A nurse is caring for a client who is prescribed massage therapy to treat panic disorder. The client states, "I can't stand to be touched by another person." Which of the following responses should the nurse make?
"Don't worry about it. Your anxiety will lessen once the massage begins."
"Why don't you like to be touched by others?"
"I will request that the massage therapist wear gloves during your treatment."
" will tell your provider that you would like a treatment other than massage."
The Correct Answer is D
A. "Don't worry about it. Your anxiety will lessen once the massage begins."
This response dismisses the client's concerns and may not be respectful of their boundaries. It does not acknowledge the client's discomfort and does not offer a solution to address their preference.
B. "Why don't you like to be touched by others?"
While the nurse is attempting to understand the client's feelings, this question might come across as invasive or judgmental. The client may not feel comfortable discussing their reasons for not liking to be touched, and this response does not offer an immediate solution to the issue at hand.
C. "I will request that the massage therapist wear gloves during your treatment."
This response shows an attempt to accommodate the client's preference by suggesting a practical solution, such as wearing gloves to create a physical barrier. However, it's important to note that some individuals may still find this uncomfortable, and it might not be a universally effective solution for everyone.
D. "I will tell your provider that you would like a treatment other than massage."
This response acknowledges the client's discomfort and demonstrates respect for their boundaries. It indicates the nurse's intention to advocate for the client's preferences and well-being. By informing the provider about the client's aversion to touch, the nurse opens the door to exploring alternative treatment options that are more suitable for the client's comfort level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "Since injuring my knee, I've decided to become the team manager."
Option A represents an adaptive use of the ego defense mechanism known as sublimation. Sublimation is a process in which a person channels potentially negative or harmful impulses or feelings into more socially acceptable and constructive activities. In this case, the adolescent with the injured knee is using the opportunity to become the team manager, which is a positive and constructive way to stay engaged with the team despite the setback of the injury.
B. "Since my mom died, I focus all my attention on my grades."
This is an example of reaction formation, a defense mechanism where someone overemphasizes the opposite of their true feelings. In this case, the individual might be hiding or avoiding their grief by focusing on grades.
C. "I didn't tell the teacher about the bullying because it wouldn't have changed anything."
This is an example of rationalization, where the individual provides a logical-sounding but potentially inaccurate explanation for their actions. It can be a defense mechanism to justify or make more acceptable one's choices.
D. "I'm not even going to think about writing that thesis paper until after prom."
This is an example of procrastination or avoidance, which is not an ego defense mechanism but a coping or time-management strategy. It doesn't represent an adaptive use of a defense mechanism in this context.
Correct Answer is D
Explanation
A. Magnesium hydroxide:
Magnesium hydroxide is an antacid commonly used to relieve indigestion and heartburn. It does not have any known significant interactions with tranylcypromine. MAOIs typically do not interfere with antacids.
B. Ibuprofen:
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain and inflammation. It does not have specific interactions with tranylcypromine. However, individuals taking MAOIs should be cautious about using NSAIDs due to the potential risk of bleeding, especially gastrointestinal bleeding. While it's not a direct interaction, it's generally advisable for individuals taking MAOIs to consult their healthcare provider before using NSAIDs.
C. Ranitidine:
Ranitidine is an H2 blocker used to reduce stomach acid production. It does not have any known significant interactions with tranylcypromine. H2 blockers like ranitidine are often used to manage gastrointestinal issues and are generally considered safe when taken with MAOIs.
D. Pseudoephedrine:
Pseudoephedrine is a decongestant commonly found in cold and allergy medications. It can cause a dangerous increase in blood pressure when combined with MAOIs, potentially leading to a hypertensive crisis. Due to this serious interaction, individuals taking MAOIs are strongly advised to avoid medications containing pseudoephedrine.
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