A community health nurse is talking with a client who has chronic kidney disease and is unsure if they want to begin hemodialysis. Which of the following statements should the nurse make?
"Many clients undergoing hemodialysis can resume their usual activities."
"Why are you unsure about starting hemodialysis?"
"Can you clarify what makes you unsure about starting hemodialysis?"
"I recommend you talk to your family about initiating hemodialysis."
The Correct Answer is C
Choice A reason: While it is true that many clients can resume usual activities while on hemodialysis, this statement does not address the client’s uncertainty. It provides reassurance but does not encourage exploration of the client’s feelings or concerns, which is essential in therapeutic communication.
Choice B reason: Asking “Why are you unsure?” can sound confrontational and may make the client defensive. It does not promote open dialogue in a supportive manner.
Choice C reason: Asking the client to clarify what makes them unsure is therapeutic. It invites the client to share their concerns in a nonjudgmental way, allowing the nurse to better understand their perspective and provide individualized support. This is the correct answer because it fosters communication and client-centered care.
Choice D reason: Recommending that the client talk to their family shifts responsibility away from the nurse-client relationship. While family support is important, the nurse’s role is to explore the client’s feelings and provide education, not to delegate the decision-making process.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Consuming additional calories each day is essential to support milk production. Breastfeeding mothers require approximately 450–500 extra calories daily to meet the increased metabolic demands of lactation. Adequate nutrition ensures sufficient milk supply and maternal health, making this the correct teaching.
Choice B reason: Avoiding seafood entirely is unnecessary. While certain fish high in mercury should be limited, many types of seafood are safe and provide beneficial omega-3 fatty acids. Blanket avoidance is not evidence-based.
Choice C reason: Waiting 1 hour after consuming alcohol is not sufficient. Alcohol passes into breast milk, and the recommended guideline is to avoid alcohol altogether or wait at least 2–3 hours per drink before breastfeeding. Therefore, this statement is inaccurate.
Choice D reason: Caffeine does enter breast milk, but it does so quickly, not slowly. Moderate caffeine intake (about 200–300 mg/day) is generally safe, but excessive intake can cause irritability and poor sleep in infants. The statement is misleading and incorrect.
Correct Answer is B
Explanation
Choice A reason: Cleansing the insertion site daily is not appropriate because frequent manipulation increases the risk of introducing pathogens into the epidural space. The site should be maintained with sterile technique and minimal disturbance to reduce infection risk.
Choice B reason: Covering the insertion site with a transparent dressing is appropriate because it allows continuous visualization of the site for signs of infection or leakage while maintaining sterility. Transparent dressings also reduce the need for frequent manipulation, thereby lowering infection risk.
Choice C reason: Administering supplemental opioids without provider orders is unsafe. Epidural analgesia is tightly regulated, and additional opioids could increase the risk of respiratory depression, sedation, and overdose.
Choice D reason: Replacing infusion tubing every 72 hours is standard for IV therapy but not specific to epidural analgesia. Epidural tubing requires specialized sterile handling and should not be routinely changed unless clinically indicated.
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