A nurse is caring for a client who is to undergo a bilateral prophylactic mastectomy. The client states that her family opposes her decision. Which of the following responses should the nurse make?

Did you tell your provider that your family doesn't agree with your decision?

Your family disagrees with your decision?

You are making the same decision I would make.

You should get your family to agree with your decision before signing the consent.

Answer and Explanation

The Correct Answer is B

Choice A reason: Asking if the client informed her provider about family disagreement shifts focus from addressing her emotional needs to a procedural question. It does not facilitate therapeutic communication or explore the client’s feelings about her family’s opposition. This response fails to support the client’s autonomy or address the psychological impact of her decision, making it less effective in this context.
Choice B reason: Restating the client’s concern about family disagreement uses reflective listening, a therapeutic technique that validates her feelings and encourages further discussion. This approach fosters trust, helps the client process her emotions, and supports her autonomy in deciding on the mastectomy, aligning with patient-centered care principles for addressing sensitive decisions.
Choice C reason: Stating that the nurse would make the same decision introduces personal bias, which is inappropriate in therapeutic communication. It shifts focus from the client’s needs to the nurse’s perspective, potentially undermining the client’s autonomy. This response does not address the family’s opposition or support the client’s decision-making process, making it ineffective.
Choice D reason: Suggesting the client needs family agreement before signing consent undermines her autonomy as a competent adult. Informed consent requires only the client’s understanding and agreement, not family approval. This response dismisses the client’s decision-making capacity and fails to address her emotional concerns about family opposition, making it inappropriate.

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Correct Answer is B

Explanation

Choice A reason: Assigning all staff to the emergency department disrupts care for existing inpatients and may overwhelm ED operations. Staff allocation should follow a triage plan, balancing hospital-wide needs. This action is impractical and risks neglecting other patients, making it less effective than preparing resources.
Choice B reason: Preparing to discharge stable clients frees up beds for incoming casualties, optimizing hospital capacity during a mass casualty event. This aligns with disaster protocols, ensuring resources are available for critical patients. It supports efficient triage and care delivery, making it the correct action.
Choice C reason: Canceling all elective surgeries immediately is premature without assessing the event’s scope. Some surgeries may continue if resources allow, per disaster protocols. This action disrupts hospital operations unnecessarily and is less urgent than preparing beds for casualties, making it inappropriate.
Choice D reason: Requesting ventilators assumes specific needs without assessing the casualty event’s nature. Ventilators may not be immediately required, and resource allocation should follow triage protocols. Preparing beds is a more immediate and versatile action, making this choice less prioritized in the initial response.

A. A client who has decreased serotonin levels. B. A client who has decreased cortisol levels. C. A client who has elevated dopamine levels. D. A client who has elevated thyroid levels.

Correct Answer is A

Explanation

Choice A reason: Decreased serotonin levels are linked to depression, as serotonin regulates mood in the brain’s limbic system. Antidepressants like SSRIs increase serotonin, alleviating low mood and anhedonia, making this client a prime candidate for therapy to address neurochemical imbalances in depression.
Choice B reason: Decreased cortisol is not directly tied to depression requiring antidepressants. Cortisol dysregulation may occur in stress disorders, but antidepressants target serotonin or norepinephrine, not adrenal function, making this client less suitable for antidepressant therapy based on this imbalance.
Choice C reason: Elevated dopamine is linked to schizophrenia or mania, not depression. Antidepressants target serotonin or norepinephrine, not dopamine. This client may need antipsychotics or mood stabilizers, not antidepressants, as dopamine excess does not indicate depressive pathology requiring such therapy.
Choice D reason: Elevated thyroid levels suggest hyperthyroidism, mimicking anxiety, not depression. Antidepressants are not indicated, as treatment targets thyroid function. Depression may coexist, but thyroid correction is prioritized, making this client unsuitable for primary antidepressant therapy based on this finding.

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A nurse is caring for a client who is to undergo a bilateral prophylactic mastectomy. The client states that her family opposes her decision. Which of the following responses should the nurse make?

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