A nurse is collecting data from a client who reports feeling stress. Which of the following should the nurse identify as an external stressor?

A recent move to a new city

Report of feeling depressed

Lack of nutritional knowledge

Recurring urinary tract infections

Answer and Explanation

The Correct Answer is A

Stressors can be categorized as external or internal. External stressors are factors or events in the environment that can cause stress.

In this case, the recent move to a new city is an external stressor because it is an event that has occurred outside of the client and is influencing their current state of stress. Moving to a new city can bring about significant changes and challenges, such as adjusting to a new environment, finding new social connections, and adapting to unfamiliar surroundings.

Feeling depressed is an internal stressor because it relates to the client's emotional state or mental health condition. Depression can be caused by various factors, such as biochemical imbalances, life circumstances, or genetic predispositions.

Lack of nutritional knowledge: This is an internal stressor because it refers to the client's lack of knowledge or awareness regarding nutrition. While the lack of nutritional knowledge can contribute to stress, it is an internal factor that can be addressed through education and learning.

While recurring urinary tract infections can be stressful for the client, they are considered an internal stressor because they involve a physical condition or health issue within the client's body. Addressing and managing the infections would involve medical interventions and possibly lifestyle modifications.

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Correct Answer is B

Explanation

"Your health care surrogate will make decisions on your behalf if you are unable": This statement is correct. A health care surrogate, also known as a health care proxy or durable power of attorney for health care, is an individual designated by the client to make medical decisions on their behalf if they become unable to make decisions for themselves. It is important for the client to choose someone they trust and who understands their values and wishes.
"You will need an attorney to appoint a health care surrogate": This statement is not necessarily true. While involving an attorney can be helpful, it is not always required to appoint a health care surrogate. In many jurisdictions, a legally valid health care surrogate designation can be made through a simple document or form provided by the hospital or a local government office. It is important to check the specific legal requirements in the client's jurisdiction.
"You should appoint a family member as your health care surrogate": This statement is a subjective recommendation and may not be applicable to all individuals. The decision of whom to appoint as a health care surrogate should be based on the client's personal preferences and the individual's ability to make informed decisions according to the client's wishes. While a family member is often chosen, it is not a requirement, and the client may choose a close friend, partner, or anyone else they trust to fulfill this role.
"Once you have completed a living will, it cannot be changed": This statement is incorrect. A living will, which is a type of advanced directive, can be changed or revoked at any time by the client as long as they are competent to do so. It is important for the client to review and update their living will periodically to ensure that it reflects their current wishes regarding medical care and treatment.

A. Apply the restraint under the client's clothes. B. Tie the restraint to the railing of the client's bed. C. Place the client in a sitting position. D. Ensure the restraint is placed across the client's chest.

Correct Answer is C

Explanation

a.Applying the restraint under the client's clothes: Restraints should be applied over the client's clothes to avoid direct skin contact and reduce the risk of skin irritation or injury.

b.Tying the restraint to the railing of the client's bed: Restraints should not be tied to bed rails or any other fixed objects. This can increase the risk of injury to the client and should be avoided.

c.Placing the client in a sitting position is appropriate when applying a belt restraint, as it helps prevent respiratory compromise and allows the client to maintain a safer and more comfortable posture.

d.A belt restraint should be placed around the client's waist, not across the chest, to avoid restricting breathing.

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A nurse is collecting data from a client who reports feeling stress. Which of the following should the nurse identify as an external stressor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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