A nurse is caring for a client following an involuntary admission to'an acute mental health facility. The client states, "I'm afraid they will give me drugs that put me to sleep." Which of the following statements should the nurse make?
"You will need to rest so that you can recover from the episode that brought you here."
"I will make sure that we respect your right to refuse medications.
"It's not your choice to be here, so you have to accept the treatment we plan for you."
"Why do you think your provider will prescribe you medications that will make you sleep?"
The Correct Answer is B
A. "You will need to rest so that you can recover from the episode that brought you here.": This response dismisses the client's fear and does not address their concern about being given medications that induce sleep. It also does not acknowledge the client's right to refuse medications or address their autonomy.
B. "I will make sure that we respect your right to refuse medications.": This response validates the client's concern and reassures them that their autonomy and right to refuse medications will be respected. It promotes trust and therapeutic communication between the nurse and the client.
C. "It's not your choice to be here, so you have to accept the treatment we plan for you.": This response undermines the client's autonomy and rights, which can erode trust and impede therapeutic rapport. Involuntary admission does not negate the client's right to participate in treatment decisions or refuse medications.
D. "Why do you think your provider will prescribe you medications that will make you sleep?": This response challenges the client's perception and may come across as confrontational. It does not address the client's fear or provide reassurance about their rights regarding medication administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. A bologna sandwich on rye bread: Rye bread contains gluten, which is harmful to individuals with celiac disease. Therefore, foods containing gluten, such as rye bread, should be avoided in the diet of a preschooler with celiac disease.
B. Corn tortilla with black beans: Corn tortillas and black beans are both gluten-free options and suitable for individuals with celiac disease. Corn tortillas are made from cornmeal, which does not contain gluten, making them a safe choice for individuals with celiac disease. Black beans are also naturally gluten-free and can provide essential nutrients like protein and fiber to the preschooler's diet.
C. Whole wheat pasta with shrimp: Whole wheat pasta contains gluten, which is not suitable for individuals with celiac disease. Therefore, whole wheat pasta should be avoided in the diet of a preschooler with celiac disease.
D. Low sodium vegetable soup with barley: Barley contains gluten and is not suitable for individuals with celiac disease. Therefore, foods containing barley, such as vegetable soup with barley, should be avoided in the diet of a preschooler with celiac disease.
Correct Answer is A
Explanation
Answer: A
Rationale: A) "Empty your ostomy pouch when it is half full.": This instruction is essential to prevent the pouch from becoming too heavy, which can cause leakage or discomfort. Regular emptying also helps maintain the integrity of the pouching system and prevents leaks.
B) "Notify the provider if your stoma becomes pink and moist.": While it's crucial to monitor the stoma's appearance for signs of complications, a pink and moist stoma typically indicates healthy tissue. This instruction may cause unnecessary concern for the client.
C) "Use a moisturizing soap to cleanse your stoma.": Moisturizing soap is not recommended for stoma cleansing, as it may leave a residue that interferes with the pouch's adhesion and can lead to skin irritation. Instead, the client should use warm water and a mild, non-moisturizing soap.
D) "Apply sterile gloves when changing your ostomy pouch.": While hand hygiene is essential when managing an ostomy, sterile gloves are not necessary for routine pouch changes. Clean, non-sterile gloves or thorough handwashing with soap and water are sufficient to prevent infection.
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