A nurse is caring for a client who is scheduled for cataract surgery. The client states, "I see Just fine and have decided to cancel my surgery." Which of the following responses should the nurse make?

"I think you will regret it if you don't have this surgery."

"It's too late to cancel your cataract surgery."

"This surgery is painless, so you shouldn't worry."

"Share with me more about the thoughts that are concerning you.”

Answer and Explanation

The Correct Answer is D

A. "I think you will regret it if you don't have this surgery." – This is non-therapeutic and pressures the client rather than encouraging discussion.

B. "It's too late to cancel your cataract surgery." – This is false information; clients have the right to refuse treatment at any time.

C. "This surgery is painless, so you shouldn't worry." – This minimizes the client’s concerns and dismisses their feelings.

D. "Share with me more about the thoughts that are concerning you." – This therapeutic response encourages the client to express their concerns, allowing the nurse to address them appropriately.

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Correct Answer is D

Explanation

A. The client reports taking the medication 30 min before the prescribed time. Taking a medication slightly earlier is unlikely to significantly affect its therapeutic efficacy.

B. The client received an influenza vaccine 1 month ago. Vaccination does not interfere with arthritis medications unless it triggers an immune response leading to disease flare-up, which is rare.

C. The client reports taking the medication with room temperature water. The temperature of the water does not impact the drug’s effectiveness.

D. The client has a history of recurring bowel inflammation. Chronic bowel inflammation (e.g., Crohn’s disease) can affect drug absorption, reducing medication effectiveness.

A. "Contacted the provider to report client findings." B. "Reports stomach pain as 3 on a pain scale of 0 to 10." C. "Vomited 120 mL of clear, yellow emesis." D. "Denies further nausea or vomiting since antiemetic administration.

Correct Answer is D

Explanation

A. "Contacted the provider to report client findings." – This is an example of collaboration or communication, not direct implementation of care.

B. "Reports stomach pain as 3 on a pain scale of 0 to 10." – This is assessment, not implementation.

C. "Vomited 120 mL of clear, yellow emesis." – This is also assessment (objective data collection).

D. "Denies further nausea or vomiting since antiemetic administration." – This is implementation, as it evaluates the effect of an intervention (antiemetic administration).

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A nurse is caring for a client who is scheduled for cataract surgery. The client states, "I see Just fine and have decided to cancel my surgery." Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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