A home health nurse is caring for a client who has a chronic illness and recently moved in with their adult child. Which of the following statements by the client should indicate to the nurse that the client has adapted to their new situational role?

"I've never been the kind of person to ask others for help."

"I'm looking forward to being able to be independent again."

"I really don't know what I'm supposed to do all day."

"It's nice having other people cook for me."

Answer and Explanation

The Correct Answer is D

A. "I've never been the kind of person to ask others for help":

This statement indicates that the client may still be struggling with accepting help from others, which suggests that they have not fully adapted to their new situational role. It reflects a reluctance to rely on others and may indicate a desire to maintain independence.

B. "I'm looking forward to being able to be independent again":

While this statement suggests a desire for independence, it does not necessarily indicate that the client has already adapted to their new situational role. It may reflect an aspiration or goal rather than a current state of adaptation.

C. "I really don't know what I'm supposed to do all day":

This statement suggests uncertainty and confusion about how to fill the day, which may indicate difficulty adjusting to the new living arrangement and role. It does not necessarily indicate adaptation but rather a sense of disorientation or discomfort with the current situation.

D. "It's nice having other people cook for me."

This statement suggests that the client has become comfortable with and is accepting of the support provided by their adult child, indicating an adaptation to their new situational role. By expressing appreciation for having others cook for them, the client demonstrates a willingness to rely on and accept assistance from their family member, which is an important aspect of adapting to changes in living arrangements and roles.

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Correct Answer is C

Explanation

A. Ensure that the width of the BP cuff is 50% of the client's upper arm circumference:

While using an appropriately sized cuff is crucial for accurate blood pressure measurement, the width of the cuff should be about 40% of the circumference of the upper arm, not 50%. However, adjusting the cuff size is not the most immediate action to take when faced with an elevated blood pressure reading.

B. Reposition the client supine and recheck her BP:

Repositioning the client supine is not necessary for routine blood pressure measurement in a sitting position. Moreover, repositioning the client may not significantly affect the blood pressure reading, especially if the initial reading was obtained correctly.

C. Recheck the client's BP in her other arm for comparison.

When obtaining a blood pressure reading, it's important to confirm the accuracy of the measurement, especially if the reading is elevated. Checking the blood pressure in the other arm allows for comparison and helps identify any significant differences between the arms, which could indicate arterial abnormalities or other issues. This step ensures accuracy and helps in making appropriate clinical decisions.

D. Request that another nurse check the client's BP in 30 min:

Waiting 30 minutes to recheck the blood pressure is not the most appropriate action when faced with an elevated reading. Prompt reevaluation and comparison of blood pressure readings are essential for accurate assessment and timely intervention, especially if the initial reading indicates hypertension.

A. "I will walk three times per week." B. "I will avoid exposure to the sun." C. "I will decrease my intake of dairy products." D. "I will take 250 milligrams of calcium once per day."

Correct Answer is A

Explanation

A. "I will walk three times per week."

Regular weight-bearing exercises, such as walking, are beneficial for maintaining bone density and reducing the risk of osteoporosis in older adults. Weight-bearing activities help stimulate bone formation and strengthen bones. Therefore, the client's statement about walking three times per week demonstrates an understanding of an effective measure for reducing the risk of osteoporosis.

B. "I will avoid exposure to the sun." - Exposure to sunlight is essential for vitamin D synthesis, which helps the body absorb calcium and maintain bone health. Therefore, avoiding sunlight would not be beneficial for reducing the risk of osteoporosis.

C. "I will decrease my intake of dairy products." - Dairy products are a rich source of calcium, which is crucial for bone health. Decreasing intake of dairy products may lead to inadequate calcium intake, increasing the risk of osteoporosis.

D. "I will take 250 milligrams of calcium once per day." - While calcium supplementation is important for maintaining bone health, the recommended daily intake for older adults is higher than 250 milligrams. The client's statement suggests an inadequate understanding of calcium supplementation for osteoporosis prevention.

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A home health nurse is caring for a client who has a chronic illness and recently moved in with their adult child. Which of the following statements by the client should indicate to the nurse that the client has adapted to their new situational role?

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