The nurse working in an outpatient clinic is performing an intake assessment for a female client. Which priority question will the nurse ask the client as part of the initial assessment?
"Do you have enough money to pay for your care today?
"Do you feel safe in your home?"
"Do you take Illegal street drugs?
Do you obtain regular medical care?
The Correct Answer is B
Explanation: The priority question the nurse should ask the client during the initial assessment is whether they feel safe in their home (Option B). This question is essential because it addresses the client's safety and well-being, particularly regarding the possibility of domestic violence or intimate partner violence.
Assessing for safety is a critical component of the initial assessment, especially for female clients, as they may be at higher risk for experiencing domestic violence or abuse. By asking about the client's safety in their home, the nurse can identify potential issues related to violence or unsafe living conditions and take appropriate actions to ensure the client's safety.
Options A, C, and D are also important assessment questions, but they are not the priority in this scenario:
A. "Do you have enough money to pay for your care today?" - This is an important question regarding the client's financial situation and ability to access healthcare. However, safety and well-being take precedence over financial concerns in the initial assessment.
C. "Do you take illegal street drugs?" - This question is crucial for assessing the client's substance use and potential risk factors related to drug use. However, the safety question (Option B) is more immediate and directly addresses the client's well-being.
D. "Do you obtain regular medical care?" - This question is vital for assessing the client's healthcare needs and access to healthcare services. However, the safety question (Option B) should be addressed first to ensure the client's immediate safety and well-being.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is c. Beneficence.
Choice A: Autonomy
Autonomy refers to the right of individuals to make decisions about their own lives and bodies. In the context of nursing, it means respecting a patient’s right to make their own healthcare decisions. However, in the case of seclusion due to loud and intrusive behavior, the primary concern is not about the patient’s decision-making capacity but rather the safety and well-being of the patient and others on the unit.
Choice B: Justice
Justice is the ethical principle that emphasizes fairness and equality. It involves ensuring that patients are treated fairly and that resources are distributed equitably. While justice is important in healthcare, it does not directly address the appropriateness of seclusion in response to disruptive behavior.
Choice C: Beneficence
Beneficence is the ethical principle that focuses on doing good and acting in the best interest of the patient. It involves taking actions that promote the well-being of patients and prevent harm. In the context of seclusion, beneficence guides the nurse to consider whether secluding the patient will prevent harm to the patient and others, thereby promoting overall safety and well-being.
Choice D: Veracity
Veracity refers to the principle of truth-telling and honesty. It involves providing accurate and truthful information to patients. While veracity is crucial in building trust between healthcare providers and patients, it does not directly relate to the decision of whether to use seclusion for managing disruptive behavior.
Correct Answer is B
Explanation
The nurse's feelings of sadness, poor sleep, and mild depression after the death of the terminally ill client indicate that the nurse is experiencing grief, which is a normal reaction to loss. However, if the nurse is finding it difficult to cope with the grief or if the grief is significantly impacting the nurse's daily life and well-being, seeking therapy is the best action.
Option B suggests seeking therapy for dysfunctional grief, which can provide the nurse with professional support and coping strategies to navigate through the grieving process. Therapeutic interventions can help the nurse process the emotions associated with the loss and provide a safe space to express and explore feelings of grief and loss.
Options A, C, and D may be helpful in certain situations, but they may not directly address the nurse's unresolved grief:
A. Taking a leave of absence to pursue healing can be considered if the nurse's grief is severely impacting their ability to function and provide safe patient care. However, it may not be necessary for everyone, and seeking therapy would be a more specific and targeted approach to address the grief.
C. Using stress reduction strategies can be beneficial for managing stress and promoting overall well-being, but it may not directly address the specific grief experienced by the nurse after the client's death.
D. Seeking an informal forum for discussing death can be helpful in processing feelings and emotions related to death and loss. However, it may not provide the level of support and guidance that therapy can offer in resolving grief.
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