A nurse is caring for a terminally ill patient during the 2300 to 0700 shift.
The patient says, "I just can't go to sleep.
I keep thinking about what my family will do when I am gone.”. What response by the nurse would be most appropriate?

Choice A rationale:

During inhalation, carbon dioxide levels are lower in the alveoli due to the exchange of gases. The higher concentration of carbon dioxide is found in the blood, which diffuses into the alveoli for elimination during exhalation.

Choice B rationale:

Alveoli do not collapse during the inhalation cycle. Surfactant, a substance produced by type II alveolar cells, reduces surface tension and prevents alveoli from collapsing, ensuring efficient gas exchange.

Choice C rationale:

Oxygen moves from the alveoli to the capillaries, while carbon dioxide moves from the capillaries to the alveoli. This exchange of gases occurs due to differences in partial pressures, facilitating the uptake of oxygen by red blood cells and the removal of carbon dioxide from the body.

Choice D rationale:

Exhaling carbon dioxide is a passive process that does not require significant effort. The respiratory muscles relax during exhalation, allowing the lungs to passively expel carbon dioxide from the body as a waste product of metabolism.

Choice A rationale:

"I'm sorry, I didn't hear what you said about your job. Please tell me again.”. This response demonstrates active listening and empathy. It acknowledges the patient's feelings and encourages them to share their concerns, promoting therapeutic communication. By asking the patient to repeat what they said, the nurse shows genuine interest in understanding the patient's emotions and concerns, fostering trust and rapport.

Choice B rationale:

"Why are you crying so hard about your job? What happened to your job?" This response, while well-intentioned, may come across as intrusive and judgmental. It does not encourage open communication and may make the patient feel defensive, hindering the nurse-patient relationship.

Choice C rationale:

"It's natural to be worried about your job. We all worry about our jobs sometimes.”. While this response acknowledges the patient's feelings, it does not address the specific concern the patient mentioned. It generalizes the situation and does not invite the patient to share more about their feelings, missing an opportunity for deeper communication and understanding.

Choice D rationale:

"Your job must be important to you since you are talking about it.”. This response makes an assumption about the importance of the patient's job without allowing the patient to express their feelings. It does not demonstrate active listening or empathy and may not encourage the patient to open up further about their concerns.