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 D
Explanation
A. 32 lb: A weight gain of 32 lb exceeds the recommended range for a client with a prepregnancy BMI ≥30 (obese). Excessive weight gain increases the risk of gestational diabetes, hypertension, and complications during delivery. Staying within guideline ranges supports maternal and fetal health.
B. 8 lb: A gain of 8 lb is below the recommended range and may indicate inadequate nutrition, which can compromise fetal growth and development. Clients with obesity are advised to gain more than this to support a healthy pregnancy while avoiding excessive weight.
C. 24 lb: A gain of 24 lb slightly exceeds the recommended range for obese clients. While less risky than very high gains, it may still increase the likelihood of postpartum weight retention and obstetric complications.
D. 16 lb: For a prepregnancy BMI ≥30, the recommended total weight gain is 11–20 lb. A gain of 16 lb falls within this guideline, balancing the needs of fetal growth while minimizing maternal and fetal complications. This makes it the most appropriate target for dietary teaching.
Correct Answer is C
Explanation
A. Place the client on bedrest: While limiting activity can prevent further strain, simply placing the client on bedrest does not immediately address airway compromise or improve oxygenation. Immediate interventions to relieve dyspnea take priority.
B. Obtain the client's ABG levels: Arterial blood gases provide valuable information about oxygenation and acid-base status, but drawing labs does not relieve acute respiratory distress. Assessment and interventions that improve breathing should come first.
C. Elevate the head of the client's bed: Elevating the head of the bed improves lung expansion, promotes oxygenation, and reduces the work of breathing. This is a primary, noninvasive intervention that directly addresses the client’s acute symptoms and should be implemented immediately.
D. Prepare the client for a ventilation perfusion scan: A V/Q scan helps diagnose pulmonary embolism but is a diagnostic measure. Diagnostic preparation does not take priority over interventions that relieve acute hypoxia and respiratory distress.
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