A home health nurse is assisting in the care of a patient following a modified radical mastectomy. Which statement by the patient indicates effective coping?
“I’m going to close my eyes until you finish dressing my incision.”.
“I would just like to spend my day staring at the TV.”.
“I’m planning to stay at home until my breast reconstructive surgery.”.
“I would like to see what this looks like today.”.
The Correct Answer is D
Choice A rationale
Closing one’s eyes during wound dressing may indicate avoidance or denial, which are not effective coping strategies. It’s important for patients to be aware of their condition and participate in their care to the extent possible.
Choice B rationale
Spending the day staring at the TV may indicate withdrawal or depression, which are not signs of effective coping. Engaging in activities, socializing, and participating in physical therapy or rehabilitation can help improve mood and promote recovery.
Choice C rationale
While it’s normal for patients to want to stay home until they feel better or until they have completed reconstructive surgery, this statement alone does not necessarily indicate effective coping. It’s important for patients to gradually resume normal activities and social interactions as their condition allows.
Choice D rationale
Expressing a desire to see the surgical site indicates acceptance and a willingness to participate in care, which are signs of effective coping. This shows that the patient is taking an active role in their recovery and is not avoiding or denying their condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Increasing vitamin C intake by drinking orange juice is not recommended for a patient with gastroesophageal reflux disease (GERD). Orange juice is acidic and can exacerbate the symptoms of GERD5.
Choice B rationale
Lying down for 30 minutes after each meal is not recommended for a patient with GERD. This can cause stomach acid to flow back into the esophagus, worsening GERD symptoms.
Choice C rationale
Eating six small meals each day is a good practice for a patient with GERD. Smaller meals are easier on the stomach and less likely to cause reflux.
Choice D rationale
Sleeping flat on the back at night is not recommended for a patient with GERD. Elevating the head of the bed can help prevent stomach acid from flowing back into the esophagus.
Correct Answer is C
Explanation
A.Changing the dressing on the tracheostomy site is an important part of tracheostomy care, but it is not the first action that should be taken.
B.Suctioning the tracheostomy tube should only be performed if there are signs of airway obstruction (e.g., increased secretions, decreased oxygenation, or adventitious breath sounds). Suctioning too frequently or unnecessarily can cause mucosal damage and hypoxia.
C. Auscultating the lungs helps the nurse determine if there is increased secretions, diminished breath sounds, or other airway concerns that may require suctioning. This ensures that care is performed appropriately based on the client’s needs.
D.Cleaning the inner cannula is a necessary part of tracheostomy care, but it should bedone after assessing the airway and performing suctioning if needed.
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