A nurse is caring for a client who has been on hemodialysis for the past 5 years. The client is refusing hemodialysis and says, "I'm tired of wasting my life; I would rather die." Which of the following statements should the nurse make?

"You are feeling anxious now; why don't you give it some time before making a final decision?"

"You should talk with your family members before making this decision."

"I will discuss this with your primary health care provider, and we can discuss this more tomorrow."

"Let me refer you to talk to someone regarding your treatment options."

Answer and Explanation

The Correct Answer is D

Rationale:

A. "You are feeling anxious now; why don't you give it some time before making a final decision?": This minimizes the client’s current emotional distress and does not address the seriousness of the statement. It may come across as dismissive rather than therapeutic.

B. "You should talk with your family members before making this decision.": Although involving family in major decisions can be helpful, the focus should be on the client's feelings and wishes first.

C. "I will discuss this with your primary health care provider, and we can discuss this more tomorrow.": Deferring the conversation may delay support for someone expressing emotional exhaustion and possible suicidal ideation. Prompt intervention is essential in these situations.

D. "Let me refer you to talk to someone regarding your treatment options.": This response acknowledges the client's emotional state while also offering a supportive and appropriate next step. It opens access to counseling or mental health services and helps the client explore options without judgment.

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Correct Answer is ["A","B","C","D","E"]

Explanation

Rationale:

A. Sudden muscular contractions: Antipsychotics like haloperidol and chlorpromazine can cause extrapyramidal symptoms (EPS), including acute dystonia, which manifests as sudden, involuntary muscle contractions typically affecting the face, neck, or back.

B. Orthostatic hypotension: Chlorpromazine, a low-potency typical antipsychotic, often causes orthostatic hypotension due to its alpha-adrenergic blockade, increasing fall risk, especially in older adults or those new to therapy.

C. Anticholinergic effects: These include dry mouth, blurred vision, constipation, and urinary retention. Chlorpromazine is particularly known for its anticholinergic side effects due to its action on muscarinic receptors.

D. Tremors: Tremors are part of parkinsonian side effects, another form of EPS commonly caused by haloperidol. They result from dopamine blockade in the nigrostriatal pathway.

E. Sedation: Both haloperidol and chlorpromazine can cause sedation. Chlorpromazine is especially sedating due to its histamine (H1) receptor blockade, which depresses the CNS.

F. Increased urination: Not typically associated with these medications. In fact, anticholinergic effects from chlorpromazine more often lead to urinary retention, not increased urination.

A. "Remove a plug from the socket by pulling the cord." B. "Use three-pronged grounded plugs." C. "Check for a tingling sensation around the cord." D. "Cover extension cords with a rug."

Correct Answer is B

Explanation

Rationale:

A. "Remove a plug from the socket by pulling the cord": Yanking the cord can damage the cord, loosen wiring, and increase the risk of sparks or electrical fire. The correct method is to grasp the plug firmly and pull it straight out to avoid strain on the wire connections.

B. "Use three-pronged grounded plugs": Three-pronged plugs provide a grounding mechanism that reduces the risk of electric shock and fire. Grounded outlets redirect excess electricity safely into the ground if a fault occurs, making them a key part of electrical safety.

C. "Check for a tingling sensation around the cord": A tingling sensation can indicate an electrical short or exposed wiring, which is a serious safety hazard. While it’s important to report and stop using such cords, the focus should be on prevention before such issues arise.

D. "Cover extension cords with a rug": Covering cords with rugs can trap heat, cause insulation to wear down, and increase fire risk. Cords should be left uncovered and positioned to avoid foot traffic while maintaining ventilation to prevent overheating.

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A nurse is caring for a client who has been on hemodialysis for the past 5 years. The client is refusing hemodialysis and says, "I'm tired of wasting my life; I would rather die." Which of the following statements should the nurse make?

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Explanation

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