The nurse is assessing a terminally ill client who is on home hospice care and notes that the client is demonstrating signs of terminal delirium and becoming more unresponsive. Which of the following instructions should the nurse give to the client’s children?
"We recommend that you sit at your parent's bedside so you can document the time of death."
"Limit the amount of environmental noise in your parent's room to decrease stimulation."
"This may be very difficult for you to watch your parent, so take some respite time to re-charge."
"Family often uses this time to tell their parent that it is okay to let go."
The Correct Answer is B
A. Documenting the time of death is not an immediate concern during the process of terminal delirium and does not directly address the patient's comfort.
B. Limiting environmental noise helps reduce stimulation, which can be beneficial for a patient experiencing terminal delirium and unresponsiveness, helping to maintain a calm environment.
C. While taking respite time may be necessary for family members, it does not directly address the needs of the patient with terminal delirium.
D. Telling the patient it is okay to let go is emotionally supportive but does not address the immediate need to manage symptoms and provide comfort during terminal delirium.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Bandura's Social Learning Theory focuses on learning through observation and imitation. The child's behavior of imitating his father and watching a cartoon reflects this theory, as he is learning and mimicking behaviors he has observed.
B. Family Development Theory addresses the stages and changes within a family unit over time, not the specific behavior of individual children imitating adults.
C. Skinner's Learning Theory focuses on reinforcement and punishment rather than observational learning and imitation.
D. Fishbein and Ajzen's Theory of Reasoned Action involves understanding behavioral intentions based on attitudes and norms, which is not directly related to the child's imitation of behavior.
Correct Answer is B
Explanation
A. Tertiary prevention involves managing and treating existing diseases to prevent further deterioration. Diet education does not fit this category as it is not aimed at those already affected by a condition.
B. Primary prevention aims to prevent the onset of disease before it occurs. Providing diet education to children is an example of primary prevention as it promotes healthy eating habits to prevent future health issues.
C. Quaternary prevention focuses on preventing unnecessary or excessive medical interventions. It does not relate to general diet education.
D. Secondary prevention involves early detection and intervention to reduce the impact of a disease. Diet education, aimed at preventing disease before it occurs, does not fall into this category.
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