A nurse is planning to conduct a support group for adolescents who have cancer.
Which of the following actions should the nurse include during the orientation phase?
Maintain the group's focus on identified issues.
Encourage the use of problem-solving skills.
Manage conflict within the group.
Establish a rapport with group members.
The Correct Answer is D
Choice A rationale:
Maintaining the group's focus on identified issues is a valuable aspect of group therapy, but it is not specific to the orientation phase. This action should be integrated throughout the entire support group process.
Choice B rationale:
Encouraging the use of problem-solving skills is an important part of support group facilitation, but this is also not unique to the orientation phase. Problem-solving skills can be encouraged and developed throughout the support group sessions.
Choice C rationale:
Managing conflict within the group is an essential skill for a support group leader, but again, this is not specific to the orientation phase. Conflict management should be an ongoing process in group therapy.
Choice D rationale:
Establishing a rapport with group members is a critical action during the orientation phase of a support group. This phase sets the tone for the group and helps build trust and comfort among the members. It is essential for the nurse to create a safe and supportive environment where group members feel comfortable sharing their experiences and emotions. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is Choice D, sore throat.
Choice A rationale: Random blood glucose 130 mg/dL is not a priority finding for the nurse to report to the provider. This level is slightly above the normal range of 70 to 110 mg/dL, but it is not indicative of a serious condition such as diabetes mellitus or hyperglycemia. Clozapine can cause hyperglycemia in some patients, but this is usually a chronic effect that develops over months or years of treatment. Therefore, a single random blood glucose measurement of 130 mg/dL is not a cause for immediate concern or intervention. The nurse should monitor the client’s blood glucose levels regularly and educate the client on the signs and symptoms of hyperglycemia, such as increased thirst, urination, hunger, and fatigue. The nurse should also encourage the client to maintain a healthy diet and exercise regimen to prevent or manage hyperglycemia.
Choice B rationale: Nausea is not a priority finding for the nurse to report to the provider. Nausea is a common side effect of clozapine that usually occurs during the initial phase of treatment or after a dose increase. It is usually mild and transient and can be managed by taking the medication with food or water, using antiemetics, or reducing the dose if necessary. Nausea does not indicate a serious or life-threatening adverse reaction to clozapine, unless it is accompanied by other symptoms such as vomiting, abdominal pain, jaundice, or fever. The nurse should assess the client’s nausea and provide supportive care and education on how to cope with it.
Choice C rationale: Heart rate 104/min is not a priority finding for the nurse to report to the provider. This level is slightly above the normal range of 60 to 100 beats per minute, but it is not indicative of a serious condition such as tachycardia or cardiac arrhythmia. Clozapine can cause orthostatic hypotension, bradycardia, syncope, and cardiac arrest in some patients, but these are rare and serious adverse effects that require immediate medical attention. Therefore, a single heart rate measurement of 104/min is not a cause for immediate concern or intervention. The nurse should monitor the client’s vital signs regularly and educate the client on the signs and symptoms of orthostatic hypotension, such as dizziness, lightheadedness, or fainting when changing positions. The nurse should also advise the client to rise slowly from a lying or sitting position, avoid alcohol and other substances that can lower blood pressure, and drink plenty of fluids to prevent dehydration.
Choice D rationale: Sore throat is a priority finding for the nurse to report to the provider. Sore throat is a sign of infection, inflammation, or irritation of the throat, which can be caused by various factors such as viruses, bacteria, allergens, or irritants. However, in a client who is taking clozapine, sore throat can also indicate a serious and potentially fatal adverse effect of the medication: severe neutropenia. Neutropenia is a condition in which the number of neutrophils, a type of white blood cell that fights infection, is abnormally low. This increases the risk of developing serious and life-threatening infections, especially in the mouth, throat, and respiratory tract. Clozapine can cause neutropenia in some patients, especially during the first 18 weeks of treatment, and it is the most common reason for discontinuing the medication. Therefore, any client who is taking clozapine and develops a sore throat should be evaluated by the provider as soon as possible to rule out neutropenia and initiate appropriate treatment if needed. The nurse should also educate the client on the importance of regular blood tests to monitor the absolute neutrophil count (ANC) and the signs and symptoms of infection, such as fever, chills, weakness, or sore throat. The nurse should also instruct the client to avoid contact with people who are sick, practice good hygiene, and report any signs of infection immediately.
Correct Answer is C
Explanation
Choice A rationale:
"Older adults are usually diagnosed with depressive disorder as they age.”. This choice is not appropriate because it makes a generalized statement about older adults being diagnosed with depressive disorder as they age. While depression can be more common in older adults due to various factors such as health issues and life changes, it's essential to explore the specific reasons for this particular client's symptoms.
Choice B rationale:
"You shouldn't worry about this because depressive disorder is easily treated.”. This choice dismisses the daughter's concerns and oversimplifies the treatment of depressive disorder. Depression can be a complex condition, and not all cases are easily treated. It's important to take the daughter's worries seriously and assess the client's condition thoroughly.
Choice D rationale:
"Everyone gets depressed from time to time.”. This response minimizes the daughter's concerns by suggesting that depression is a common experience for everyone. While it's true that many people may experience occasional sadness, clinical depression is a different matter and should be addressed with more empathy and attention.
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