A nurse is caring for a client who is rehabilitating from injuries resulting from a motor vehicle crash. Which of the following client statements should the nurse identify as the priority?
"I'm scared that my partner will leave me if I can't recover from these injuries."
"I don't feel like I'm able to take care of my family anymore."
"I have not been able to sleep at night because it hurts when I move."
"I will not be able to do my job as a result of these injuries."
The Correct Answer is C
A. "I'm scared that my partner will leave me if I can't recover from these injuries.": This address psychosocial needs. While important, it does not take precedence over physiological needs according to Maslow's Hierarchy.
B. "I don't feel like I'm able to take care of my family anymore.": This reflects a role-performance issue. While distressing, it is not an immediate physical threat to the client’s stability.
C. "I have not been able to sleep at night because it hurts when I move.": Using Maslow’s Hierarchy of Needs, physiological needs such as pain management and rest are the priority. Severe pain can also hinder physical rehabilitation.
D. "I will not be able to do my job as a result of these injuries.": This is a vocational/financial concern. It is secondary to the client’s immediate physical comfort and recovery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Production of erythropoietin: While the kidney produces EPO, this is a hormonal function and not the primary physical process of the nephron unit itself.
B. Filtration, reabsorption, and secretion: These are the three fundamental processes that allow the nephron to clear waste from the blood while retaining essential water and nutrients.
C. Only filtration of blood: Filtration is only the first step; without reabsorption, the body would lose all its fluid and nutrients in minutes.
D. Regulation of acid-base balance: This is one outcome of nephron function, but the primary mechanism involves the combined effort of filtration, reabsorption, and secretion.
Correct Answer is B
Explanation
A. Collecting duct: The collecting duct handles water and electrolyte fine-tuning, not large molecule filtration.
B. Glomerulus: The glomerular filtration membrane acts as a sieve. Normally, it is too fine to allow large proteins (like albumin) to pass. If protein is in the urine, it indicates the glomerular "sieve" is damaged.
C. Distal convoluted tubule: This part of the nephron deals with secretion and reabsorption of ions, not protein filtration.
D. Loop of Henle: This area focuses on the concentration of urine through salt and water transport.
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