A nurse is caring for a client with high blood pressure who states, "I am afraid to take my blood pressure medication.”. How should the nurse respond?.
"Did your symptoms occur before or after you took the medication?".
"You won't get better until you take your medication.”.
"You seem upset about taking your blood pressure medication.”.
"Why do you feel afraid to take your medication?".
The Correct Answer is C
Choice A rationale
Identifying the timing of symptoms in relation to medication administration is a critical part of physical assessment and adverse effect monitoring. However, in this specific therapeutic communication context, the nurse is skipping the emotional validation of the client's stated fear. While clinically relevant for pharmacological evaluation, this closed-ended question does not address the psychological barrier preventing the client from adhering to the prescribed antihypertensive regimen at this moment.
Choice B rationale
This response is non-therapeutic because it uses a patronizing and authoritative tone that may increase the client's anxiety or defensiveness. Telling a client they will not get better without the medication ignores their expressed fear and shuts down further dialogue. Effective communication requires acknowledging the client's feelings first to build trust. By using a "must" or "should" approach, the nurse fails to explore the underlying reasons for the client's significant health-related concerns.
Choice C rationale
This is a therapeutic response that uses the technique of reflection to acknowledge the client's emotional state. By identifying that the client seems upset, the nurse validates their feelings and encourages further expression of their fears. This open-ended approach fosters a supportive environment where the client feels heard. Validation is the first step in addressing medication non-adherence, as it allows the nurse to eventually provide education that is tailored to the client's specific worries.
Choice D rationale
Asking "why" is generally considered a non-therapeutic communication technique because it can make a client feel defensive or put them on the spot to justify their emotions. Clients may not always have a logical explanation for their fear, and being asked to provide one can increase their stress level. It is more effective to use open statements or reflections that allow the client to elaborate on their feelings without the pressure of a direct interrogation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Board games with strict rules are generally more appropriate for school-aged children who have reached a developmental level of cognitive maturity that allows them to understand cooperation and competition. Preschoolers, typically aged three to five, are still developing their social skills and often struggle with the concept of losing or following complex logical structures. Their play is more focused on the process rather than the outcome or adherence to a rigid set of external game regulations.
Choice B rationale
Dress-up and imitative play are hallmarks of the preschool period, reflecting Erikson's stage of initiative versus guilt. During this time, children use their imaginations to explore different roles and make sense of the world around them. This type of play fosters language development, emotional regulation, and social understanding. By pretending to be adults or fantasy characters, they practice problem-solving and empathy, which are crucial milestones for cognitive and psychosocial growth in this specific age group.
Choice C rationale
Puzzles with very small, intricate pieces present both a frustration risk and a safety hazard for preschoolers. Fine motor skills are still refining during these years, and overly complex tasks can lead to a sense of failure. Furthermore, very small pieces can pose a choking hazard if the child still engages in occasional oral exploration. Preschoolers do better with larger, easily manipulated pieces that allow them to see the results of their efforts more clearly and quickly.
Choice D rationale
Reading a chapter book without illustrations is developmentally inappropriate for the preschool age. Children in this stage are visual learners who rely on pictures to provide context and maintain interest in a narrative. Their attention spans are relatively short, and they are just beginning to understand the relationship between spoken words and written symbols. Illustrated books support emergent literacy by providing visual cues that help the child follow the story and expand their growing vocabulary.
Correct Answer is ["A","B","C","E"]
Explanation
Choice A rationale
Redirecting goals to reduce unrealistic expectations is an effective cognitive-behavioral strategy for stress management. By aligning goals with reality, the individual reduces the constant activation of the sympathetic nervous system caused by a perceived gap between current status and unattainable objectives. This modification of cognitive appraisal helps lower cortisol levels and decreases the chronic stress response. It empowers middle-aged clients to focus on achievable tasks, thereby increasing their sense of self-efficacy and overall emotional stability.
Choice B rationale
Scheduling short breaks throughout the day allows for periodic activation of the parasympathetic nervous system, which counteracts the fight-or-flight response. These micro-rest periods help lower heart rate and blood pressure, preventing the cumulative physiological effects of sustained stress. For middle-aged adults balancing complex professional and personal roles, these breaks serve as a necessary reset. This practice promotes long-term resilience by ensuring that the body is not in a constant state of high physiological arousal.
Choice C rationale
Guided imagery is a relaxation technique that uses the mind-body connection to reduce physiological stress. By focusing on peaceful, detailed mental images, the brain triggers a relaxation response that decreases oxygen consumption and slows respiratory rates. This technique is particularly useful for middle-aged clients as it can be practiced almost anywhere. It effectively disrupts the cycle of stressful thoughts, leading to a measurable reduction in muscle tension and an improvement in overall psychological well-being and focus.
Choice D rationale
Taking frequent naps instead of addressing stressors is considered a maladaptive avoidance coping mechanism rather than a healthy stress management technique. While rest is important, excessive napping can disrupt normal sleep-wake cycles, potentially leading to insomnia or depressed mood. Furthermore, avoidance does not resolve the underlying stressor, often leading to increased anxiety when the individual eventually faces the unresolved issue. Effective programs should focus on active problem-solving and relaxation rather than passive escape or avoidance behaviors.
Choice E rationale
Listening to soothing music has been scientifically shown to lower blood pressure and reduce levels of the stress hormone cortisol. Music with a slow tempo can induce the alpha brain waves associated with relaxation and calm. This intervention is a low-cost, accessible way for clients to manage their physiological responses to environmental stressors. It provides a positive sensory focus that can improve mood and decrease the perception of stress, making it a valuable tool in a stress management program.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.