nurse hears a client in active labor say to her husband, “Don’t touch me.
Stay away.” The husband states, “I don’t know what to do. Everything I do is wrong.” Which response by the nurse would be the most supportive?
“Would you like to take a break for a while?”.
“You are doing a great job.
It’s very difficult to support someone during this part of labor.”.
“Perhaps she’ll respond better to someone else.
Can you call someone to help?”.
The Correct Answer is B
The correct answer is choice B. “You are doing a great job.
It’s very difficult to support someone during this part of labor.” This response acknowledges the husband’s feelings and efforts, and provides reassurance and encouragement.
It also reflects the reality that active labor can be very intense and painful for the woman, and she may not want to be touched or talked to.
Choice A is wrong because it suggests that the husband is not needed or wanted, and may make him feel rejected or useless.
Choice C is wrong because it implies that the husband is not a good support person, and may hurt his self-esteem or damage his relationship with his wife.
Choice D is wrong because it focuses on the physical aspect of labor, rather than the emotional one.
It also assumes that the woman wants medication, which may not be the case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
No explanation
Correct Answer is C
Explanation
This is because the patient is experiencing supine hypotension syndrome, which occurs when the weight of the gravid uterus compresses the inferior vena cava and reduces venous return and cardiac output. Turning the patient onto her side will relieve the pressure and improve blood flow.
Choice A is wrong because taking the patient’s blood pressure will not address the cause of her symptoms and may delay appropriate intervention.
Choice B is wrong because breathing into her cupped hands will not improve her circulation and may increase her carbon dioxide levels.
Choice D is wrong because elevating the patient’s legs will not relieve the compression of the inferior vena cava and may worsen her condition.Normal blood pressure for a pregnant woman is 110/70 to 120/80 mmHg.Normal heart rate for a pregnant woman is 60 to 90 beats per minute.Normal respiratory rate for a pregnant woman is 16 to 24 breaths per minute.
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