The nurse is performing an admission assessment on a client who has chronic pain. Which statement made by the client causes the most concern?

"I am so depressed living with this pain that I don't know if I can go on anymore."

"At home I take something for pain before it gets too bad."

"I try to pretend that the pain isn't part of me, but it's hard to do."

"I live with pain every day, and it sometimes prevents me from doing the things I love to do."

Answer and Explanation

The Correct Answer is A

This statement raises concern because it suggests that the client is experiencing thoughts of hopelessness and suicidal ideation. Expressions of feeling overwhelmed by pain to the extent of questioning the desire to continue living indicate a need for immediate attention and intervention to address the client's emotional distress and ensure their safety.

B. This statement indicates the client's proactive approach to pain management by taking medication preemptively before pain becomes severe. It reflects an understanding of pain management strategies and a willingness to address pain effectively.

C. Although this statement acknowledges the challenge of coping with pain, it also suggests the client's attempts to cope by mentally dissociating from the pain. While coping mechanisms vary among individuals, this response does not raise immediate concern unless accompanied by more severe signs of distress.

D. This statement acknowledges the chronic nature of the client's pain and its impact on daily activities but does not indicate thoughts of self-harm or severe emotional distress. It reflects the client's adaptation to living with pain and a willingness to engage in activities despite its presence.

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

Explanation

A. "How often do you punish him by giving him a time-out or by using physical discipline?": This response focuses on the mother's disciplinary methods rather than addressing the child's behavior directly. It may come across as judgmental or critical of the mother's parenting approach and does not provide helpful guidance or support.

B. "Physical punishment is not the best way to modify a child's behavior.": This response is appropriate because it addresses the mother's concern about punishment for the child's behavior. It educates the mother about the ineffectiveness and potential harm of physical punishment in modifying behavior. Instead, positive reinforcement, redirection, and open communication are recommended strategies for guiding children's behavior.

C. "It isn't unusual for him to fondle his genitals, as this is part of his exploration of his body.": This response normalizes the child's behavior of touching and playing with his genitals as part of natural childhood development. It reassures the mother that such behavior is common and not necessarily indicative of abnormality or misconduct. Education about normal childhood sexual development can alleviate parental concerns and promote understanding and acceptance.

D. "Constantly touching the genitals indicates a urinary tract infection in a toddler.": This response is incorrect and may unnecessarily alarm the mother. While frequent touching of the genitals could indicate discomfort or irritation associated with a urinary tract infection in a toddler, it is not the case for a 7-year-old child. Additionally, it is essential to avoid making medical diagnoses without proper assessment by a healthcare professional.

E. "Give him a little time, and he'll grow out of it. He's just too young to understand right now." This response acknowledges the child's developmental stage and suggests that the behavior is likely temporary and will naturally resolve as the child matures. It reassures the mother that the behavior is typical for a child of this age and may not require immediate intervention.

A. Na+ 150 mEq/L B. Cl-95 mEq/L C. K+3.7 mEq/L D. HCO3-26 mEq/L

Correct Answer is A

Explanation

A. The elevated serum sodium (Na+) level of 150 mEq/L validates the symptoms of vomiting and diarrhea in the client. Vomiting and diarrhea lead to fluid loss and dehydration, resulting in an increased serum sodium concentration due to the loss of water from the body. Hypernatremia (elevated serum sodium) is consistent with dehydration resulting from prolonged vomiting and diarrhea. An elevated sodium level is indicative of hypertonic dehydration, where water loss exceeds electrolyte loss, leading to increased serum sodium concentration

B. Cl-95 mEq/L: Chloride (Cl-) is an electrolyte often lost in cases of vomiting and diarrhea due to the loss of gastric secretions and chloride-rich fluids. A chloride level of 95 mEq/L is slightly lower than normal (normal range: 96-106 mEq/L), which suggests mild chloride depletion.

C. K+3.7 mEq/L: Potassium (K+) levels within the normal range (3.5-5.0 mEq/L) do not necessarily validate symptoms of vomiting and diarrhea. While potassium loss can occur in cases of prolonged vomiting and diarrhea, the potassium level provided falls within the normal range.

D. HCO3-26 mEq/L: Bicarbonate (HCO3-) levels within the normal range (22-29 mEq/L) do not necessarily validate symptoms of vomiting and diarrhea. Elevated bicarbonate levels may indicate metabolic alkalosis, which can occur as a compensatory mechanism in response to acid loss through vomiting or diarrhea, but this value alone does not confirm the symptoms.

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The nurse is performing an admission assessment on a client who has chronic pain. Which statement made by the client causes the most concern?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The mother of a 7-year-old child is concerned that the child "touches and plays" with the genitals despite being punished for doing so. Which response should the nurse make to the mother? (SELECT ALL THAT APPLY)

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

Explanation

The nurse assesses a client admitted with a history of vomiting and diarrhea for 5 days. Which laboratory value validates the symptoms of the client?

Correct Answer is A

Explanation

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