The nurse is caring for a patient who is one day post-mastectomy and notes that she is sobbing and gasping for breath. What should the nurse do first?
Notify the registered nurse.
Raise the head of the bed.
Sit with her and listen to her concerns.
Ask the patient what is wrong.
The Correct Answer is B
Choice A reason: Notifying the registered nurse is important but should come after initially assessing the patient's immediate needs.
Choice B reason: Raising the head of the bed may help with breathing but does not address the cause of the patient's distress.
Choice C reason: Sitting with her and listening to her concerns is supportive but should follow an initial assessment of why she is sobbing and gasping for breath.
Choice D reason: Asking the patient what is wrong is the first step in assessing the situation and providing appropriate care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Conversion typically refers to the expression of psychological distress through physical symptoms, which is not the case here.
Choice B reason: Undoing is a defense mechanism where a person tries to 'undo' an unhealthy thought or behavior with a healthier one, which does not apply to Michael's situation.
Choice C reason: Compensation is a defense mechanism where a person overachieves in one area to make up for deficiencies in another, which describes Michael's actions.
Choice D reason: Sublimation involves channeling unacceptable impulses into socially acceptable activities, which is not explicitly indicated in this scenario.
Correct Answer is B
Explanation
Choice A reason: While legs feeling heavy can be a common sensation after a spinal block, it is not as concerning as other potential symptoms.
Choice B reason: Hypotension is a significant concern following a spinal block as it can indicate a high level of blockage affecting the autonomic nerves, which can lead to serious complications.
Choice C reason: Numbness below the injection site is expected after a spinal block and is not typically a cause for concern unless it is prolonged or accompanied by other symptoms.
Choice D reason: Nausea can occur but is less concerning than hypotension, which can have more immediate and severe consequences.
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