A nurse in a community health center is consulting with a client who lost her home in a fire a few days ago. Which of the following responses should the nurse make?

"Let's focus on something positive and not discuss the fire today."

"I think you should move in with your parents temporarily."

"I don't believe that you will experience long-term effects from this."

"Tell me how I can best help you right now."

Answer and Explanation

The Correct Answer is D

A. "Let's focus on something positive and not discuss the fire today." This response is dismissive and invalidates the client's feelings and experiences.
B. "I think you should move in with your parents temporarily." This response is prescriptive and assumes that the nurse knows what is best for the client without understanding her specific needs and circumstances.
C. "I don't believe that you will experience long-term effects from this." This response minimizes the client's potential trauma and does not acknowledge the serious impact such an event can have.
D. "Tell me how I can best help you right now." This response is empathetic and client-centered, allowing the client to express her needs and feel supported.

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Correct Answer is D

Explanation

A. Levothyroxine 100 mcg PO qd "qd" is an error-prone abbreviation and should be avoided. It should be written as "daily."
B. Heparin 15,000 units SC q12h "SC" is an error-prone abbreviation and should be written as "subcutaneously."
C. Lorazepam 0.5 mg PO qhs "qhs" is an error-prone abbreviation and should be written as "at bedtime."
D. Acyclovir 400 mg PO tid This is correctly transcribed using acceptable abbreviations.

A. Draw up the formula into a syringe. B. Determine the pH level of gastric contents. C. Flush the nasogastric tube with 30 mL of water. D. Measure the total volume of gastric residual.

Correct Answer is B

Explanation

A. Draw up the formula into a syringe. This step is premature and should be done after confirming the tube placement and checking for residual volume.
B. Determine the pH level of gastric contents. Checking the pH level of gastric contents helps confirm the placement of the nasogastric tube in the stomach, which is crucial before administering feedings or medications to prevent aspiration.
C. Flush the nasogastric tube with 30 mL of water. Flushing is important but should be done after confirming tube placement.
D. Measure the total volume of gastric residual. Measuring residual volume is important but should be done after confirming tube placement.

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A nurse in a community health center is consulting with a client who lost her home in a fire a few days ago. Which of the following responses should the nurse make?

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