A nurse is caring for an older adult client whose wife passed away a month ago with cardiac issues and is currently being treated for similar cardiac issues. He is tearful and states, "How could you possibly understand what I am going through?" Which of the following is an appropriate response by the nurse?
"You are right, I cannot really understand. Perhaps you would like to tell me more about what you are feeling."
"It takes time to get over the loss of a loved one."
"Why don't you try something to take your mind off your troubles?"
"I might not share your exact situation, but I do know what people go through when they deal with a loss."
The Correct Answer is A
Choice A reason: This response acknowledges the client's feelings and validates their experience. It opens the door for the client to express their emotions and share their thoughts. This empathetic approach helps build trust and provides emotional support.
Choice B reason: Telling the client that it takes time to get over the loss of a loved one is a generalized statement that may not provide the support the client needs. It can come across as dismissive and may not encourage further conversation.
Choice C reason: Suggesting that the client try something to take their mind off their troubles can seem dismissive of their grief. It does not address the client's emotional needs or encourage them to talk about their feelings.
Choice D reason: While this response shows some understanding, it does not fully acknowledge the uniqueness of the client's situation. It is important to validate the client's feelings and encourage them to express their emotions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Hyperopia, also known as farsightedness, is a condition where distant objects can be seen more clearly than near objects. It is caused by the eyeball being too short or the cornea having too little curvature. In this scenario, the client's ability to adjust and focus on near and distant objects is not indicative of hyperopia.
Choice B reason: Photophobia is an increased sensitivity to light. It can be caused by various eye conditions, infections, or even migraines. The client's ability to focus on objects at different distances does not correlate with sensitivity to light.
Choice C reason: Myopia, or nearsightedness, is the opposite of hyperopia. Individuals with myopia can see near objects clearly but have difficulty focusing on distant objects. The client's ability to focus on both near and far objects rules out myopia.
Choice D reason: Accommodation is the process by which the eye adjusts its focus from near to distant objects (or vice versa). This involves changes in the shape of the lens, controlled by the ciliary muscles. The client's ability to focus on objects at varying distances correctly describes the accommodation process, making it the appropriate answer.
Correct Answer is B
Explanation
Rationale
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B. Sudden pain relief: The intense pain associated with otitis media is caused by the accumulation of fluid and pressure against the tympanic membrane. When the membrane ruptures, that pressure is instantaneously released, resulting in a sudden and dramatic decrease in pain. This is often followed by purulent (pus-filled) or serosanguineous (bloody) drainage in the external ear canal.
Why the others are incorrect
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A. Increased temperature: While a fever is a common sign of an acute infection (Acute Otitis Media), it is not a specific indicator that the eardrum has ruptured. In fact, systemic symptoms like fever may actually decrease once the pressure and infection are vented through a rupture.
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C. Popping sensation when swallowing: This sensation is typically associated with the opening and closing of the Eustachian tube as it attempts to equalize pressure in the middle ear. It is a common symptom of Eustachian tube dysfunction or fluid in the ear, but it indicates an intact eardrum rather than a ruptured one.
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D. Green-blue discharge in the ear canal: While drainage (otorrhea) occurs after a rupture, the color is typically clear, bloody, or yellowish-white (purulent). Green-blue discharge is more characteristic of Pseudomonas infections, often seen in otitis externa (swimmer's ear), rather than a standard tympanic membrane rupture from middle ear effusion.
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