A nurse is assisting with a group therapy session and notes a client who remains silent.

Which of the following actions should the nurse take?

Ask other group members to limit the number of times they speak

Allow the client extra time to think of a response

Appoint the client to lead the discussion

Tell the client to leave the group if they cannot contribute

Answer and Explanation

Correct Answer : B

a. Asking other group members to limit their speaking may place unnecessary pressure on the quiet client and make them feel singled out. The goal is to create a supportive environment where the client feels comfortable contributing when they are ready. Limiting the other group members' participation does not address the individual needs of the client who is silent.

b. Some clients may need extra time to process information or formulate their responses, particularly in a group setting where they might feel overwhelmed or anxious. Allowing the client extra time respects their pace and encourages participation without pressuring them.

c. Appointing the client to lead the discussion if they cannot contribute are not appropriate actions. These approaches can increase the client's discomfort and create a negative atmosphere, which goes against the principles of group therapy. It is important to foster an inclusive and supportive environment that encourages participation at each person's pace.

d. Telling a client to leave the group if they cannot contribute is not appropriate action. These approaches can increase the client's discomfort and create a negative atmosphere, which goes against the principles of group therapy.

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Correct Answer is E

Explanation

Adequate fluid intake helps to soften the stool, prevent constipation, and ease bowel movements. It can also help with bladder function and prevent urinary tract infections. This intervention is particularly relevant given the client's complaint of abdominal cramping and a small, hard, painful bowel movement.

The other options are not appropriate based on the information provided:

"Encourage prolonged dangling before ambulation" is not necessary or relevant in this case. The client is already transferring out of bed to a chair independently and ambulating independently in the hallway, indicating sufficient mobility.
"Irrigate indwelling catheter with 500 mL of fluid" is not indicated based on the provided information. The urinary catheter is intact, and the client is producing an appropriate amount of urine. There is no indication of urinary retention or need for irrigation.
"Administer an enema" is not necessary at this point. The client has reported a small, hard, painful bowel movement, which indicates constipation. However, conservative measures such as encouraging oral fluid intake and possibly adding dietary fiber should be tried first before considering an enema.
"Assist the client with a sitz bath" is not directly related to the client's current symptoms. A sitz bath is typically used for perineal hygiene, pain relief, or healing after certain surgical procedures, but it does not address the reported abdominal cramping or constipation.

A. Case manager B. Nutritionist C. Primary care provider D. Pediatric nurse practitioner

Correct Answer is A

Explanation

A case manager is a member of the interprofessional team who specializes in coordinating and facilitating access to healthcare services and resources for individuals and families. They can assist the client in identifying and accessing financial assistance programs or resources that can help with the cost of baby formula.

Case managers have knowledge of community resources and can provide guidance and support in navigating the system to meet the client's needs. While a nutritionist may provide guidance on infant nutrition, they may not have direct access to financial assistance programs or resources. The primary care provider and pediatric nurse practitioner may be involved in the client's care but may not have the specific expertise in addressing financial concerns.

Therefore, referring the client to a case manager is the most appropriate action in this situation.

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A nurse is assisting with a group therapy session and notes a client who remains silent. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

Correct Answer is E

Explanation

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Correct Answer is A

Explanation

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A nurse is assisting with a group therapy session and notes a client who remains silent.

Which of the following actions should the nurse take?