A client who has a borderline personality disorder is being discharged today. When the nurse makes morning rounds, the client begins the interaction by claiming the night shift nurse is aloof and expresses joy to see that, "My favorite nurse is on duty now." Which response is best for the nurse to provide to this client's dichotomous tendency?

"I am happy that you are getting better and will be able to go home."

"Tomorrow I will talk to that nurse about how you were treated last night."

"I am glad you like me. Which nurse was acting aloof to you?"

"What did the night nurse do that makes you think the nurse is aloof?"

Answer and Explanation

The Correct Answer is A

A. "I am happy that you are getting better and will be able to go home."
This response focuses on the client’s progress and avoids engaging with their polarized views. It provides positive reinforcement and shifts the focus toward recovery.

B. "Tomorrow I will talk to that nurse about how you were treated last night."
This could escalate the situation and may inadvertently validate the client's idealization or devaluation of others, without fully understanding the dynamics.

C. "I am glad you like me. Which nurse was acting aloof to you?"
This response reinforces the client’s idealization of the current nurse, which could perpetuate dichotomous thinking.

D. "What did the night nurse do that makes you think the nurse is aloof?"
This invites the client to focus on negative perceptions of the night nurse, potentially escalating their emotional instability.

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Correct Answer is D

Explanation

A. Administering the placebo as prescribed when the client reports pain is ethically questionable.
Placebos are typically used in research or clinical trials and should not be administered without the client's informed consent and understanding.
B. While informing the charge nurse about the prescribed placebo is appropriate, refusing to administer it without further action may not address the ethical concerns surrounding placebo use.
C. Informing the client that the provider prescribed a placebo instead of pain medication is important for transparency and informed consent. However, this should be accompanied by discussing the ethical considerations with the healthcare provider.
D. Discussing ethical concerns about placebo use with the healthcare provider is the most appropriate intervention. This ensures that the nurse advocates for the client's well-being and addresses any potential ethical issues surrounding the use of placebos in pain management.

A. Pull the pinnae up and back to administer the drops. B. Administer the drops with the head held upright. C. Cool and shake the bottle before administering the drops. D. Insert the tip of the dropper into the canal of the ear.

Correct Answer is A

Explanation

A. Pulling the pinnae up and back helps straighten the ear canal in adults, allowing easier administration of the ear drops and better penetration into the ear canal. This technique is appropriate for adults.
B. Administering the drops with the head held upright may be necessary for some ear drop medications, but it is not the most appropriate technique for all types of ear drops.
C. Cooling and shaking the bottle before administering the drops may be necessary for certain types of medications but is not universally recommended for all ear drop preparations.
D. Inserting the tip of the dropper into the canal of the ear is appropriate for administering ear drops, but it should be accompanied by the correct technique of pulling the pinnae up and back to straighten the ear canal in adults.

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Naxlex Comprehensive Predictor Exams

The health care provider prescribes a placebo instead of pain medication. Which intervention should the nurse implement?

Correct Answer is D

Explanation

The healthcare provider prescribes ear drops to an adult client with an ear infection. Which teaching should the nurse provide?

Correct Answer is A

Explanation

The nurse manager is involved in agency restructuring. During this reengineering process, it is most important for the nurse to address which employee concern?

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The nurse notes that a client with depression has been more withdrawn and noncommunicative during the past two weeks. Which Intervention is most important to include in the updated plan of care for this client?

The nurse is caring for a client with a binge eating disorder. Which goal should the nurse first establish with the client?

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