A nurse is evaluating the effectiveness of the plan of care for a client who has experienced sexual assault. Which of the following findings indicates effectiveness of the plan of care?
Exhibits grief response behaviors
States a desire for revenge
Asks for advice about making life decisions
Demonstrates an increase in regressive behavior
The Correct Answer is C
Choice A rationale:
Exhibiting grief response behaviors may indicate the client is processing emotions related to the assault but may not necessarily indicate effectiveness of the plan of care.
Choice B rationale:
Stating a desire for revenge suggests unresolved anger and is not indicative of effective coping or progress.
Choice C rationale:
A sign of effectiveness in the plan of care for a client who has experienced sexual assault is the client's willingness to seek guidance and support in making important life decisions. This indicates a sense of trust in the nurse and a desire to move forward in a positive way.
Choice D rationale:
Demonstrating an increase in regressive behavior might indicate emotional distress but does not necessarily indicate effectiveness of the plan of care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Dry mouth is a common side effect of amitriptyline, which is a tricyclic antidepressant. Informing the client of potential side effects is important for their understanding and management of medication-related symptoms.
Choice B rationale:
Amitriptyline is not known to cause an increase in blood pressure. In fact, it can have a hypotensive effect.
Choice C rationale:
Weight loss is not a typical side effect of amitriptyline. It can often lead to weight gain.
Choice D rationale:
Amitriptyline can cause urinary retention rather than increased urination.
Correct Answer is C
Explanation
Choice A rationale:
Palliative care is not necessarily focused on prolonging the client's life, but rather on improving the quality of life and managing symptoms.
Choice B rationale:
Palliative care is not limited to individuals with a specific life expectancy, such as less than 6 months. It can be provided at any stage of a serious illness.
Choice C rationale:
Palliative care aims to address the physical, emotional, and psychosocial needs of both the client and their family.
Choice D rationale:
Palliative care involves a holistic approach that includes traditional medical treatments along with psychosocial and emotional support.
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