A nurse is caring for a client who has a new diagnosis of chronic stress. Which of the following findings should the nurse recognize as a manifestation of denial?

The client reports that they get upset with their family members for no reason.

The client brings a list of questions about their diagnosis to their appointment.

The client refuses to accept treatment for their diagnosis.

The client calls the office multiple times per day to speak with their provider.

Answer and Explanation

The Correct Answer is C

A. The client reports that they get upset with their family members for no reason: Irritability and emotional outbursts are common behavioral responses to stress but do not necessarily indicate denial. They reflect difficulty coping rather than refusal to acknowledge the reality of the condition.

B. The client brings a list of questions about their diagnosis to their appointment: Seeking information demonstrates engagement and active coping with the diagnosis, which is a sign of acceptance and adaptive behavior, not denial.

C. The client refuses to accept treatment for their diagnosis: Denial is a defense mechanism in which a client consciously or unconsciously refuses to acknowledge the reality of a diagnosis or the need for treatment. Refusal to accept prescribed interventions directly reflects the client’s difficulty recognizing or accepting their condition.

D. The client calls the office multiple times per day to speak with their provider: Frequent calls indicate anxiety or a need for reassurance, which may reflect heightened stress or worry, but this behavior alone does not demonstrate denial of the diagnosis.

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Free Nursing Study Resources

Correct Answer is ["A","B","F"]

Explanation

A. "I should notify my provider before taking any new over-the-counter or prescription medications.": Many anti-tuberculosis medications, such as rifampin and isoniazid, have significant drug-drug interactions. Rifampin is a potent cytochrome P450 inducer, which can alter the metabolism of other medications, potentially reducing their effectiveness or increasing toxicity. Notifying the provider ensures safe co-administration and prevents adverse effects.

B. "I can expect my contact lenses to turn red or orange.": Rifampin can cause harmless discoloration of body fluids, including tears and saliva, which may stain contact lenses orange-red. This is an expected effect of therapy and does not indicate harm or require discontinuation, but the client should be educated to avoid alarm.

C. "I will need to take my medications for a total of 5 weeks.": Tuberculosis treatment requires a prolonged course, typically 6 months or longer, depending on the regimen. A 5-week duration is insufficient for eradication and increases the risk of drug resistance. This statement indicates misunderstanding of therapy duration.

D. "I should decrease my alcohol intake to one to two drinks per day.": Alcohol should be completely avoided during anti-TB therapy, particularly with isoniazid and pyrazinamide, due to increased risk of hepatotoxicity. Suggesting a partial reduction demonstrates misunderstanding of safe practices during treatment.

E. "I am no longer contagious.": The client is still considered contagious until sputum cultures are negative, usually after several weeks of effective therapy. Assuming non-contagious status prematurely could lead to inadvertent transmission.

F. "I will need to have someone observe me when I take my medication.": Directly Observed Therapy (DOT) is the recommended approach for TB treatment to ensure adherence and prevent drug resistance. Understanding the need for observation demonstrates accurate comprehension of safe treatment practices.

A. Encourage client to use incentive spirometer every 4 hr. B. Elevate the head of the client's bed to a 45-degree position when awake. C. Place an abduction pillow between the client's legs. D. Use a sequential compression device on the client's unaffected leg.

Correct Answer is C

Explanation

A. Encourage client to use incentive spirometer every 4 hr: While using an incentive spirometer is important to prevent postoperative pulmonary complications, standard practice recommends using it every 1–2 hours while awake rather than every 4 hours. Less frequent use may not adequately prevent atelectasis.

B. Elevate the head of the client's bed to a 45-degree position when awake: For a total hip arthroplasty, strict hip precautions are required to prevent dislocation. Elevating the head of the bed excessively can inadvertently flex the hip past recommended limits (usually less than 90 degrees), increasing the risk of injury.

C. Place an abduction pillow between the client's legs: Using an abduction pillow maintains proper hip alignment and prevents adduction of the operated leg, which significantly reduces the risk of hip dislocation postoperatively. This is a standard and critical component of post-hip arthroplasty care.

D. Use a sequential compression device on the client's unaffected leg: Sequential compression devices are used bilaterally to prevent venous thromboembolism unless contraindicated. Applying it to only the unaffected leg does not provide complete prophylaxis and is not standard practice.

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A nurse is caring for a client who has a new diagnosis of chronic stress. Which of the following findings should the nurse recognize as a manifestation of denial?

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