A nurse is caring for a client who is about to undergo open-heart surgery. The client states that he is very nervous about the surgery. Which of the following responses should the nurse make?
Give the client some reading material about their upcoming surgery to help ease their mind.
Suggest that the client take a walk around the unit.
Refer the client to the pastoral care team.
Speak with the client and ask him to describe what they are feeling.
The Correct Answer is D
Choice A reason:
Providing reading material about the surgery can be informative, but it may not be the best approach for someone who is already very nervous. It could potentially increase anxiety if the information is overwhelming or if the client misinterprets the material.
Choice B reason:
Suggesting a walk could serve as a distraction and help to calm the client's nerves. However, it might not address the underlying anxiety about the surgery itself. It's a temporary measure that doesn't offer emotional support or address the client's immediate concerns.
Choice C reason:
Referring the client to the pastoral care team could be beneficial if the client is seeking spiritual support or comfort. However, this should be based on the client's personal preferences and beliefs, and it may not be the most direct way to address the client's stated nervousness.
Choice D reason:
Engaging the client in a conversation about their feelings provides an opportunity for emotional support and can help the nurse understand the client's specific fears. This approach can lead to a more personalized care plan to alleviate anxiety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Bleeding is not commonly associated with the use of haloperidol. While antipsychotic medications can have a wide range of side effects, bleeding is not typically reported as an adverse effect of haloperidol.
Choice B reason:
Pancreatitis is not a recognized adverse effect of haloperidol. This condition involves inflammation of the pancreas and is more commonly associated with medications that affect the gastrointestinal system directly.
Choice C reason:
Dysrhythmias, or abnormal heart rhythms, are known adverse effects of haloperidol. This medication can affect the electrical activity of the heart, potentially leading to serious cardiac events.
Choice D reason:
Cataracts are not a direct adverse effect of haloperidol. While long-term use of some medications can increase the risk of developing cataracts, haloperidol is not specifically linked to this condition.
Correct Answer is B
Explanation
Choice A reason:
Taking away TV privileges and placing the client in seclusion could be perceived as punitive rather than therapeutic. It may escalate the situation and does not address the immediate need to ensure safety and de-escalate the aggression.
Choice B reason:
Stating that hitting others is unacceptable is a clear and direct way to address the behavior. It sets a firm boundary and communicates the expectations for behavior within the unit, which is essential in managing aggressive situation.
Choice C reason:
Saying that the behavior will disappoint the provider personalizes the issue and may not be effective in the moment. The focus should be on the immediate safety of all clients and the unacceptability of the behavior, rather than on the potential emotional response of the provider.
Choice D reason:
Asking why the client hit another client immediately after the incident may not be productive and could lead to further justification of the behavior or additional aggression. It's important to first address the behavior and ensure safety before exploring the reasons behind it.
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