A young woman with severe jaundice has an altered body image. The patient says, "Will I always be this horrible color?" What is the best response by the nurse?
"No. The color will fade gradually as liver inflammation decreases."
"Yes, but cosmetics can disguise the color."
"Yes, but your sclera will return to their previous white color."
"No. The color will change to freckles."
The Correct Answer is A
A. "No. The color will fade gradually as liver inflammation decreases.": This response provides accurate information and reassurance, addressing the patient's concerns about her appearance while being supportive.
B. "Yes, but cosmetics can disguise the color.": This dismisses the patient’s concerns and is not empathetic or accurate, as jaundice usually resolves when liver function improves.
C. "Yes, but your sclera will return to their previous white color.": While the sclera may clear up, this does not address the entire issue of jaundice affecting skin color.
D. "No. The color will change to freckles.": This is misleading and untrue, potentially worsening the patient's anxiety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Standard Precautions: These are appropriate for hepatitis B since the virus is primarily transmitted through blood and body fluids. Hand hygiene and gloves are sufficient unless there is an additional infection requiring other precautions.
B. Respiratory precautions: Not needed as hepatitis B is not airborne or droplet-transmitted.
C. Reverse isolation: This is used for immunocompromised patients, not for patients with hepatitis B.
D. Enteric precautions: These are used for infections spread via the fecal-oral route, such as Clostridioides difficile, not hepatitis B.
Correct Answer is A
Explanation
A. Encourage turning, coughing, and deep breathing every 2 hours: Bed rest increases the risk of respiratory complications like atelectasis and pneumonia, so encouraging turning, coughing, and deep breathing helps prevent these complications by improving lung ventilation.
B. Raise the knee gatch to prevent the patient from sliding down in bed: While this may help position the patient, it is not the priority action to prevent complications related to bed rest and hepatitis.
C. Provide undisturbed periods of 6 hours to encourage rest: While rest is important, prolonged periods without movement can lead to complications like pneumonia or pressure ulcers. Movement should still be encouraged.
D. Restrict fluids: Fluid restriction is not necessary for most hepatitis patients unless there are specific complications like ascites or severe edema. Fluid intake should generally be encouraged to prevent dehydration.
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