A nurse is caring for a client whose spouse recently died. The client is newly diagnosed with diabetes. The client is tearful during a diabetic teaching session with the nurse, and states "You can't possibly understand what I'm going through." Which of the following responses is the most therapeutic for the nurse make?

"I might not share your exact situation, but I do know what people go through when they deal with a loss."

"It takes a long time to get over the loss of a loved one".

"Why don't you try something to take your mind off your troubles?

"You are correct. Could you describe what you are feeling?"

Answer and Explanation

The Correct Answer is D

D. This response validates the client's feelings without making assumptions, allows the client to share more about their experience, and fosters a supportive environment. It's important for healthcare professionals to create a space where clients feel heard and understood, especially during times of grief and new diagnoses, which can be overwhelming.
A. It acknowledges the client's feelings while also expressing the nurse's understanding of the grieving process. It reassures the client that they are not alone in their experiences, even if the nurse hasn't experienced the exact situation. However, telling the client that you know what they are going through may not make them feel understood.
B. While this response acknowledges the client's grief, it may come across as minimizing or dismissive of their current emotional distress related to their diabetes diagnosis. It focuses solely on the loss of the spouse and doesn't address the client's immediate concerns about managing their newly diagnosed condition. Therefore, it may not be the most therapeutic response in this situation.
C. This response might unintentionally invalidate the client's feelings by suggesting they should distract themselves from their grief and diabetes diagnosis. It could be perceived as dismissive or insensitive, as it doesn't address the client's emotional needs or offer support. Additionally, suggesting distraction may not be helpful or appropriate for someone experiencing significant emotional distress.

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Correct Answer is D

Explanation

D. Impaired immunity is a serious complication of prolonged stress that can have significant implications for overall health and susceptibility to illness. Chronic stress has been linked to dysregulation of the immune system, leading to decreased immune function and increased susceptibility to infections, autoimmune disorders, and other illnesses. Impaired immunity can compromise the body's ability to fight off pathogens and may contribute to the development or exacerbation of various health conditions.
A. Increased muscle tension is a common physiological response to stress but it is not typically considered a serious complication. Prolonged muscle tension can lead to discomfort, headaches, and musculoskeletal issues, but it is not usually life-threatening or associated with severe complications.
B. Altered sleep patterns, such as insomnia or disrupted sleep, can be significant consequences of prolonged stress. Chronic sleep disturbances can negatively impact physical health, cognitive function, and emotional well-being. While altered sleep patterns can have serious implications for overall health and quality of life, they are not typically considered life-threatening in the short term.
C. Increased peristalsis refers to heightened movement of the gastrointestinal tract, which can result in symptoms such as diarrhea or gastrointestinal discomfort. While gastrointestinal disturbances are common manifestations of stress, they are generally not considered the most serious complication of prolonged stress. However, severe or persistent gastrointestinal symptoms may warrant medical evaluation and management.

A. Confidentiality B. Justice C. Veracity D. Health Care Proxy

Correct Answer is A

Explanation

A. Confidentiality refers to the ethical duty of healthcare providers to safeguard patient information and maintain privacy. Upholding confidentiality means that healthcare providers must not disclose sensitive information about a patient to unauthorized individuals without the patient's consent. In this scenario, if the client asks the nurse not to disclose their medical diagnosis to their family members, respecting this request would uphold the principle of confidentiality by protecting the privacy of the patient's health information.
B. Justice in healthcare refers to the fair and equitable distribution of resources and the provision of healthcare services. While justice is an important ethical principle, it is not directly applicable to the client's request regarding the disclosure of their medical diagnosis to their family members.
C. Veracity, also known as truthfulness, is the ethical principle of honesty and truthfulness in communication with patients. Upholding veracity means providing patients with accurate and truthful information about their health condition and treatment options. In this scenario, if the nurse complies with the client's request not to disclose their medical diagnosis to their family members, it may involve withholding information and not fully disclosing the truth to the family members. Therefore, upholding the client's request may conflict with the principle of veracity.
D. A healthcare proxy is a legal document that allows an individual (the proxy) to make healthcare decisions on behalf of another person (the principal) if the principal is unable to make decisions for themselves. The existence of a healthcare proxy does not directly relate to the client's request regarding the disclosure of their medical diagnosis to their family members.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client who has been experiencing prolonged stress. For which most serious complication should the nurse monitor the client?

Correct Answer is D

Explanation

The client asks the nurse not to tell the family about the medical diagnosis. In meeting this request, the nurse would be upholding which of the following?

Correct Answer is A

Explanation

The client experiencing abdominal distention and severe vomiting has just had a nasogastric (NG) tube inserted. When teaching this client, which rationale for the use of the NG tube should the nurse include?

A client is to receive enteral nutrition. Which information should the nurse provide to the client and family? (SELECT ALL THAT APPLY)

It is a busy day on the medical-surgical floor, and the nurse must teach a client ready for discharge about his medications. How can the nurse most efficiently utilize time and provide this education?

A client is admitted with hypovolemia due to severe bleeding. Which Intravenous fluid does the nurse anticipate using to replace fluid losses?

The nurse has finished providing a tube feeding to a client. What should the nurse document about this procedure? (SELECT ALL THAT APPLY)

Which statement made by a client experiencing insomnia indicates a need for further education by the nurse? "I

A client is hyperventilating due to an acute psychologic stressor. The arterial blood gas results show that the client is in respiratory alkalosis. What is the nurse's initial intervention?