A young man who has had a traumatic mid-thigh amputation of his right leg refuses to look at the wound during dressing changes. Which response by the nurse is appropriate?
"Oh, for gosh sakes. it doesn't look that bad."
"I understand, but you are going to have to look someday."
"Respect your wish not to look at it right now."
"You won't be able to go home until you look at it."
The Correct Answer is C
The appropriate response by the nurse in this situation would be to respect the young man's wish not to look at the wound during dressing changes. This response shows empathy and understanding toward the patient's feelings and emotions and allows him to have control over his own care. It is important for healthcare providers to respect their patient's autonomy and decisions regarding their own care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Primary prevention refers to actions taken to prevent the occurrence of a disease or condition. In this case, the nurse is educating women on the need for calcium to prevent bone loss, which is an example of primary prevention. By providing information on how to maintain strong bones and prevent bone loss, the nurse is helping to reduce the risk of conditions such as osteoporosis.
Correct Answer is D
Explanation
A stage II pressure ulcer is a wound that involves partial-thickness loss of skin. The most appropriate NANDA nursing diagnosis problem statement for a client with this condition would be Impaired Skin Integrity. This diagnosis reflects the fact that the client's skin has been damaged and is no longer intact. Risk for Injury, Altered Tissue Perfusion, and Impaired Tissue Integrity are also NANDA nursing diagnoses, but they are not as specific or relevant to the client's condition as Impaired Skin Integrity.
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