A nurse is assessing a client who reports an increase in anxiety. Which of the following responses should the nurse make?

It doesn’t appear as though you are feeling anxious.

Tell me what has been happening lately.

I think you should see a therapist.

Do you think your anxiety is worse than everyone else’s?

Answer and Explanation

The Correct Answer is B

Choice A reason:

Saying “It doesn’t appear as though you are feeling anxious” is not an appropriate response. This statement invalidates the client’s feelings and can make them feel misunderstood or dismissed. It is important for the nurse to acknowledge the client’s report of anxiety and provide a supportive environment for them to express their concerns.

Choice B reason:

“Tell me what has been happening lately” is the most appropriate response. This open-ended question encourages the client to share more about their experiences and feelings, which can help the nurse understand the underlying causes of the anxiety. It also shows empathy and a willingness to listen, which are crucial in building a therapeutic relationship.

Choice C reason:

“I think you should see a therapist” might be a helpful suggestion, but it is not the best immediate response. While referring the client to a therapist can be part of the long-term management plan, the nurse should first listen to the client’s concerns and provide immediate support. Suggesting therapy right away might make the client feel like their concerns are being brushed off.

Choice D reason:

“Do you think your anxiety is worse than everyone else’s?” is not a helpful response. This question can come across as judgmental and may make the client feel defensive or invalidated. It is important for the nurse to focus on understanding the client’s individual experience rather than comparing it to others.

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Correct Answer is B

Explanation

Choice A reason: Hypothermia

Hypothermia, or abnormally low body temperature, is not a typical manifestation of acute osteomyelitis. Osteomyelitis usually presents with signs of infection, such as fever, rather than a drop in body temperature. Therefore, hypothermia is not a relevant symptom in this context.

Choice B reason: Localized edema

Localized edema, or swelling, is a common symptom of acute osteomyelitis. The infection in the bone can cause inflammation and swelling in the surrounding tissues. This is often accompanied by warmth and redness over the affected area. Therefore, localized edema is a key manifestation of acute osteomyelitis.

Choice C reason: Numbness of toes on the affected foot

Numbness of the toes is not a typical symptom of acute osteomyelitis. While nerve involvement can occur in severe cases, it is not a primary manifestation. Acute osteomyelitis primarily presents with signs of infection and inflammation, such as pain, swelling, and redness.

Choice D reason: Bradycardia

Bradycardia, or a slow heart rate, is not associated with acute osteomyelitis. The condition typically presents with systemic signs of infection, such as fever and malaise, rather than changes in heart rate. Bradycardia is more commonly related to cardiac conditions or certain medications.

A. Rinse mouth 2 times per day with an alcohol-based mouthwash. B. Take the medication with an NSAID. C. Take an antiemetic 1 hour following administration. D. Drink 2 to 3 liters of water per day.

Correct Answer is D

Explanation

Choice A reason:

The statement “Rinse mouth 2 times per day with an alcohol-based mouthwash” is incorrect. Methotrexate can cause mouth sores and irritation, and using an alcohol-based mouthwash can exacerbate these symptoms. Instead, patients are often advised to use a non-alcoholic mouthwash or a saline rinse to help prevent and soothe mouth sores.

Choice B reason:

The statement “Take the medication with an NSAID” is incorrect. Methotrexate should not be taken with nonsteroidal anti-inflammatory drugs (NSAIDs) without medical supervision because this combination can increase the risk of severe side effects, including bone marrow suppression and gastrointestinal toxicity. Patients should always consult their healthcare provider before combining these medications.

Choice C reason:

The statement “Take an antiemetic 1 hour following administration” is not standard advice for methotrexate. While methotrexate can cause nausea, antiemetics are typically taken before or at the same time as the methotrexate dose to prevent nausea, not after. Patients should follow their healthcare provider’s instructions regarding the timing of antiemetics.

Choice D reason:

The statement “Drink 2 to 3 liters of water per day” is correct. Methotrexate can cause kidney damage, and staying well-hydrated helps to prevent this by promoting the excretion of the drug and reducing its concentration in the kidneys. Drinking plenty of fluids is an important part of managing methotrexate therapy safely.

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