A nurse is caring for a client who is at the end of life and is unresponsive.
Which of the following actions should the nurse take?
Continue to talk to the client as if they are awake.
Limit the client's visitors to one at a time.
Avoid touching the client.
Whisper when talking in the client's room.
The Correct Answer is A
Choice A rationale:
When caring for a client at the end of life who is unresponsive, it is essential to maintain a compassionate and supportive presence. Continuing to talk to the client as if they are awake is a respectful and therapeutic approach. Even though the client may not respond verbally, they may still be able to hear and sense the presence of their loved ones and the healthcare team. This communication can provide comfort and reassurance.
Choice B rationale:
Limiting the client's visitors to one at a time is a reasonable consideration, as it can help reduce potential overwhelm and maintain a calm environment. However, this choice should be based on the client's and family's preferences. Some clients and families may prefer to have multiple visitors present for support and companionship during this difficult time.
Choice C rationale:
Avoiding touching the client is not recommended when caring for an unresponsive client at the end of life. Physical touch, when gentle and respectful, can convey comfort and support. The nurse should be sensitive to the client's preferences and the family's wishes regarding physical contact.
Choice D rationale:
Whispering when talking in the client's room is not necessary. While it's important to maintain a quiet and peaceful environment, speaking in a normal tone is appropriate. The client may still be able to hear and may find comfort in the familiar voices of their loved ones and the healthcare team. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Self-awareness is a fundamental component of emotional intelligence. It involves recognizing and understanding one's own emotions, strengths, weaknesses, and values. This self-awareness enables individuals to manage their emotions effectively and develop healthy relationships.
Choice B rationale:
Self-esteem is related to self-worth and confidence but is not a core component of emotional intelligence. While having healthy self-esteem can contribute to emotional well-being, it is not a direct aspect of emotional intelligence.
Choice C rationale:
Role performance is not a primary component of emotional intelligence. Emotional intelligence focuses on one's ability to recognize, understand, and manage emotions in themselves and others, rather than on role-related behaviors.
Choice D rationale:
Body image is related to self-perception and body confidence but is not a core element of emotional intelligence. Emotional intelligence primarily deals with emotional awareness and management, social skills, and empathy.
Correct Answer is A
Explanation
Choice A rationale:
Secondary prevention involves early detection and intervention to prevent the progression of a disease. In the case of breast cancer, a mammogram is a secondary prevention measure because it aims to detect cancer at an early stage, especially in individuals with a family history of the disease. Early detection can lead to timely treatment and improved outcomes.
Choice B rationale:
Echocardiograms are typically used to assess the function of the heart and diagnose existing heart conditions. While it is a valuable diagnostic tool, it is not an example of secondary prevention, which is focused on early detection and prevention of disease.
Choice C rationale:
Influenza vaccination is an example of primary prevention, as it aims to prevent the initial occurrence of the disease by providing immunity against the influenza virus. It is not considered a form of secondary prevention.
Choice D rationale:
Not scheduling a series of tests for an asymptomatic client does not fit the definition of secondary prevention. Secondary prevention involves screening and early detection in individuals at risk or with early signs of a disease to prevent its progression. An asymptomatic client without known risk factors may not require such testing as a preventive measure.
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