A nurse is caring for a client who is expressing anger about their diagnosis of colorectal cancer. Which action should the nurse take?

Discuss the risk factors for colon cancer.

Focus on teaching the client about future management of their illness.

Provide the client with written information about the phases of loss and grief.

Reassure the client that this is an expected response to grief.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Discussing the risk factors for colon cancer may not be helpful or comforting to a client who is expressing anger about their diagnosis. It might lead to feelings of guilt or regret if the client feels they could have done something to prevent the disease.

Choice B rationale

Focusing on future management of the illness may be overwhelming for a client who is currently expressing anger about their diagnosis. It might be more beneficial to address the client’s current emotional state before discussing future plans.

Choice C rationale

Providing written information about the phases of loss and grief may be helpful, but it may not address the client’s immediate emotional needs. The client may not be ready to read and process this information while they are expressing anger.

Choice D rationale

Reassuring the client that anger is an expected response to grief can validate the client’s feelings and help them feel understood. It’s important to acknowledge and validate the client’s emotions during this difficult time.

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Correct Answer is C

Explanation

Choice A rationale

A patient being in a wheelchair with the wheels locked does not necessarily indicate elder abuse. It could simply mean that the patient has mobility issues and the wheelchair is a means of transportation for them. The wheels being locked could be a safety measure to prevent the wheelchair from moving unexpectedly.

Choice B rationale

The patient reporting receiving a full bath twice each week does not indicate elder abuse. In fact, it shows that the patient’s hygiene needs are being met regularly. Regular bathing is part of good personal hygiene and is important for overall health.

Choice C rationale

The caregiver insisting on staying in the room during the nurse’s assessment could be a potential sign of elder abuse. This could indicate that the caregiver is controlling or overbearing, and may be trying to monitor or control the patient’s interactions with others. It could also suggest that the caregiver is trying to hide something or prevent the patient from speaking freely.

Choice D rationale

The caregiver being the patient’s financial power of attorney does not necessarily indicate elder abuse. A financial power of attorney is a legal document that gives someone the authority to handle financial transactions on behalf of another person. It is often used when a person is unable to manage their own financial affairs due to illness or incapacity.

A. 36.5°C B. 37.5°C C. 38.5°C D. 39.5°C

Correct Answer is C

Explanation

Choice A rationale

A temperature of 36.5°C is considered normal.

Choice B rationale

A temperature of 37.5°C is slightly elevated but still within the normal range.

Choice C rationale

A temperature of 38.5°C is considered a fever. Given the client’s symptoms of a productive cough with thick yellow sputum and abnormal breath sounds, this could indicate an infection such as pneumonia, which would likely cause a fever.

Choice D rationale

A temperature of 39.5°C is a high fever and could indicate a severe infection. However, the client’s symptoms are more consistent with a moderate fever.

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A nurse is caring for a client who is expressing anger about their diagnosis of colorectal cancer. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A home health nurse is conducting an admission assessment of an elderly patient who has their caregiver present. Which observation should the nurse identify as a potential sign of elder abuse?

Correct Answer is C

Explanation

The client was admitted with a productive cough with thick yellow sputum.Breath sounds with crackles were heard in the left upper lobe and decreased breath sounds at bases bilaterally. What is the client’s temperature?

Correct Answer is C

Explanation

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