A nurse is caring for a client following a below-the-knee amputation. The client states, "My life is over." Which of the following responses should the nurse make?
"Why do you think your life is over?"
"Would you like to meet with another client who is an amputee?"
"Most people can adjust following this surgery."
"You are upset. We can talk about this later."
The Correct Answer is B
Choice a.This response may come across as challenging or confrontational. While the nurse is asking for more information, the phrasing could inadvertently put the client on the defensive. It doesn't validate the client's feelings and may not encourage a productive dialogue.
- Choice b. “Suggesting peer support or mentorship from someone who has gone through a similar experience could be beneficial in some situations, as it may help the client feel less isolated.
- Choice c. “Most people can adjust following this surgery.” may be true, but it does not acknowledge the client’s individual experience and feelings. It may also sound dismissive or minimizing of the client’s challenges.
- Choice d. “You are upset. We can talk about this later.” may be intended to give the client some space, but it does not convey empathy or support. It may also make the client feel rejected or ignored.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Desmopressin is a synthetic form of antidiuretic hormone (ADH), which regulates water balance in the body. Diabetes insipidus is a condition caused by a deficiency or resistance to ADH, resulting in excessive urination and thirst. Desmopressin helps reduce urine output and prevent dehydration by mimicking the action of ADH on the kidneys. Lithium is a mood stabilizer that can cause nephrogenic diabetes insipidus by interfering with the response of the kidneys to ADH. Regular insulin is used to treat diabetes mellitus, not diabetes insipidus, as it lowers blood glucose levels by facilitating its uptake into cells.
Furosemide is a diuretic that increases urine output and can worsen dehydration in clients with diabetes insipidus.
Correct Answer is B,A,C,D
Explanation
The nurse should first check for contraindications to tPA, such as hemorrhagic stroke, recent surgery, bleeding disorder, or uncontrolled hypertension. Then, the nurse should weigh the client to calculate the correct dose of tPA based on body weight. Next, thenurse should administer the tPA within three hours of symptom onset to improve the chances of recovery. Finally, the nurse should transfer the client to the CCU for close monitoring of vital signs, neurological status, and possible complications.
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