The nurse is caring for a client diagnosed with Crohn's Disease who is crying. The client tells the nurse, am so frustrated. I never know when I will get sick and end up in the hospital" which statement would be the nurse's best response?
“I understand how frustrating this must be for you, just be strong.”
"Are you thinking about not continuing treatment.”
"You must keep thinking about the good things in your life."
“I can see that you are upset. I can sit down and we can talk.”
The Correct Answer is D
A. "I understand how frustrating this must be for you, just be strong." : While it acknowledges frustration, it dismisses the client’s emotions and offers an unrealistic solution ("just be strong").
B. "Are you thinking about not continuing treatment?" : This response is inappropriate because the client has not indicated nonadherence. It may also make the client feel defensive rather than supported.
C. "You must keep thinking about the good things in your life." : While positive thinking is beneficial, this statement invalidates the client's distress rather than addressing their concerns.
D. "I can see that you are upset. I can sit down and we can talk.": This is a therapeutic response that acknowledges the client’s feelings and provides an opportunity for open discussion, which is key in supporting clients with chronic illnesses.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Obstruction of the bile duct: Biliary cirrhosis (now called primary or secondary biliary cholangitis) can occur due to prolonged bile duct obstruction, leading to liver damage and cirrhosis.
B. Hepatitis C: Hepatitis C can cause cirrhosis, but it is not a direct cause of biliary cirrhosis. Instead, it leads to post-viral cirrhosis.
C. Hepatotoxic medications: Certain medications (e.g., acetaminophen overdose) can cause liver damage, but they do not specifically cause biliary cirrhosis.
D. Excessive alcohol consumption: Alcohol abuse can cause alcoholic cirrhosis, but not biliary cirrhosis.
Correct Answer is C
Explanation
A. Notify the health care provider: While notifying the provider is important, assessing the client comes first to determine if there is active bleeding.
B. Administer a 1-liter bolus of normal saline: Fluid resuscitation is used for shock, but the cause of symptoms must be assessed first.
C. Inspect the biopsy site dressing: The most concerning complication after a liver biopsy is internal bleeding, as the liver is highly vascular. Pallor and near-syncope may indicate hemorrhage. The priority action is to assess the biopsy site for bleeding before taking further action.
D. Position the client on the right side: Clients are typically positioned on the right side after a liver biopsy to apply pressure and reduce bleeding risk, but since the client is already experiencing symptoms of hypovolemia, assessment and intervention for potential hemorrhage take precedence.
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