A nurse is caring for a client who has a new diagnosis of diabetes mellitus and is refusing to learn how to self-administer insulin. Which of the following responses should the nurse make?
“I’d like to hear your thoughts about giving yourself this medication.”
"You will suffer serious health issues if you don't take your medication."
"Why don't you want to learn how to give yourself your medication?"
“Have you considered how your decision to refuse medication will affect your family?"
The Correct Answer is A
A. “I’d like to hear your thoughts about giving yourself this medication.”: This response uses open-ended, therapeutic communication that invites the client to express concerns, fears, or misconceptions. It demonstrates respect for autonomy and helps build trust while allowing the nurse to assess readiness to learn. Understanding the client’s perspective is essential before providing education or problem-solving.
B. “You will suffer serious health issues if you don't take your medication.”: This response uses fear and threats, which can increase anxiety and resistance rather than promote cooperation. It does not encourage dialogue or address the client’s underlying concerns.
C. “Why don't you want to learn how to give yourself your medication?”: Questions beginning with “why” can feel accusatory or judgmental, causing the client to become defensive. Although the nurse needs to understand the client’s reluctance, this phrasing may inhibit open communication. A more neutral approach is preferred.
D. “Have you considered how your decision to refuse medication will affect your family?”: This response applies guilt and shifts the focus away from the client’s feelings and autonomy. It does not promote therapeutic communication or support informed decision-making. Using guilt can undermine trust and collaboration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. “I insert needles into meridian lines of my child's body to help with pain relief.”: Inserting needles along meridian lines describes acupuncture, a traditional practice aimed at balancing energy flow. Acupuncture does not involve suction or heated containers placed on the skin.
B. "I rub the edge of a coin lengthwise on my child's back when he is sick.": Rubbing a coin on the back refers to coining, also known as gua sha, which is used to release illness or bad energy. Coining produces linear marks rather than circular suction marks.
C. “I sometimes place a bottle containing steam against my child's skin.": Placing a heated bottle or cup against the skin creates suction as the air cools, which is characteristic of cupping therapy. Cupping commonly leaves circular marks due to localized pressure and increased blood flow.
D. "I apply petroleum jelly with garlic along my child's wrist to treat infectious disease.": Applying garlic with petroleum jelly reflects a topical folk remedy. This specific practice is not formally categorized as cupping or acupuncture
Correct Answer is B
Explanation
A. Polio: The inactivated polio vaccine does not contain live virus and does not increase bleeding risk in clients with thrombocytopenia. It is generally considered safe to administer and does not worsen platelet destruction. Routine immunization schedules can usually be continued with this vaccine.
B. Measles, mumps, and rubella virus: The MMR vaccine is a live attenuated vaccine and is associated with the development or worsening of thrombocytopenia. In a client with idiopathic thrombocytopenic purpura, this vaccine should be withheld due to the risk of further platelet reduction and bleeding complications. Careful timing or deferral is recommended until platelet counts stabilize.
C. Diphtheria and tetanus toxoids and pertussis: This vaccine is inactivated and does not pose a risk of viral replication or immune-mediated platelet destruction. While injection technique may need to be adjusted to reduce bleeding risk, the vaccine itself is not contraindicated.
D. Hepatitis B: Hepatitis B vaccine is non-live and safe for clients with thrombocytopenia. Although intramuscular injections can increase the risk of localized bleeding, the vaccine itself does not exacerbate ITP. Applying firm pressure after injection helps minimize bruising or hematoma formation.
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