The nurse is caring for a client who lost his family in a fire. Upon entering the room, the client states angrily. "I hate this place. No one can help me." The nurse's best response would be:

"Please, don't be so angry. Things will get better."

"Maybe I can help. Tell me more about how you're feeling."

"I'm so sorry that you feel that way."

"You shouldn't talk like that."

Answer and Explanation

The Correct Answer is B

B. This is the best response. It demonstrates empathy, active listening, and a willingness to understand the client's emotions. By inviting the client to express their feelings further, the nurse creates an opportunity for therapeutic communication and can better assess how to support the client emotionally.

A. This response dismisses the client's feelings of anger and sadness and may come across as minimizing their emotions. It does not acknowledge the client's current state of distress or provide validation for their feelings.

C. This response expresses empathy and acknowledges the client's feelings, which is important. However, it may seem somewhat passive and could benefit from further exploration or invitation for the client to elaborate on their feelings.

D. This response is dismissive and judgmental. It may make the client feel invalidated or criticized for expressing their emotions, which can further escalate feelings of anger or distress.

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Correct Answer is B

Explanation

B. Deep breathing and coughing exercises help to maintain lung expansion and prevent atelectasis (collapse of lung tissue), clear secretions from the airways, which can reduce the risk of respiratory infections like pneumonia, improve oxygenation and ventilation-perfusion matching in the lungs. Additionally, deep breathing exercises can stimulate circulation indirectly by improving oxygenation and gas exchange, which can benefit circulatory function.

A. Massaging bony areas can help prevent pressure ulcers (bedsores) in immobile patients, but it does not directly improve respiratory or circulatory functions. While skin integrity is important, it does not address the physiological needs of respiratory and circulatory systems.

C. While nutrition is important for overall health, especially in a nonresponsive client who may not be able to feed themselves orally, tube feedings primarily address nutritional needs and do not directly impact respiratory or circulatory functions. They are important for preventing malnutrition and supporting recovery, but they do not specifically target the goals of improving respiratory or circulatory functions.

D. Changing positions regularly is crucial for preventing complications such as pressure ulcers and maintaining skin integrity. It can also aid in improving circulation by relieving pressure on vulnerable areas and promoting blood flow. Proper positioning can optimize respiratory function by preventing pooling of secretions and improving lung ventilation. Additionally, positional changes encourage movement of the diaphragm and chest wall, which aids in ventilation and gas exchange.

A. develop a nurse-client relationship. B. enhance well-being. C. assess skin integrity. D. stimulate circulation. E. moisturize the skin.

Correct Answer is ["A","B","C","D","E"]

Explanation

A. Bathing can indeed foster a nurse-client relationship. It provides an opportunity for interaction and communication between the nurse and the client, promoting trust and rapport.

B Bathing can contribute to the client's overall sense of well-being. It promotes comfort, relaxation, and a feeling of cleanliness, which are important aspects of holistic care.

C. Bathing allows the nurse to visually assess the client's skin integrity. During the process, the nurse can identify any changes in skin color, presence of lesions, wounds, or other abnormalities that may require further assessment or intervention.

D. Bathing, particularly when accompanied by gentle massage or movement of limbs, can stimulate circulation. This helps improve blood flow to tissues, aiding in wound healing and reducing the risk of complications such as pressure ulcers.

E. Depending on the type of bath products used (e.g., moisturizing soap or bath oils), bathing can help moisturize the skin. This is especially beneficial for clients with dry skin or conditions that predispose them to skin dryness.

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The nurse is caring for a client who lost his family in a fire. Upon entering the room, the client states angrily. "I hate this place. No one can help me." The nurse's best response would be:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

To increase both the respiratory and circulatory functions of a nonresponsive client, what is the most important intervention for the nurse to perform?

Correct Answer is B

Explanation

The nurse recognizes that the Rationale(s) for giving a client a bath is (are) to: (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","C","D","E"]

Explanation

A nurse educator is teaching student nurses about droplet precautions. The educator emphasizes the differences between indications for droplet precautions versus airborne precautions. Which of the following statements about droplet precautions are correct? (SELECT ALL THAT APPLY)

The nurse is teaching a client about isometric exercise. Which activity indicates that the client understands the teaching? The client:

The nurse explains to the client that intravenous fluid administration is used to:

A client is brought into the emergency department for an overdose of morphine. The client has a respiratory rate of 5 to 8 breaths per minute. Which of the following ABG results would the nurse expect to see?

The nurse is assessing internal variables that influence a client's health care beliefs and practices. As part of this assessment, the nurse should consider the client's:

A client who has advanced cancer has been placed on hospice care, and the nurse is helping the client to understand what that means. Which statement made by the client indicates that teaching was effective? "I will:

Which nursing activity is an example of using primary prevention in client care?