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Which response by the nurse is most therapeutic?

"Tell me about the visit with your significant other.".

"I can see that you are feeling lonely.".

"Would you like to talk for a while?".

"What did you enjoy about your visit tonight?".

Answer and Explanation

The Correct Answer is C

This response shows that the nurse is willing to listen and provide support to the client.

It also allows the client to decide if they want to talk and share their feelings.

Choice A is not correct because it is not the most therapeutic response.

While it does encourage the client to talk about their visit with their significant other, it does not show that the nurse is willing to listen and provide support.

Choice B is not correct because it is not the most therapeutic response.

While it does acknowledge that the client may be feeling lonely, it does not show that the nurse is willing to listen and provide support.

Choice D is not correct because it is not the most therapeutic response.

While it does encourage the client to talk about their visit, it does not show that the nurse is willing to listen and provide support.

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Correct Answer is C

Explanation

Nurses who provide end of life care are trained to communicate in a way that is concise, yet sensitive.

A personalized approach is often taken to meet the unique communication needs of each patient and to recognize when a person may be in pain or distressed 1.

Choice A is not the answer because asking questions in a vague, nonspecific format can lead to confusion and misunderstanding.

Choice B is not the answer because getting the most difficult questions over with first can be overwhelming for the client.

Choice D is not the answer because sharing personal values may not put the client at ease and may even make them feel uncomfortable.

A. Blood pressure. B. Respiratory rate. C. Temperature. D. Pulse rate.

Correct Answer is B

Explanation

If a nurse observes that a client is using accessory muscles, it indicates an obstruction of the airways, which reduces oxygen saturation.

Accessory muscles help in the act of forced expiration to wash out carbon dioxide and improve oxygen saturation 1.

Therefore, the nurse should obtain the respiratory rate first.

Choice A is not the answer because determining pulse pressure will not provide any significant indication of respiratory distress 1.

Choice C is not the answer because temperature does not provide any significant data about the use of accessory muscles in respiration 1.

Choice D is not the answer because pulse rate does not provide any significant data about the use of accessory muscles in respiration 1.

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Which response by the nurse is most therapeutic?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has only months predicted to live. The client avoids questions regarding plans for care. What is the next approach for the nurse to use when discussing end of life issues with the client?

Correct Answer is C

Explanation

The nurse observes that a client is using accessory muscles. Which vital sign should the nurse obtain first?

Correct Answer is B

Explanation

The nurse is using guided imagery with a client who is experiencing chronic pain. What should the nurse direct the client's attention on during the session?

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A client who is on complete bedrest frequently calls the nurse for the bedpan to urinate. Which action should the nurse take to evaluate the client for urinary retention?

What equipment should the nurse use to most accurately measure a 2ml dose of a viscous liquid solution to be given orally?