An adolescent with a congenital heart defect is admitted for diagnostic testing with surgery scheduled in 3 days. Which intervention should the nurse implement to best support the client's psychosocial needs?
Enable limited time for cell phone use.
Provide an activity room to spend time with other adolescents.
Deliver 3 meals and snacks each day upon request.
Allow family and friends to be present during assessments.
The Correct Answer is B
Choice A reason: Enabling limited time for cell phone use is not the best intervention that the nurse can implement to support the client's psychosocial needs. While cell phone use can help the client stay connected with their peers and social media, it can also be a source of distraction and stress. The nurse should encourage the client to balance their cell phone use with other activities that promote their well-being.
Choice B reason: Providing an activity room to spend time with other adolescents is the best intervention that the nurse can implement to support the client's psychosocial needs. This intervention can help the client cope with the anxiety and isolation that may result from their condition and hospitalization. It can also provide an opportunity for the client to interact with other adolescents who have similar experiences and challenges, and to engage in fun and meaningful activities that enhance their self-esteem and mood.
Choice C reason: Delivering 3 meals and snacks each day upon request is not the best intervention that the nurse can implement to support the client's psychosocial needs. While it is important to maintain the client's nutrition and hydration, it is not enough to address their emotional and social needs. The nurse should also encourage the client to eat with other adolescents or family members when possible, and to express their preferences and concerns about their food.
Choice D reason: Allowing family and friends to be present during assessments is not the best intervention that the nurse can implement to support the client's psychosocial needs. While it is important to involve the client's family and friends in their care, it is not necessary to have them present during every assessment. The nurse should respect the client's privacy and autonomy, and ask for their consent before allowing others to observe or participate in their assessments. The nurse should also provide the client with opportunities to talk to their family and friends in a comfortable and confidential setting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Obtaining a swab of secretions from the penis and urethra is not the appropriate action to take in this situation. This may be done to test for sexually transmitted infections (STIs), such as chlamydia or gonorrhea, that can cause epididymitis, an inflammation of the tube that carries sperm from the testicle. However, epididymitis usually causes gradual pain and swelling, not sudden and severe, and is unlikely to be triggered by a physical activity. Moreover, obtaining a swab may be painful and unnecessary for the adolescent.
Choice B reason: Collecting a sterile urine sample for culture and sensitivity is not the appropriate action to take in this situation. This may be done to test for urinary tract infections (UTIs) or kidney stones that can cause testicular pain. However, UTIs and kidney stones usually cause other symptoms, such as burning or difficulty urinating, blood in the urine, or lower back pain. They are also unlikely to be triggered by a physical activity. Moreover, collecting a urine sample may be difficult and uncomfortable for the adolescent.
Choice C reason: Providing the adolescent with a urinal for urinary hesitancy is not the appropriate action to take in this situation. Urinary hesitancy is the difficulty or delay in starting or maintaining a urine stream. It can be caused by various factors, such as anxiety, medication, prostate problems, or nerve damage. It is not a common symptom of testicular pain and is not related to the cause of the pain. Moreover, providing a urinal may be embarrassing and unnecessary for the adolescent. ⁷
Choice D reason: Reporting the findings immediately to the healthcare provider is the appropriate action to take in this situation. Sudden and severe testicular pain and swelling can be a sign of testicular torsion, a medical emergency that occurs when the testicle twists and cuts off its blood supply. Testicular torsion can be caused by trauma, strenuous exercise, or cold temperature. It can lead to permanent damage or loss of the testicle if not treated promptly. The adolescent needs urgent evaluation and possible surgery to untwist the testicle and restore blood flow.
Correct Answer is D
Explanation
Choice A reason: Encouraging the parent to come to the clinic if the child develops a fever is not the best response that the nurse can give. This is because a fever may indicate a serious infection, such as Lyme disease, that requires prompt treatment. The nurse should not wait for the child to develop a fever before advising the parent to seek medical attention.
Choice B reason: Instructing the parent to apply an antihistamine ointment for one week is not the best response that the nurse can give. This is because an antihistamine ointment may not be effective for a fungal infection, such as ringworm, or a bacterial infection, such as Lyme disease, that may cause a circular rash. The nurse should not recommend any OTC product without knowing the exact cause of the rash.
Choice C reason: Offering reassurance that OTC corticosteroid creams are safe and effective is not the best response that the nurse can give. This is because corticosteroid creams may worsen a fungal infection, such as ringworm, or mask the symptoms of a bacterial infection, such as Lyme disease, that may cause a circular rash. The nurse should not recommend any OTC product without knowing the exact cause of the rash.
Choice D reason: Explaining the need for the child to have an immediate medical evaluation is the best response that the nurse can give. This is because a circular rash can be a sign of a serious condition, such as Lyme disease, that requires urgent diagnosis and treatment. The nurse should inform the parent that the rash may not be ringworm, as many people assume, and that it may be caused by a tick bite or another factor. The nurse should also advise the parent to avoid touching or scratching the rash and to keep it clean and dry until the child sees a doctor.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.