An 18-year-old male has suffered a C5 spinal cord injury which has resulted in tetraplegia. His mother is crying in the waiting room 2 days after the injury has occurred. When the nurses sit down to talk to her, she asks whether her son will ever play football again. Which of the following responses would be best?
Reflect on how she's feeling, and encourage her to express other fears that she has about his injury.
Explain that you aren't sure, but you will ask the physician to talk to her right away.
Advise her that it isn't in his best interest for her to be so upset, and explain the importance of moral support
Reassure her that given time and motivation he will return to normal function.
The Correct Answer is A
A. Reflect on how she's feeling, and encourage her to express other fears that she has about his injury – Acknowledging emotions and encouraging open expression helps the mother process her grief and begin adjusting to the reality of the injury.
B. Explain that you aren't sure, but you will ask the physician to talk to her right away – Deferring to the physician misses an opportunity for emotional support.
C. Advise her that it isn’t in his best interest for her to be so upset, and explain the importance of moral support – This dismisses her emotions rather than addressing them.
D. Reassure her that given time and motivation he will return to normal function – Providing false reassurance is inappropriate, as a C5 spinal cord injury results in permanent loss of function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Alert and oriented, blood and urine without ketones, no orthostatic blood pressure changes – These findings indicate improved hydration, resolution of hyperosmolarity, and recovery of neurological function, key markers of HHS improvement.
B. Alert and oriented, balanced intake and output, moist mucous membranes – While improved hydration is good, ketone clearance and hemodynamic stability are more important indicators.
C. Respirations easy and unlabored, eats 50-75% of meals, vital signs stable – Respiratory status is not the primary concern in HHS.
D. Equal intake and output, denies pain or shortness of breath – These signs do not specifically indicate resolution of HHS.
Correct Answer is B
Explanation
A. Give the patient access to a video about diabetes. – Incorrect. Educational materials are helpful but should be provided after assessing the patient's current knowledge level.
B. Determine what the patient knows about managing diabetes. – Correct Answer. The first step in teaching is to assess the patient's baseline knowledge to tailor the education to their needs.
C. Establish short-term, realistic goals for the patient. – Incorrect. Goal-setting is important but should come after assessing the patient’s knowledge and readiness to learn.
D. Evaluate the effectiveness of the patient's admission teaching plan. – Incorrect. The nurse should first determine what new information needs to be taught before evaluating previous teaching.
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