A nurse is assessing a client who is to undergo a left lobectomy to treat lung cancer. The client tells the nurse that she is scared and wishes she had never smoked. Which of the following responses should the nurse make?
"Your doctor is a great surgeon. You will be fine."
"You may feel scared. Let's talk about what you are afraid of."
"I understand your fears. I was a smoker also."
"Don't worry. The important thing is you have now quit smoking."
The Correct Answer is B
This response is empathetic and therapeutic, as it acknowledges the client's feelings and invites her to express her concerns. It also shows respect and interest in the client's perspective.
a) This response is false reassurance and nontherapeutic, as it dismisses the client's feelings and implies
that the surgery will solve everything.
b) This response is self-disclosure and nontherapeutic, as it shifts the focus from the client to the nurse and
does not address the client's fears.
d) This response is minimizing and nontherapeutic, as it tells the client how to feel and does not acknowledge the client's regret or anxiety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
A. Dyspnea:
Dyspnea (shortness of breath) is a common symptom in emphysema due to the destruction of alveolar walls and the resulting reduction in surface area for gas exchange. As the disease progresses, the patient experiences increasing difficulty in breathing, especially during exertion or when the disease becomes more severe.
B. Barrel chest:
A barrel chest is often seen in emphysema, as it results from hyperinflation of the lungs. The increased air trapping due to damaged alveoli causes the chest to expand and become rounded, leading to the characteristic "barrel chest" appearance. This happens because the lungs are constantly overinflated, and the chest wall becomes rigid and rounded as a result.
D. Clubbing of the fingers:
Clubbing of the fingers can occur in chronic respiratory conditions like emphysema due to prolonged hypoxia (low oxygen levels in the blood). This is a compensatory mechanism that involves changes in the nails and fingers. The tips of the fingers become rounded and bulbous over time, and this is commonly associated with long-standing pulmonary diseases.
Correct Answer is B
Explanation
A humidifier bottle adds moisture to the oxygen, which prevents drying and irritation of the nasal mucosa
and enhances gas exchange.
a. Remove the nasal cannula while the client eats. This is not advisable, as the client may become hypoxic during eating, especially if they have pneumonia and impaired lung function. The nurse should monitor the client's oxygen saturation and respiratory status during meals and adjust the oxygen delivery device as needed.
c. Secure the oxygen tubing to the bed sheet near the client's head. This is not safe, as it can cause entanglement, dislodgement, or kinking of the tubing, which can compromise oxygen delivery and cause injury to the client.
d. Apply petroleum jelly to the nares as needed to soothe mucous membranes. This is not recommended, as petroleum products can ignite in the presence of oxygen and cause burns or fire. A water-based lubricant should be used instead.
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