A client states to the nurse, “I understand that I need a mastectomy, but I am worried about the pain and appearance afterwards.” When responding to the client, the nurse will need to address which domain?

Cognitive

Psychomotor

Affective

Behavioral

Answer and Explanation

The Correct Answer is C

Choice A reason: The cognitive domain involves knowledge and understanding, such as explaining the procedure or its rationale. The client’s statement indicates understanding (“I understand”), so their concern is not about knowledge but emotional worries about pain and appearance, which are better addressed in the affective domain to provide emotional support.

Choice B reason: The psychomotor domain focuses on physical skills, like performing a task or procedure. The client’s concerns about pain and appearance are emotional, not skill-based. Addressing psychomotor skills, such as teaching self-care techniques, is irrelevant to the client’s expressed emotional worries, requiring a focus on feelings instead.

Choice C reason: The affective domain involves emotions, attitudes, and feelings. The client’s worries about pain and appearance post-mastectomy reflect emotional concerns. Addressing this domain through empathetic listening and emotional support helps alleviate anxiety, validates feelings, and fosters coping, making it the most appropriate focus for the nurse’s response.

Choice D reason: The behavioral domain is not a standard learning domain in nursing education (cognitive, psychomotor, affective are typical). If interpreted as behavior modification, it is irrelevant here, as the client’s concerns are emotional, not behavioral. The nurse should focus on addressing the client’s feelings rather than attempting to change behaviors.

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Correct Answer is C

Explanation

Choice A reason: Supine with head elevated is used for comfort or respiratory support but not for lumbar puncture. This position does not allow access to the lumbar spine or flex the back to open intervertebral spaces, which is necessary for safe needle insertion during the procedure.

Choice B reason: Prone with legs extended is used for procedures like wound care but not lumbar puncture. This position does not flex the spine to widen intervertebral spaces, making needle insertion difficult and risky. The lateral recumbent position is standard for accessing the subarachnoid space.

Choice C reason: Lateral recumbent with knees flexed maximizes lumbar spine flexion, opening intervertebral spaces for safe needle insertion into the subarachnoid space during a lumbar puncture. This position reduces the risk of nerve damage and ensures accurate cerebrospinal fluid collection, making it the standard choice.

Choice D reason: Sitting upright with back straight may be used in some procedures but is less common for lumbar puncture. It does not provide optimal spinal flexion compared to the lateral recumbent position, which better exposes the lumbar vertebrae, reducing complications during needle insertion.

A. Have you been having swelling in your legs? B. Have you been experiencing difficulty breathing? C. Have you been experiencing chest pain? D. Have you been experiencing heart palpitations?

Correct Answer is B

Explanation

Choice A reason: Leg swelling (edema) is a symptom of heart failure due to fluid retention from poor cardiac output. However, it is less urgent than breathing difficulties, which indicate pulmonary edema, a life-threatening complication. Assessing breathing takes priority, as it directly affects oxygenation, a critical physiological need.

Choice B reason: Difficulty breathing (dyspnea) is a hallmark of heart failure, often due to pulmonary edema from fluid backup in the lungs. This compromises oxygenation, making it a life-threatening symptom requiring immediate assessment. The ABCD-E framework prioritizes breathing, making this the most critical question to evaluate heart failure severity.

Choice C reason: Chest pain may indicate angina or myocardial infarction, which can contribute to heart failure. However, it is less specific to heart failure than dyspnea, which directly signals pulmonary congestion. Breathing difficulties pose a more immediate threat, as they affect oxygenation, a priority in acute heart failure assessment.

Choice D reason: Heart palpitations may occur in heart failure due to arrhythmias but are less specific and urgent than dyspnea. Palpitations may indicate stress or other conditions, but breathing difficulties directly reflect pulmonary edema, a critical complication requiring immediate attention to ensure adequate oxygenation and prevent respiratory failure.

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A client states to the nurse, “I understand that I need a mastectomy, but I am worried about the pain and appearance afterwards.” When responding to the client, the nurse will need to address which domain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing a client for a lumbar puncture. Which position should the nurse place the client in to facilitate the procedure?

Correct Answer is C

Explanation

The nurse is assessing a client and asks which of the following questions to evaluate potential heart failure symptoms?

Correct Answer is B

Explanation

A client states to the nurse, “I understand that I need a mastectomy, but I am worried about the pain and appearance afterwards.” When responding to the client, the nurse will need to address which domain?

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