A client makes minimal eye contact with others and remains alone in their room during the day. Which question is an important consideration when planning the client’s care?
Has the client had negative interactions with other clients in the past?.
Does the client have hostile thoughts about others?.
Is the client fearful of others on the unit?.
What are the client’s cultural norms?.
The Correct Answer is D
What are the client’s cultural norms? This question is important because it helps to assess whether the client’s behavior is influenced by their cultural background and values, which may differ from those of the staff and other clients.
For example, some cultures may value privacy, modesty, or respect for elders more than others, and may avoid eye contact or social interaction as a sign of politeness or deference.
Understanding the client’s cultural norms can help to provide culturally sensitive and appropriate care.
Choice A is wrong because it assumes that the client’s behavior is caused by negative interactions with other clients, which may not be the case.
Choice B is wrong because it assumes that the client’s behavior is caused by hostile thoughts about others, which may not be the case.
Choice C is wrong because it assumes that the client’s behavior is caused by fear of others in the unit, which may not be the case.
These choices are not relevant to planning the client’s care and may reflect bias or stereotyping on the part of the staff.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Select a 0.5 mL syringe, 30 gauge, 8 mm needle and inject at a 90-degree angle. This is because Humulin R is a clear and colorless solution that can be given by subcutaneous injection.
A 0.5 mL syringe can hold up to 50 units of insulin, which is enough for the prescribed dose of 7 units. A 30 gauge, 8 mm needle is suitable for thin patients with poor skin turgor. Injecting at a 90-degree angle ensures that the insulin reaches the subcutaneous tissue and not the muscle.
Choice A is wrong because a 31 gauge, 6 mm needle is too short and may not deliver the insulin into the subcutaneous tissue.
Choice C is wrong because pinching the skin is not necessary for thin patients with poor skin turgor.
Choice D is wrong because a 1.0 mL syringe is too large for the prescribed dose of 7 units and may cause dosing errors. A 28 gauge, 12.7 mm needle is too long and may inject the insulin into the muscle, which can affect its absorption and action.
Correct Answer is C
Explanation
What has it been like for you since your wife died? This statement shows empathy and invites the client to share his feelings and experiences.
It also acknowledges the client’s loss and validates his grief.
Choice A. Tell me how your wife died.
This statement is too intrusive and may cause the client to feel uncomfortable or defensive. It also focuses on the past event rather than the present situation.
Choice B. Have you considered attending a grief group? This statement is too premature and may imply that the nurse is trying to solve the client’s problem or dismiss his feelings.
It also assumes that the client needs or wants a grief group.
Choice D. You have wonderful children and grandchildren who are very supportive.
This statement is too superficial and may minimize the client’s grief or make him feel guilty. It also shifts the attention away from the client and his wife.
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