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?

"I will make sure that we respect your right to refuse medications."

"You will need to rest so that you can recover from the episode that brought you here."

"Why do you think your provider will prescribe you medications that will make you sleep?"

"It's not your choice to be here, so you have to accept the treatment we plan for you."

Answer and Explanation

The Correct Answer is A

A. "I will make sure that we respect your right to refuse medications." – This response respects the client's autonomy and reassures them that their rights will be upheld.

B. "You will need to rest so that you can recover from the episode that brought you here." – This statement dismisses the client's concerns rather than addressing them.

C. "Why do you think your provider will prescribe you medications that will make you sleep?" – While open-ended questions can encourage discussion, this does not directly reassure the client about their rights.

D. "It's not your choice to be here, so you have to accept the treatment we plan for you." – This statement is inappropriate and disregards the client's legal rights.

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Correct Answer is C

Explanation

A. Crispy foods like rice bars can be difficult to swallow and increase the risk of aspiration.

B. Dry foods such as soda crackers require excessive chewing and can be a choking hazard.

C. This is the correct answer. Scrambled eggs have a soft, moist texture that is easy to chew and swallow, making them a good option for clients with dysphagia.

D. Peanut butter is thick and sticky, making it difficult to swallow and increasing aspiration risk.

A. Place the client in Trendelenburg position. B. Reinsert the protruding intestinal tissue. C. Cover the wound with a saline-soaked dressing. D. Monitor vital signs every 30 min.

Correct Answer is C

Explanation

A. Placing the client in Trendelenburg position is incorrect because this position does not reduce tension on the abdominal wound and may increase intra-abdominal pressure.

B. Reinserting the protruding intestinal tissue is incorrect because this can introduce infection and cause further damage.

C. This is the correct answer. The priority action is to cover the wound with a sterile, saline-moistened dressing to prevent tissue drying and reduce infection risk.

D. Monitoring vital signs is important, but the priority is to protect the exposed abdominal contents.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is assisting in the selection of foods for a client who has dysphagia caused by a stroke. Which of the following foods should the nurse recommend?

Correct Answer is C

Explanation

A nurse is caring for a client who is postoperative following abdominal surgery. The client reports feeling like "something opened up." The nurse peels back the dressing to find separation of the incision with protrusion of intestinal tissue. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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