During a therapy session, a client begins to cry while discussing a traumatic experience. What is the nurse’s most appropriate response?
“I can see this is very difficult for you.”.
“Please don’t cry, it’s not good for you.”.
“Why are you crying?”
“Let’s move on to a different topic to distract you.”.
The Correct Answer is A
Choice A rationale
“I can see this is very difficult for you.”. This response is appropriate as it acknowledges the client’s emotions and provides validation. It demonstrates empathy and encourages the client to express their feelings, which is essential in therapeutic communication.
Choice B rationale
“Please don’t cry, it’s not good for you.”. This response is inappropriate as it dismisses the client’s emotions and may make them feel invalidated. Crying is a natural response to emotional distress, and the nurse should support the client in expressing their feelings.
Choice C rationale
“Why are you crying?” This response is also inappropriate as it may come across as judgmental or dismissive. It does not provide the support and empathy the client needs during a difficult moment.
Choice D rationale
“Let’s move on to a different topic to distract you.”. This response is not appropriate as it avoids addressing the client’s emotions and may make the client feel that their feelings are not important. The nurse should focus on supporting the client through their emotional experience.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
The right circumstance refers to the appropriate setting and resources being available for the task to be delegated. It ensures that the situation is suitable for delegation, considering factors such as the patient’s condition and the complexity of the task. However, this is not the focus of the question, which is about the nurse’s demonstration during delegation.
Choice B rationale
The right communication involves clear, concise, and complete instructions given to the assistive personnel. It ensures that the delegatee understands the task, the expected outcomes, and any specific instructions or precautions. This is the correct answer because the nurse is demonstrating effective communication during the delegation process.
Choice C rationale
The right supervision refers to the appropriate monitoring and evaluation of the task being performed by the delegatee. It ensures that the nurse provides guidance, support, and feedback as needed. While important, this is not the focus of the question, which is about the nurse’s demonstration during delegation.
Choice D rationale
The right task refers to the appropriateness of the task being delegated, ensuring it is within the delegatee’s scope of practice and competency level. It ensures that the task is suitable for delegation. However, this is not the focus of the question, which is about the nurse’s demonstration during delegation.
Correct Answer is C
Explanation
Choice A rationale
Using a standardized pediatric medication reference guide is not appropriate for administering insulin to a diabetic client. Insulin dosages are typically based on the client’s blood glucose levels and individual needs, not standardized pediatric references. Ensuring patient safety requires accurate and individualized dosage calculations.
Choice B rationale
Relying on memory for dosage calculations is not a safe practice. Human memory is fallible, and errors in dosage calculations can have serious consequences for the client. It is essential to use reliable methods and double-check calculations to ensure accuracy and patient safety.
Choice C rationale
Asking another nurse to double-check calculations is the most appropriate action for ensuring patient safety. This practice helps to catch any potential errors and ensures that the correct dosage is administered. Double-checking calculations is a standard safety measure in medication administration.
Choice D rationale
Performing dosage calculations manually is important, but it should be combined with double- checking by another nurse. Manual calculations alone do not provide an additional layer of verification to catch potential errors. Ensuring patient safety requires both accurate calculations and verification by another healthcare professional.
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