A nurse is caring for a client who states, "I don't want to start dialysis treatments." Which of the following responses should the nurse make?
"I'm sorry to hear that, but I know the dialysis will make you feel better."
"What are your concerns about the dialysis treatments?"
"Do you think your doctor would have recommended dialysis if you didn't need it?"
"Most people do get tired of dialysis treatments after a while.”
The Correct Answer is B
A. "I'm sorry to hear that, but I know the dialysis will make you feel better.": This response dismisses the client’s feelings and moves too quickly to reassurance without first exploring the client’s perspective. It can make the client feel unheard and pressured to accept the treatment.
B. "What are your concerns about the dialysis treatments?": This response encourages open communication by inviting the client to express their fears, concerns, or misunderstandings. It shows respect for the client's autonomy and fosters a therapeutic relationship built on trust and understanding.
C. "Do you think your doctor would have recommended dialysis if you didn't need it?": This shifts focus away from the client’s feelings and places undue emphasis on the authority of the provider. It may make the client feel invalidated or coerced rather than supported in making an informed decision.
D. "Most people do get tired of dialysis treatments after a while.": This statement reinforces negative feelings about dialysis and can increase the client’s anxiety or resistance toward the treatment rather than helping them work through their concerns in a constructive manner.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Place the client in a supine position: A supine position can impair lung expansion and increase the risk of respiratory complications. Clients with a chest tube are best positioned in a semi-Fowler’s or high-Fowler’s position to promote lung re-expansion and ease of breathing.
B. Empty the collection chamber every 8 hr: The collection chamber in a chest drainage system should not be emptied routinely, it should be emptied as needed to prevent it from overfilling. It is a closed system, and breaking it by emptying can introduce infection or disrupt the pressure needed for effective drainage.
C. Ensure the device is kept below the level of the client's chest: Keeping the chest drainage system below chest level uses gravity to promote drainage and prevents backflow of fluid or air into the pleural space. This positioning is essential to maintain the effectiveness and safety of the chest tube system.
D. Clamp the chest tube every 4 hr: Routine clamping of a chest tube is not recommended as it can lead to a dangerous buildup of air (tension pneumothorax). Clamping is reserved for specific, short-term procedures under direct provider orders, such as changing the drainage system.
Correct Answer is A
Explanation
A. Ask the client's family about cultural or religious practices regarding postmortem care: Respecting the client's and family's cultural and religious preferences is an important aspect of providing dignified and individualized postmortem care. Some practices may have specific rituals that should be honored.
B. Remove the client's dentures from their mouth before rigor mortis begins: Dentures are usually placed back into the client's mouth, not removed, to maintain a natural facial appearance and support the facial structure before rigor mortis sets in.
C. Turn on all the lights in the room before the family views the client's body: Creating a calm, peaceful environment is preferred when the family views the body. Harsh lighting may feel overwhelming or intrusive during such an emotional time.
D. Position the client's bed flat without a pillow under their head: Elevating the head of the bed slightly and placing a pillow under the head can help prevent blood from pooling in the head and face, preserving a more natural appearance. Leaving the bed flat is not ideal.
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