A nurse is caring for a client who is recovering from a cerebrovascular accident in a rehabilitation facility. The client tells the nurse, "I am sick of being in here, and I want to go home." Which of the following responses should the nurse make?
"It would be best to discuss your feelings with your provider."
"It must be very frustrating for you to be here."
"You are making progress in your treatment plan."
"You should call your partner to discuss this."
The Correct Answer is B
A. This response deflects the client's feelings and does not acknowledge the client's frustration.
B. This response acknowledges the client's feelings of frustration and validates their experience, showing empathy and understanding.
C. While it is important to encourage the client's progress, this response does not directly address the client's expressed emotions.
D. Suggesting that the client call their partner may not address the underlying feelings of frustration and may overlook the opportunity for therapeutic communication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Condoms are designed for single use only and should be disposed of after each use.
B. Storing condoms in a cool, dry place away from direct sunlight or heat sources (like a nightstand drawer) helps maintain their integrity and effectiveness.
C. Natural-skin condoms do not protect effectively against STIs as they are porous.
D. Petroleum jelly can degrade latex, reducing the effectiveness of the condom.
Water-based lubricants are recommended.
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}
Explanation
A. Clamping the chest tube during ambulation can lead to increased intrathoracic pressure, which may cause tension pneumothorax or other complications. Chest tubes should remain unclamped to maintain proper drainage. However, it may be done briefly during tube changes or if there is a suspected air leak, always under specific medical orders.
B. Burning pain in the chest could indicate complications such as infection or irritation at the insertion site. Reporting this symptom to the provider allows for timely assessment and intervention.
C. A loose dressing around the chest tube can compromise the integrity of the system, leading to air leaks or contamination. Reinforcing the dressing helps maintain a sterile environment and prevents dislodgement of the tube.
D. Maintaining the appropriate water seal level in the chest drainage system is essential for proper functioning. This prevents air from entering the pleural space while allowing drainage to occur effectively.
E. Stripping or milking the chest tube is no longer a recommended practice as it can cause damage to the tissues and lead to airway obstruction or clot formation. Instead, gentle manipulation or rotation of the tubing may be done if there are signs of occlusion, but routine stripping is not recommended
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