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 B
Explanation
Rationale:
A. I should clean my stoma with moisturizing soap: Moisturizing soaps can leave a residue that interferes with the adhesive of the pouching system. The stoma area should be cleaned with warm water or a mild, non-moisturizing soap to ensure the pouch adheres properly.
B. I should cut my pouch opening 1/8 inch larger than my stoma: The opening should be just slightly larger than the stoma about 1/8 inch to prevent constriction while still protecting the surrounding skin from effluent and minimizing skin irritation.
C. I should expect my stoma to be blistered: A healthy stoma should appear moist, pink or red, and smooth. Blistering is a sign of skin breakdown or irritation and indicates improper pouch fitting or leakage, which requires intervention.
D. I should change my stoma pouch 30 minutes after heals: There isn't a specific 30-minute post-meal rule. The most important guideline for changing a pouch is when it's about one-third to one-half full, or if there is leakage or discomfort.
Correct Answer is A
Explanation
Rationale:
A. 0.45% sodium chloride: This is a hypotonic solution that helps lower serum sodium levels by diluting extracellular sodium and promoting cellular rehydration. It is commonly used to treat hypernatremia when there is no significant fluid volume overload.
B. 0.9% sodium chloride: This isotonic solution contains the same concentration of sodium as the blood. It does not correct hypernatremia and may worsen it if sodium levels are already elevated, especially in dehydrated clients.
C. Lactated Ringer's: While this is an isotonic fluid, it contains sodium and electrolytes that do not help reduce high serum sodium levels. It is more appropriate for fluid resuscitation than for treating hypernatremia.
D. 3% sodium chloride: This hypertonic solution is used for severe hyponatremia, not hypernatremia. Administering it to someone with elevated sodium levels would further increase sodium concentration and worsen the condition.
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