A nurse is caring for a client who is newly diagnosed with cancer. Which of the following nursing interventions to maximize successful coping to the treatment plan should the nurse initiate at this time? (SELECT ALL THAT APPLY)

Encourage the client to express feelings and concerns

Tell the client what coping skills he should use

Assist the client with time management and priorities

Allow the client input into the treatment plan

Provide extensive instructions about the client's treatment plan and prognosis

Answer and Explanation

Correct Answer : A,C,D

A. This intervention promotes emotional expression and allows the client to verbalize their fears, worries, and uncertainties related to the cancer diagnosis. Encouraging the client to express their feelings fosters a sense of emotional support, validation, and empathy, which are essential for coping with the emotional impact of the diagnosis.
C. Cancer diagnosis and treatment often involve multiple appointments, tests, and treatments, which can be overwhelming for the client. Assisting the client with time management and priorities can help alleviate stress and enhance coping by providing structure, organization, and support in managing the demands of the treatment plan and daily life responsibilities.
D. Involving the client in decision-making and allowing them input into the treatment plan empowers the client and promotes a sense of control and autonomy over their care. Collaborative decision-making enhances the client's engagement, adherence, and satisfaction with the treatment plan, which are essential for successful coping and treatment outcomes.
B. Telling the client what coping skills to use may not be the most effective approach, as it disregards the individuality of the client's coping mechanisms and preferences. Instead, the nurse should explore with the client what coping strategies they have used in the past and provide guidance and support in identifying and implementing effective coping strategies that align with the client's needs and preferences.
E. Providing extensive instructions about the treatment plan and prognosis is important for promoting understanding, informed decision-making, and adherence to the treatment plan. However, the timing and amount of information should be tailored to the client's readiness and preferences. Too much information too soon may overwhelm the client and hinder coping, while inadequate information may lead to uncertainty and anxiety. Therefore, the nurse should provide information in a clear, empathetic, and supportive manner, ensuring that the client's informational needs are met while respecting their emotional readiness.

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Correct Answer is A

Explanation

A. In respiratory alkalosis, the pH is elevated (alkalotic), the PaCO2 (partial pressure of carbon dioxide) is decreased (hypocapnia), and the HCO3 (bicarbonate) level may be within normal limits or slightly decreased due to compensatory mechanisms. In this option, the pH is elevated (7.54), the PaCO2 is decreased (25), and the HCO3 level is within normal limits (24). These findings support respiratory alkalosis.
B. pH 7.50, PaCO2 40, HCO3 28: In this option, the pH is elevated (7.50), the PaCO2 is within normal limits (40), and the HCO3 level is elevated (28). These findings are not consistent with respiratory alkalosis. Instead, they suggest metabolic alkalosis, where both the pH and bicarbonate levels are elevated.
C. pH 7.35, PaCO2 35, HCO3 22: In this option, the pH is within normal limits (7.35), the PaCO2 is within normal limits (35), and the HCO3 level is within normal limits (22). These findings are not consistent with respiratory alkalosis.
D. pH 7.32. PaCO2 48, HCO3 24: In respiratory alkalosis, the pH is elevated (alkalotic), the PaCO2 is decreased (hypocapnia), and the HCO3 level may be within normal limits or slightly decreased due to compensatory mechanisms. In this option, the pH is within normal limits (7.32), the PaCO2 is elevated (48), and the HCO3 level is within normal limits (24). These findings are not consistent with respiratory alkalosis.

A. chronic stress changes genetic structure. B. physiologic responses that were originally adaptive become maladaptive over time. C. the patient experiences a deficit of available corticosteroids and catecholamines D. the patient loses psychologic energy while worrying about stress.

Correct Answer is B

Explanation

B. This statement aligns with the concept of allostatic load, which refers to the cumulative physiological toll that chronic stress places on the body over time. Initially, the body's stress response system (the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system) is designed to help individuals cope with acute stressors. However, when stress becomes chronic, these physiological responses can become dysregulated and maladaptive, leading to negative health outcomes such as cardiovascular disease, immune dysfunction, and mental health disorders.
A. Chronic stress has been associated with various changes in gene expression and epigenetic modifications. However, these changes typically occur over longer periods and are not the primary mechanism by which chronic stress leads to illness in most cases.
C. Chronic stress can lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system, which are responsible for producing and regulating corticosteroids (such as cortisol) and catecholamines (such as adrenaline and noradrenaline). While acute stress typically results in increased production of these stress hormones, chronic stress can lead to desensitization and dysregulation of these systems, resulting in alterations in hormone levels and potential deficits in the availability of these stress mediators. However, deficits in corticosteroids and catecholamines are not the sole mechanism by which chronic stress leads to illness.
D. While chronic stress can certainly contribute to psychological fatigue and depletion of energy reserves, this is not the primary mechanism by which chronic stress leads to illness. The physiological responses to chronic stress, such as dysregulation of stress hormones, inflammation, and oxidative stress, are more directly linked to the development of various illnesses.

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A nurse is caring for a client who is newly diagnosed with cancer. Which of the following nursing interventions to maximize successful coping to the treatment plan should the nurse initiate at this time? (SELECT ALL THAT APPLY)

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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