The nurse is caring for a client who is in the final stages of cancer, is depressed and distant.
The client asks the nurse, "Why is God punishing me?" Which would be the most appropriate action for the nurse to take?
Call the physician to request an antianxiety medication.
Share personal religious beliefs with the client.
Sit quietly with the client and offer caring touch.
Advise the client about a good worship center nearby.
The Correct Answer is C
Choice A rationale:
Calling the physician to request an antianxiety medication might address the client's anxiety, but it does not directly respond to the client's existential question about God punishing them.
Choice B rationale:
Sharing personal religious beliefs with the client can be inappropriate and may not align with the client's beliefs, potentially causing discomfort or offense.
Choice C rationale:
Sitting quietly with the client and offering caring touch demonstrates empathy, compassion, and presence. It allows the nurse to provide emotional support without imposing personal beliefs or judgments. This approach encourages the client to express their feelings and facilitates a therapeutic nurse-client relationship.
Choice D rationale:
Advising the client about a good worship center nearby does not directly address the client's existential question or provide emotional support. Additionally, the client may not be interested in religious activities at this moment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Avoiding assisting a restless patient to walk does not address the issue of patient confusion and the risk of falling. Restless patients might need assistance, and refusing to help them walk could lead to further complications or falls.
Choice B rationale:
Discouraging the family from staying with the patient does not promote patient safety. Family members can provide additional support and supervision, reducing the risk of falls for a confused patient.
Choice C rationale:
Moving the patient farther away from the nurses' station does not address the patient's confusion or the risk of falling. It might even increase the response time in case of an emergency.
Choice D rationale:
Asking the family about the patient's preferences for movies or music and offering these activities is an appropriate way to engage the patient without resorting to restraints. Providing stimulating and enjoyable activities can help distract and calm the patient, reducing restlessness and the risk of falls.
Correct Answer is B
Explanation
Choice A rationale:
Maintaining the patient in a supine position during rest would not be appropriate for a client with shortness of breath. This position can worsen breathing difficulties, especially in clients with respiratory issues. It reduces lung expansion and can lead to increased work of breathing.
Choice B rationale:
Monitoring the client's oxygen saturation hourly is the appropriate intervention for a client with shortness of breath. Oxygen saturation (SpO2) levels indicate the percentage of oxygen bound to hemoglobin in the blood. Monitoring SpO2 levels helps assess the client's oxygenation status and provides crucial information about the effectiveness of respiratory interventions. Normal oxygen saturation levels typically range between 95% to 100%. Monitoring allows timely recognition of hypoxemia, enabling prompt intervention to improve oxygenation and prevent complications.
Choice C rationale:
Ambulating the client in the hall four times daily may not be suitable for a client experiencing shortness of breath, as it can exacerbate respiratory distress. Ambulation increases oxygen demand and can further compromise oxygenation in individuals struggling to breathe.
Choice D rationale:
Encouraging high protein foods during mealtime is unrelated to the immediate management of shortness of breath. While proper nutrition is essential for overall health and healing, it does not directly address the acute issue of respiratory distress.
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