most important for the nurse to encourage?

Correct Answer is B

Explanation

The nurse is inserting a urinary catheter that has been prescribed for the client. When the tip of the catheter reemerges from the insertion site, which action should the nurse take next?

Correct Answer is B

Explanation

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