The nurse recognizes that the client's energy has been depleted despite attempts to intervene and the client dies. This is a description of which phase of the General Adaptation Syndrome?

Exhaustion

Resistance

Alarm

Recovery

Answer and Explanation

The Correct Answer is C

C. If the stressor persists for a prolonged period and the body is unable to adapt or cope effectively, it enters the exhaustion phase. During this phase, the body's resources become depleted. The client experiences decreased energy, reduced ability to cope with stress, and may develop stress-related illnesses or complications.

A. It is characterized by the body's immediate response to a stressor, where physiological changes occur such as increased heart rate, heightened senses, and activation of the fight-or-flight response.

B. After the initial alarm reaction, if the stressor persists, the body enters the resistance phase. In this phase, physiological changes stabilize as the body attempts to cope with the stressor.

D. This phase occurs if the stressor is removed or successfully managed, allowing the body to recover and return to a state of homeostasis. During recovery, the body repairs any damage caused by the stress response and replenishes its energy and resources.

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Correct Answer is D

Explanation

D This action involves escalating the issue to a higher authority who can provide guidance and support. The nursing supervisor can assess the situation, provide advice on managing the critically ill client, and potentially reassign the nurse or provide additional resources.

A. This option does not address the immediate need to ensure the patient's safety and continuity of care. It's important to consider patient welfare and seek appropriate support before considering leaving the unit.

B. Discussing the client's care with another nurse could be a subsequent step, but it does not address the immediate need to ensure the nurse is qualified to provide the necessary care.

C. Proceeding without addressing the issue could jeopardize patient safety and is not ethically or professionally responsible. It's crucial to acknowledge limitations and seek appropriate assistance.

A. drink a full glass of water. B. hold the solution for a couple of minutes. C. take fast breaths through the nose. D. lie on the left side with the right knee bent

Correct Answer is D

Explanation

D. Before administering a cleansing enema, the client is typically instructed to assume a left-side lying position with the right knee bent. This position helps to facilitate the flow of the enema solution into the colon and allows for better retention of the solution. It also helps to prevent leakage and discomfort during the procedure.

A. Drinking water before administering an enema can help hydrate the client and promote normal bowel function. However, it is not typically a specific instruction related to the administration of the enema itself. Hydration is generally beneficial for bowel health but is not directly related to the enema procedure.

B. After administering the enema solution, the client should be instructed to hold the solution in the bowel for a sufficient amount of time to allow it to soften and loosen stool. The exact duration can vary based on the type and purpose of the enema, but typically, the client is encouraged to retain the solution for a specified period (as instructed by the healthcare provider) before evacuating.

C. This instruction is unrelated to the administration of a cleansing enema. Breathing techniques may be taught for relaxation or to manage discomfort during procedures, but they do not specifically apply to the process of administering an enema.

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The nurse recognizes that the client's energy has been depleted despite attempts to intervene and the client dies. This is a description of which phase of the General Adaptation Syndrome?

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Naxlex Comprehensive Predictor Exams

The inexperienced nurse is reassigned to another unit to care for a critically ill client whose care is beyond her capability. What action should the nurse take first?

Correct Answer is D

Explanation

A client is prescribed a cleansing enema. Prior to administering the enema, the client should be told to:

Correct Answer is D

Explanation

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