Which statement shows that the nurse has empathy for a client who has recently made a suicide attempt after breaking up with a significant other?

"Forget him. There are other fish in the sea."

"You must have been very upset to do what you did."

"Don't worry, you'll get over him in time."

"Why do you think your boyfriend broke up with you?"

Answer and Explanation

The Correct Answer is B

Choice A Reason:
The statement "Forget him. There are other fish in the sea." minimizes the client's feelings and does not acknowledge the emotional pain they are experiencing. It is a cliché that can come across as dismissive rather than empathetic.

Choice B Reason:
"You must have been very upset to do what you did." This statement acknowledges the client's distress and does not judge their actions. It reflects an understanding of the depth of their emotional pain, which is a key component of empathy.

Choice C Reason:
"Don't worry, you'll get over him in time." While this statement may be intended to provide reassurance, it does not address the immediate emotional state of the client. It could be perceived as brushing aside their current feelings.

Choice D Reason:
"Why do you think your boyfriend broke up with you?" This question could be seen as probing for information rather than offering support. It might imply that the client is at fault for the breakup, which is not an empathetic approach.

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Correct Answer is B

Explanation

Choice A reason:
Magnesium sulfate is used in the management of severe preeclampsia primarily for seizure prophylaxis. One of the key side effects of magnesium sulfate is its impact on neuromuscular transmission, leading to diminished deep-tendon reflexes as serum magnesium levels rise. The therapeutic range for anticonvulsant prophylaxis is typically between 5-8 mg/dL. Reflexes may begin to diminish when serum levels reach 8-12 mg/dL, indicating potential magnesium toxicity. Therefore, diminished reflexes are a warning sign to reassess the infusion rate and possibly reduce or discontinue the medication.

Choice B reason:
A respiratory rate of 16 breaths per minute falls within the normal adult range and suggests that the client's respiratory system is not being adversely affected by the magnesium sulfate infusion. Respiratory rate is a critical parameter to monitor during magnesium sulfate therapy, as respiratory depression is a serious side effect of magnesium toxicity. Maintaining a normal respiratory rate indicates that it is safe to continue the infusion at the current rate.

Choice C reason:
While a urine output of 50 mL/hr is on the lower end of the normal range, it is still considered adequate for most adults. In the setting of magnesium sulfate therapy for severe preeclampsia, maintaining adequate urine output is essential for ensuring that the kidneys can excrete the magnesium to prevent accumulation and toxicity. If urine output decreases significantly, it may necessitate reevaluation of the infusion rate or additional interventions to support renal function.

Choice D reason:
A heart rate of 56 beats per minute is slightly bradycardic but may not be clinically significant if the client is asymptomatic. However, magnesium has a direct effect on cardiac function, and high levels can lead to bradycardia and other cardiac conduction abnormalities. It is important to monitor the client's heart rate and rhythm during magnesium sulfate therapy to detect any early signs of cardiac involvement due to magnesium toxicity.

A. Offer the client a warm beverage. B. Monitor the client's gag reflex. C. Help the client to a side-lying position with knees flexed. D. Bring the client a heating pad to apply to the abdomen for comfort.

Correct Answer is C

Explanation

Choice A reason:

Offering a warm beverage to a client with suspected appendicitis is not advisable. Preoperative clients are typically required to have an empty stomach to reduce the risk of aspiration during anesthesia. Introducing fluids or food could delay surgery and increase the risk of complications.

Choice B reason:

Monitoring the client's gag reflex is not a priority in the care of a client with suspected appendicitis. The gag reflex is more relevant in neurological assessments or when evaluating swallowing function, not in the context of appendicitis.

Choice C reason:

Helping the client to a side-lying position with knees flexed can provide comfort and may help relieve abdominal pain. This position reduces tension on the abdominal muscles and can be a supportive measure while the client awaits surgery.

Choice D reason:

Applying a heating pad to the abdomen is contraindicated in clients with suspected appendicitis. Heat can cause the appendix to rupture, leading to peritonitis, which is a severe and potentially life-threatening complication. Therefore, this action should be avoided.

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Which statement shows that the nurse has empathy for a client who has recently made a suicide attempt after breaking up with a significant other?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?

Correct Answer is B

Explanation

A client with suspected appendicitis is waiting for surgery. What should the nurse do?

Correct Answer is C

Explanation

A client with chronic bronchitis has a non-productive cough, rhonchi in bilateral lung fields, and difficulty expectorating the secretions. Which intervention should the nurse incorporate into the plan of care?

For a client with diabetes mellitus, which new lab finding is the greatest concern?

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