A nurse is interviewing a client who has a personality disorder. The nurse and client have agreed on an interview time, but the client resists discussing her feelings until 5 minutes prior to the end of the session and then asks for additional time. Which of the following actions should the nurse take?
Extend the scheduled time, as the client is finally able to discuss important feelings.
End at the scheduled time, telling the client that he can continue at the next scheduled session.
Arrange for another nurse to continue the interview.
Set an extra meeting time to discuss the client's feelings.
The Correct Answer is B
Choice A reason: Extending the scheduled time could reinforce the client's resistance to discussing feelings until the end of the session, which is not therapeutic.
Choice B reason: Ending at the scheduled time maintains boundaries and structure, which are important in the therapeutic relationship, especially with clients who have personality disorders.
Choice C reason: Arranging for another nurse to continue the interview may disrupt the continuity of care and the therapeutic relationship.
Choice D reason: Setting an extra meeting time could be considered if the client's needs are urgent, but it is not the best option in this scenario as it may reinforce avoidance behaviors.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Choice A reason: Fecal impaction typically presents with the inability to pass stool and may not be associated with the absence of bowel sounds.
Choice B reason: Incisional infection is usually indicated by localized redness, warmth, and possible discharge, not necessarily by the absence of bowel sounds or flatus.
Choice C reason: Health care-associated Clostridium difficile often presents with diarrhea, not the absence of bowel sounds or flatus.
Choice D reason: Paralytic ileus is characterized by impaired intestinal motility and transit, absence of the passage of flatus, diminished bowel sounds, abdominal distension, and intestinal dilatation, fitting the symptoms described.
Correct Answer is B
Explanation
Choice A reason: Tumor in situ refers to a tumor that has not invaded surrounding tissues, which is not indicative of stage IV cancer.
Choice B reason: Stage IV cancer is characterized by distant metastasis, meaning the cancer has spread to other sites away from the primary location.
Choice C reason: While the spread into nearby tissues indicates progression, it does not necessarily mean stage IV unless there is distant metastasis.
Choice D reason: The presence of no abnormal cells would not be consistent with any stage of cancer.
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