The nurse is caring for a client that fell at home and is planning to move in with their adult child. Which of the following statements, by the client, would require immediate follow up by the nurse?

"I will try to make myself useful while I am in their home."

"My adult child has been preparing my grandchildren for my arrival."

"I will miss my home that I lived in for so long."

"My other adult child is willing to help me too."

Answer and Explanation

The Correct Answer is C

A. "I will try to make myself useful while I am in their home." This statement reflects a positive attitude and willingness to contribute, which does not require immediate follow-up.

B. "My adult child has been preparing my grandchildren for my arrival." This statement indicates that preparations are being made, which is generally a good sign and does not require immediate follow-up.

C. "I will miss my home that I lived in for so long." This statement requires immediate follow-up because it may indicate emotional distress or difficulty adjusting to the new living situation. The nurse should assess the client’s feelings and provide support to help them cope with the transition.

D. "My other adult child is willing to help me too." This statement is positive and indicates additional support, which is generally reassuring and does not require immediate follow-up.

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Correct Answer is ["B","D"]

Explanation

A. "Addressing organ donation and autopsy issues." Advanced directives typically address preferences about medical treatment and end-of-life care, but organ donation and autopsy decisions are not always included in these directives. Organ donation often involves a separate document or registration.

B. "Naming a durable power of attorney for my health care needs." An advanced directive often includes designating a durable power of attorney (DPOA) for healthcare decisions. This person is authorized to make medical decisions on the patient’s behalf if they become unable to do so themselves.

C. "Addressing who gets my personal items if I should die." The distribution of personal items is typically covered in a will, not an advanced directive. Advanced directives focus on healthcare decisions rather than the distribution of personal property.

D. "Naming which life-sustaining treatments I want and do not want." Advanced directives often include instructions about specific medical treatments and interventions that the patient does or does not want, such as resuscitation, mechanical ventilation, or tube feeding.

A. "Are you usually anxious about unknown situations?" B. "Do you have any questions about this admission?" C. "Are you here for the same reason?" D. "Can you tell me more about that experience?"

Correct Answer is D

Explanation

A. "Are you usually anxious about unknown situations?" This question may help understand the client's general anxiety but does not directly address the specific concern related to their current hospital admission.

B. "Do you have any questions about this admission?" This response is practical and offers the client an opportunity to clarify any doubts about the current admission, which might help reduce anxiety.

C. "Are you here for the same reason?" This question is specific to the reason for the admission but may not fully address the anxiety related to the hospital environment.

D. "Can you tell me more about that experience?" This response encourages the client to discuss their previous negative experience, which can help in understanding their anxiety and providing targeted support.

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The nurse is caring for a client that fell at home and is planning to move in with their adult child. Which of the following statements, by the client, would require immediate follow up by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient diagnosed with a terminal illness who is interested in signing a healthcare Advanced Directive. Which of the following are included in this type of end-of-life planning? Select all that apply.

Correct Answer is ["B","D"]

Explanation

The nurse is admitting a client to the hospital. The client states, "Hospitals make me anxious ever since my last visit. Which of the following would be the most appropriate response by the nurse?

Correct Answer is D

Explanation

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