A nurse is assessing a client who is about to undergo a left lobectomy to treat lung cancer. The client expresses fear and regret about her past smoking habit.
How should the nurse respond?
"It's okay to feel scared. Let's talk about what you are afraid of."
"Don't worry. The important thing is you have now quit smoking."
"Your doctor is a great surgeon. You will be fine."
"I understand your fears. I was a smoker also."
The Correct Answer is A
Choice A rationale:
It's okay to feel scared. Let's talk about what you are afraid of.
Acknowledges the client's feelings: This response directly acknowledges the client's fear and regret, which is a crucial first step in providing emotional support. It validates the client's experience and creates a safe space for open communication.
Invites the client to share: By inviting the client to talk about their fears, the nurse encourages open expression of emotions. This can help the client to process their feelings and gain a sense of control over their situation.
Promotes understanding: By actively listening to the client's concerns, the nurse can gain a better understanding of their individual needs and fears. This understanding can then guide the nurse in providing tailored support and interventions.
Facilitates coping: Talking about fears can help the client to identify and explore coping strategies. The nurse can assist in this process by offering suggestions, providing resources, and teaching relaxation techniques.
Strengthens the nurse-client relationship: By demonstrating empathy, active listening, and support, the nurse can foster a trusting relationship with the client. This relationship can provide a source of comfort and reassurance during a challenging time.
Choice B rationale:
Don't worry. The important thing is you have now quit smoking.
Dismisses the client's feelings: This response minimizes the client's fear and regret, which can be invalidating and hinder emotional expression.
Focuses on the past: While it's important to acknowledge the positive step of quitting smoking, this response shifts the focus away from the client's current emotional state and concerns about the upcoming surgery.
Offers false reassurance: Telling the client not to worry can be unrealistic and unhelpful, as it doesn't address the underlying fears.
Choice C rationale:
Your doctor is a great surgeon. You will be fine.
Provides premature reassurance: While it's appropriate to express confidence in the medical team, this response may not fully address the client's emotional needs. It can also inadvertently downplay the seriousness of the surgery and potential risks.
Shifts focus away from the client: This response focuses on the surgeon's skills rather than the client's feelings and concerns.
Choice D rationale:
I understand your fears. I was a smoker also.
May be perceived as self-focused: While sharing a personal experience can sometimes build rapport, it's important to ensure the focus remains on the client's needs and experiences. This response could inadvertently shift the attention to the nurse's own story.
Does not directly address the client's fears: While expressing understanding can be helpful, it's important to follow up with s and encouragement to explore the client's specific concerns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
Choice A is incorrect. Alprazolam does not have any known dietary interactions with aged cheeses. This information is specific to monoamine oxidase inhibitors (MAOIs), not benzodiazepines like alprazolam.
Choice B is incorrect. While some benzodiazepines can have side effects like drowsiness or dizziness that might indirectly affect blood pressure, alprazolam itself is not known to directly cause an increase in blood pressure.
Choice D is incorrect. Doubling the next dose of medication if a dose is missed is dangerous and can lead to overdose and increased risk of serious side effects. The client should be instructed to contact their doctor if they miss a dose.
Choice C is correct. Alprazolam is a pregnancy category D medication, meaning it has positive evidence of fetal risk. Studies have shown an increased risk of birth defects, including cleft lip and palate, in babies exposed to alprazolam during pregnancy. Therefore, it is crucial for women of childbearing age to use a reliable form of contraception while taking alprazolam to prevent unintended pregnancy and potential harm to the fetus.
Additional teaching points for the nurse:
The nurse should inform the client about the specific risks associated with alprazolam during pregnancy and the importance of discussing alternative treatment options if pregnancy is desired.
The nurse should emphasize the importance of using a reliable form of contraception that is effective both during and after treatment with alprazolam, as the medication can remain in the system for some time after the last dose.
The nurse should provide the client with resources on contraception and reproductive health, and encourage her to talk to her doctor about any s or concerns she may have.
Correct Answer is A
Explanation
Rationale:
A. Agoraphobia: This choice directly aligns with the client's presentation of being afraid to leave her home alone. Agoraphobia is a specific phobia characterized by an intense fear of situations that the individual perceives as inescapable or that might potentially lead to panic or embarrassment. Common triggers for agoraphobic individuals include crowded spaces, open spaces, public transportation, or being alone outside of the home. The client's inability to leave her home for weeks due to fear is a classic symptom of agoraphobia.
B. Xenophobia: This choice refers to the fear of strangers or foreigners. While the client may experience anxiety in unfamiliar situations, the primary focus of her fear is being outdoors alone rather than encountering unfamiliar people. Additionally, the daughter's description of the client's fear specifically mentions being alone, further supporting agoraphobia as the more likely diagnosis.
C. Mysophobia: This choice refers to an extreme or obsessive fear of germs or contamination. While anxiety related to cleanliness could coexist with agoraphobia, the primary presenting complaint in this case is the fear of being outdoors, not specifically germs or contamination.
D. Aerophobia: This choice refers to the fear of flying or being in high places. There is no indication in the scenario that the client's fear is specifically related to heights or flying, making this choice less likely.
Therefore, based on the specific nature of the client's fear and the limited information provided, agoraphobia is the most probable diagnosis and the one the nurse should anticipate planning care for.
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