A public health nurse is teaching a group of nurses about smallpox. Which of the following statements by one of the nurses indicates understanding of the teaching?

Choice A reason:

While articulating expectations is important, the nurse’s response is more focused on addressing the client’s feelings and encouraging participation in therapy. Simply stating expectations without addressing the client’s emotions may not be as effective.

Choice B reason:

The nurse’s response demonstrates empathy by acknowledging the client’s feelings and gently guiding them towards participating in group therapy. This approach helps build trust and rapport, which are essential in therapeutic relationships, especially with clients exhibiting delusional behavior.

Choice C reason:

Setting limits on manipulative behavior is important, but in this context, the nurse’s response is more about encouraging participation and showing understanding rather than strictly setting limits.

Choice D reason:

Reflection involves mirroring the client’s feelings or statements to show understanding. While the nurse’s response does show understanding, it is not a direct example of reflection. The primary focus is on empathy and encouragement.

Choice A reason:

A sudden decrease in abdominal pain can indicate that the appendix has perforated. When the appendix bursts, the pressure is relieved, leading to a temporary reduction in pain. However, this is quickly followed by severe pain and signs of peritonitis, such as a rigid abdomen and high fever.

Choice B reason:

The absence of Rovsing’s sign is not a specific indicator of a perforated appendix. Rovsing’s sign is a clinical test used to diagnose appendicitis, where pain is elicited in the right lower quadrant when the left lower quadrant is palpated. Its absence does not necessarily indicate perforation.

Choice C reason:

A low-grade fever is a common symptom of appendicitis but does not specifically indicate perforation. A perforated appendix typically leads to a high fever due to the spread of infection within the abdomen.

Choice D reason:

A rigid abdomen is a sign of peritonitis, which can occur after the appendix has perforated. While this is an important symptom, the sudden decrease in pain followed by severe symptoms is more indicative of perforation.