A home health nurse is visiting a client who has advanced Alzheimer's disease. The client's partner states, "I miss being able to go places with my friends." Which of the following is an appropriate response by the nurse?
"We can discuss this when you're not feeling overwhelmed."
"I understand how you feel. I've had a relative go through the same thing."
"Have you tried taking your partner with you when you go out?"
"Tell me more about your expectations."
The Correct Answer is D
Choice A Reason:
"We can discuss this when you're not feeling overwhelmed." Is incorrect. This response acknowledges the partner's feelings but doesn't directly address their concern about missing social outings. It offers to revisit the topic later, which might be helpful, but it doesn't provide immediate support or suggestions.
Choice B Reason:
"I understand how you feel. I've had a relative go through the same thing." Is incorrect. While expressing empathy is essential, comparing experiences might inadvertently minimize the partner's feelings. Each situation is unique, and the partner might need specific advice or support tailored to their circumstances.
Choice C Reason:
"Have you tried taking your partner with you when you go out?" is incorrect. This response suggests a potential solution by proposing involving the client with Alzheimer's in social outings. However, in advanced stages, this might not always be feasible or suitable due to the nature of the condition. It's essential to be sensitive to the client's needs and abilities.
Choice D Reason:
"Tell me more about your expectations." Is correct. This response invites the partner to share more about their feelings and desires without assuming a solution. It opens a dialogue to understand the partner's concerns and expectations better, allowing the nurse to offer appropriate support or guidance.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
"The sides of the sling are for the client to hold on to." Is inaccurate. The sides of the sling in a mechanical lift are typically designed for the lift's attachment points, not for the client to hold on to. Clients usually need to remain relaxed and may not be able to hold on during the transfer.
Choice B Reason:
"The lower end of the sling goes below the client's calves." Is inaccurate. While it's important to position the sling correctly, stating that the lower end goes below the client's calves might not be universally accurate. The placement of the sling would depend on the type of lift and the specific needs of the client. It's crucial to follow manufacturer instructions and individualized care plans for sling placement.
Choice C Reason:
"This type of device is used for a client who cannot assist." Is accurate. This statement correctly identifies the primary purpose of a mechanical lift, which is to assist individuals who are unable to bear weight or assist with movement due to physical limitations. The mechanical lift helps transfer individuals safely without relying on their own strength or ability to assist in the movement.
Choice D Reason:
"The device requires the client to use upper body strength." Is inaccurate. This statement is incorrect. The purpose of a mechanical lift is to assist clients who cannot use their own strength, especially those who cannot bear weight or assist with movement. It is the machine that aids in lifting and transferring the individual, not the client's strength.
Correct Answer is A
Explanation
Choice A Reason:
A filter needle is used to prevent any glass particles from entering the syringe when drawing medication from an ampule, as ampules are made of glass that can sometimes break and leave shards.
Choice B Reason:
Adding 0.5 ml of diluent to the medication is incorrect. Adding diluent to medication from an ampule is not a standard practice. Ampules usually contain pre-measured doses of medication and are designed for direct withdrawal without dilution. Adding diluent could alter the concentration and effectiveness of the medication.
Choice C Reason:
The ampule should be cleansed before opening to remove any potential contaminants. Once the ampule is opened, the inside of the ampule and the medication should be considered sterile, so there is no need to cleanse the tip after opening.
Choice D Reason:
Injecting air into the ampule prior to drawing the medication into a syringe is incorrect. This action is not typically necessary when withdrawing medication from an ampule. Some medications may require air to equalize pressure, but it's crucial to follow specific guidelines for each medication. In most cases, creating positive pressure by injecting air into the ampule is not recommended, as it could affect the stability or integrity of the medication.
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