A nurse is caring for a client who is scheduled for a bronchoscopy. The client states, "I no longer wish to have this procedure." Which of the following responses should the nurse make?

"Why have you changed your mind about the procedure?"

"You have the right to refuse the procedure."

"Have you had any troubles with swallowing?

"Your doctor wants you to have this procedure."

Answer and Explanation

The Correct Answer is B

Rationale:

A. "Why have you changed your mind about the procedure?": Asking “why” can feel confrontational and may pressure the client to justify their decision rather than respecting their autonomy. It’s better to acknowledge their feelings without judgment.

B. "You have the right to refuse the procedure.": Affirming the client’s right to refuse respects their autonomy and legal rights. It opens the door for further discussion and ensures informed consent is voluntary and ongoing.

C. "Have you had any troubles with swallowing?": This question is unrelated to the client’s decision to refuse the bronchoscopy and does not address their expressed concern or right to refuse.

D. "Your doctor wants you to have this procedure.": Emphasizing the provider’s wishes may pressure the client and undermine their autonomy. The nurse’s role is to support informed decision-making, not to coerce.

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Correct Answer is A

Explanation

Rationale:

A. Tilt the client's head forward during meals: Tilting the head forward, also known as the chin-tuck technique, helps close the airway and reduce the risk of aspiration in clients with dysphagia. This position facilitates safer swallowing by improving bolus control and airway protection.

B. Encourage socialization during meal times: While social interaction is generally beneficial, clients with dysphagia require focused attention during meals to prevent choking or aspiration. Distractions can compromise concentration on swallowing techniques and safety precautions.

C. Elevate the head of the client's bed to 30": Although elevating the head of the bed helps reduce aspiration risk, a 30" elevation is not optimal for swallowing. A 45–90 degree upright position is typically recommended during meals to support safer swallowing mechanics.

D. Provide three large meals per day: Clients with dysphagia benefit more from small, frequent meals to reduce fatigue and lower the risk of aspiration. Large meals can overwhelm their ability to chew and swallow safely, increasing the risk of complications.

A. Ecchymosis on the inner left thigh B. Diminished pulses on the affected extremity C. One fingerbreadth of space between the cast and the ski D. Client report of muscle spasms of the left leg

Correct Answer is B

Explanation

Rationale:

A. Ecchymosis on the inner left thigh: Bruising can occur as a result of trauma or surgery and is expected after cast placement. While it should be monitored, it is not the most urgent concern unless it worsens or is accompanied by signs of active bleeding or compartment syndrome.

B. Diminished pulses on the affected extremity: Reduced or absent pulses indicate compromised circulation, which may be a sign of compartment syndrome or vascular injury. This is the highest priority because it threatens tissue viability and requires immediate intervention to prevent permanent damage.

C. One fingerbreadth of space between the cast and the skin: This indicates appropriate cast fit and allows for some swelling. It is not a cause for concern and confirms that the cast is not overly tight, helping to prevent pressure injuries or circulatory compromise.

D. Client report of muscle spasms of the left leg: Muscle spasms can occur from immobilization or injury and may cause discomfort, but they do not immediately endanger the limb. Pain relief and repositioning may help, but this is not the priority over vascular assessment.

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A nurse is caring for a client who is scheduled for a bronchoscopy. The client states, "I no longer wish to have this procedure." Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is B

Explanation

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