A nurse is caring for a client who has been on hemodialysis for the past 5 years. The client is refusing hemodialysis and says, "I'm tired of wasting my life; I would rather die." Which of the following statements should the nurse make?
"You are feeling anxious now; why don't you give it some time before making a final decision?"
"You should talk with your family members before making this decision."
"I will discuss this with your primary health care provider, and we can discuss this more tomorrow."
"Let me refer you to talk to someone regarding your treatment options."
The Correct Answer is D
Rationale:
A. "You are feeling anxious now; why don't you give it some time before making a final decision?": This minimizes the client’s current emotional distress and does not address the seriousness of the statement. It may come across as dismissive rather than therapeutic.
B. "You should talk with your family members before making this decision.": Although involving family in major decisions can be helpful, the focus should be on the client's feelings and wishes first.
C. "I will discuss this with your primary health care provider, and we can discuss this more tomorrow.": Deferring the conversation may delay support for someone expressing emotional exhaustion and possible suicidal ideation. Prompt intervention is essential in these situations.
D. "Let me refer you to talk to someone regarding your treatment options.": This response acknowledges the client's emotional state while also offering a supportive and appropriate next step. It opens access to counseling or mental health services and helps the client explore options without judgment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E","F"]
Explanation
Rationale:
A. Client's chief complaint: Hearing voices is an auditory hallucination, which is a hallmark positive symptom of schizophrenia. Hallucinations reflect a distortion of reality and are typically responsive to antipsychotic treatment.
B. Client's job performance history: Poor job performance reflects functional decline, which is a negative symptom (e.g., avolition or anhedonia), not a positive one. It indicates loss of normal function rather than distortion.
C. Client's relationships with family and friends: Social withdrawal is another negative symptom, reflecting a lack of interest or emotional engagement. Positive symptoms are additions to normal experience, not losses like this.
D. Client's copying nurses' words: Repeating others’ words is known as echolalia, a disorganized thought manifestation commonly seen in schizophrenia. It indicates impaired cognitive processing and communication.
E. Client's statement about their mother: The delusional belief that their mother is trying to kill them represents a paranoid delusion, a classic positive symptom. Such fixed false beliefs are unrelated to reality and resistant to logic.
F. Client's speech pattern: Unclear, jumbled, and disorganized speech reflects disorganized thinking, another positive symptom of schizophrenia. This makes coherent communication and goal-directed behavior difficult.
Correct Answer is D
Explanation
Rationale:
A. "Perform aerobic activities three times per week.": While exercise can be beneficial, excessive aerobic activity may worsen fatigue in clients with MS. Low-impact and well-paced exercise is more appropriate.
B. "Soak in a hot bath.": Heat can exacerbate symptoms in clients with MS by increasing nerve conduction issues, potentially leading to worsening fatigue or vision changes.
C. "Have your partner complete activities of daily living for you.": Encouraging dependence can contribute to decreased function and self-esteem. Clients should be supported to remain as independent as possible within their limits.
D. "Schedule rest periods during the day.": Fatigue is a common symptom of MS. Rest periods help conserve energy and prevent exacerbation of symptoms, promoting better overall functioning.
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