A nurse is caring for a client who is to begin chemotherapy. The client asks the nurse about managing hair loss. Which of the following responses should the nurse make?

"I can't imagine how difficult it would be to lose my hair."

"Let's discuss this when we have more time."

"I will get you information about some head-covering options."

"I wouldn't worry about this right now. Let's focus on your chemotherapy."

Answer and Explanation

The Correct Answer is C

A.   Incorrect. While expressing empathy is important, the nurse should also provide practical information and support.
B.   Incorrect. Delaying the discussion may leave the client feeling unheard and anxious about their upcoming chemotherapy.
C.   Correct. This response acknowledges the client's concerns and provides a proactive solution to address the potential issue of hair loss. Offering information about head covering options demonstrates the nurse's support and willingness to help the client manage the physical and emotional impact of chemotherapy.
D.   Incorrect. Dismissing the client's concern may contribute to their anxiety and apprehension about the chemotherapy process. It's important to address all aspects of the client's experience, including potential side effects like hair loss.

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Correct Answer is C

Explanation

A. Incorrect. Irrigation of a wound with antibiotic solution typically does not require informed consent.
B. Incorrect. Insertion of a nasogastric tube does not usually require informed consent unless it involves specific risks or is part of a research protocol.
C. Correct. Placement of a central venous catheter is an invasive procedure that involves risks, and informed consent is usually required.
D. Incorrect. Administration of an iron injection using the Z-track technique is a routine procedure and does not usually require informed consent.

A. Check the client's temperature. B. Instruct the client to take a brisk walk. C. Position the client on their left side. D. Provide the client with a glass of orange juice.

Correct Answer is C

Explanation

The client's symptoms of feeling dizzy, having a racing heart, and becoming pale while lying on their back may indicate supine hypotensive syndrome. This condition can occur during pregnancy when the weight of the uterus compresses the inferior vena cava, reducing blood flow to the heart and causing a drop in blood pressure.

Positioning the client on their left side helps relieve the pressure on the inferior vena cava and improves blood flow. This position allows for optimal circulation and helps alleviate the symptoms associated with supine hypotensive syndrome.

Checking the client's temperature is not necessary in this situation as the symptoms described are not typically associated with a fever. The priority is addressing the client's symptoms related to supine hypotensive syndrome.

Instructing the client to take a brisk walk is not recommended as it may exacerbate their symptoms. Walking increases physical exertion and could further decrease blood flow to the heart.

Providing the client with a glass of orange juice may be helpful if the symptoms were related to low blood sugar (hypoglycemia). However, in this case, the symptoms are more consistent with supine hypotensive syndrome. The priority is to reposition the client to improve blood flow and relieve symptoms. If the client continues to experience symptoms or if there are concerns about low blood sugar, further assessment and appropriate interventions should be implemented.

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A nurse is caring for a client who is to begin chemotherapy. The client asks the nurse about managing hair loss. Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the plan of care for a group of clients. The nurse should identify that informed consent is required for which of the following procedures?

Correct Answer is C

Explanation

A nurse is collecting data from a client during a routine prenatal visit. The client is in their second trimester of pregnancy and reports feeling dizzy, has a racing heart, and becomes pale while lying on their back. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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