A client undergoing burn debridement states, "You are the worst nurse I have ever seen. All you do is hurt me." Which of the following responses should the nurse make?
"That's a hurtful thing to say."
"Tell me more about that."
"Well, that's your opinion."
"Why would you say such a thing?".
The Correct Answer is B
Choice A rationale:
Focuses on the nurse's feelings rather than the client's needs. This response may make the client feel guilty or defensive, and it does not address the underlying cause of their anger or frustration.
Shuts down communication. Saying "That's a hurtful thing to say" can signal to the client that the nurse is not open to hearing their concerns, which can hinder the development of trust and rapport.
Fails to acknowledge the client's pain. The client is in a vulnerable position, experiencing both physical and emotional pain. This response does not recognize the validity of their experience, which can further alienate them.
Choice B rationale:
Invites the client to share their perspective. By saying "Tell me more about that," the nurse demonstrates a willingness to listen and understand the client's concerns. This can help to build trust and rapport, and it can provide valuable insights into the client's experience.
Promotes exploration of feelings. Allowing the client to express their feelings can help them to process their emotions and to feel more understood. This can lead to a greater sense of control and empowerment, which can be beneficial for their overall coping and healing.
Gathers information to tailor care. By listening to the client's concerns, the nurse can gain a better understanding of their specific needs and preferences. This information can then be used to adjust the plan of care to better meet the client's individual needs.
Choice C rationale:
Dismisses the client's feelings. Saying "Well, that's your opinion" minimizes the client's experience and sends the message that their feelings are not important. This can damage the therapeutic relationship and make the client feel even more isolated and unsupported.
Fails to address the underlying issue. This response does not attempt to explore the reasons for the client's anger or frustration, which means that the problem is likely to continue.
Choice D rationale:
Sounds accusatory and confrontational. Asking "Why would you say such a thing?" can put the client on the defensive and make them feel like they have to justify their feelings. This can hinder open communication and make it more difficult to address the root of the problem.
May make the client feel judged or criticized. This response can come across as judgmental and uncaring, which can further alienate the client and damage the therapeutic relationship.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The adverse effect the nurse should report to the provider is A. Sweating and fever.
This combination of symptoms is a key indicator of Serotonin Syndrome, a potentially life-threatening condition that, while rare with buspirone alone, can occur, particularly if the client is taking other medications that increase serotonin (like SSRIs or MAOIs).
The nurse should report these signs immediately because:
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Sweating (Diaphoresis) and High Fever (Hyperthermia) are core components of the triad of symptoms for Serotonin Syndrome (autonomic instability).
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Serotonin Syndrome also involves changes in mental status (e.g., confusion, hallucinations, which is option D) and neuromuscular hyperactivity (e.g., muscle rigidity, tremors).
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This is a medical emergency that requires immediate intervention to prevent complications like rhabdomyolysis, metabolic acidosis, and renal failure.
In comparison:
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C. Decreased appetite is a common, generally mild, and manageable side effect.
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D. Hallucinations are a serious central nervous system side effect, but when presented alongside the life-threatening systemic signs of Serotonin Syndrome (A), option A represents the more urgent and dangerous adverse reaction.
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B. Discolored urine is not a standard adverse effect and would need investigation, but is not as acutely critical as signs of Serotonin Syndrome.
Correct Answer is D
Explanation
Choice A rationale:
This statement is accusatory and blaming, rather than promoting understanding and problem-solving. It focuses on the negative behavior of the sibling and seeks external validation for the speaker's feelings, rather than attempting to address the underlying issue directly with the sibling.
It uses "should" language, which can come across as judgmental and critical, potentially escalating conflict.
It does not express the speaker's own feelings or needs, making it difficult for the other person to understand and respond effectively.
Choice B rationale:
While this statement demonstrates a willingness to take responsibility for actions, it does not directly address the communication between the family members. It focuses on redirecting the father's anger rather than exploring the underlying reasons for the conflict.
It could be interpreted as silencing the children's voices and potentially reinforcing a hierarchical dynamic within the family, where one parent holds authority over the others.
Choice C rationale:
This statement is manipulative and threatening, using a fear of exposure to control the other person's behavior. It undermines trust and safety within the family, making it difficult to have open and honest communication.
It does not address the core issue at hand and instead escalates conflict by using a "tit-for-tat" approach.
Choice D rationale:
This statement effectively demonstrates several key principles of effective communication: It expresses curiosity and a genuine desire to understand the other person's perspective.
It avoids accusations or assumptions, instead inviting open dialogue.
It focuses on specific behaviors and events ("each time you go to the mall") rather than making sweeping generalizations about the person's character.
It uses "I" language to express the speaker's own feelings and concerns, inviting empathy and understanding.
It creates an opportunity for the other person to share their perspective and work towards a resolution together.
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