During a cardiac assessment, a patient begins to express concern about experiencing shortness of breath and chest pain. The patient says, "I'm so scared that something is really wrong with my heart." Which of the following is the best therapeutic communication response by the nurse?

"You're probably overthinking it. There's no need to be so anxious."

"It's normal to feel that way, but it's probably nothing serious. Let's focus on the assessment."

"Don't worry. The tests will show that everything is fine with your heart."

"I understand your concern. Let's talk about what you're feeling, and I'll explain what we're doing to assess your heart."

Answer and Explanation

The Correct Answer is D

Rationale:

A. Saying "You're probably overthinking it. There's no need to be so anxious" is incorrect because it minimizes the patient's feelings and can make the patient feel dismissed. Therapeutic communication requires validation, not judgment.

B. Saying "It's normal to feel that way, but it's probably nothing serious. Let's focus on the assessment" is incorrect because it assumes the situation is not serious and does not address the patient’s emotional needs. This approach can reduce trust and increase anxiety.

C. Saying "Don't worry. The tests will show that everything is fine with your heart" is incorrect because it provides false reassurance. Premature reassurance without assessment is unsafe, especially when the patient is experiencing symptoms like shortness of breath and chest pain, which may indicate a cardiac emergency.

D. Saying "I understand your concern. Let's talk about what you're feeling, and I'll explain what we're doing to assess your heart" is correct. This response acknowledges the patient’s feelings, encourages expression of concerns, and provides information about the plan of care. It uses therapeutic communication by combining empathy, active listening, and patient education, which helps reduce anxiety and promotes trust.

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Correct Answer is D

Explanation

Rationale:

A. These cells are found in the basal layer of the epidermis and function as mechanoreceptors, meaning they detect light touch and pressure stimuli. They are associated with sensory nerve endings and play a role in the sense of touch. Merkel cells do not produce pigment and therefore do not affect skin color. Including them in a discussion about pigmentation would be incorrect.

B. Keratinocytes are the most abundant cell type in the epidermis. Their primary function is to produce keratin, a tough, fibrous protein that provides structural support, waterproofing, and protection against physical and chemical insults. Keratinocytes do receive pigment from melanocytes via melanosomes (pigment-containing vesicles), which gives the skin its color, but keratinocytes themselves do not produce melanin. Their role is mainly in pigment distribution, not pigment production.

C. These are immune cells of the epidermis that act as antigen-presenting cells. They detect pathogens, process antigens, and activate the immune system. While crucial for skin defense, Langerhans cells do not contribute to skin color or pigmentation.

D. Melanocytes are specialized pigment-producing cells located in the basal layer of the epidermis. They synthesize melanin, the pigment responsible for the color of skin, hair, and eyes. The type (eumelanin vs. pheomelanin), amount, and distribution of melanin produced by melanocytes determine an individual's skin tone. Melanin also serves a protective function by absorbing and dispersing ultraviolet (UV) radiation, reducing DNA damage that can lead to skin cancers. Variations in skin color between individuals are primarily due to differences in melanocyte activity, not the number of melanocytes, which is relatively similar across all humans.

A. Temperature B. Pulse oximetry C. Respiratory rate D. Blood pressure E. Mucous membrane color

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"A"}}

Explanation

Rationale:

Temperature: Worsened. Increased from 38.2°C to 38.6°C, indicating a slight rise in fever.
Pulse oximetry: Improved. Oxygen saturation improved from 85% to 95% after oxygen therapy and interventions.
Respiratory rate: Improved. Rate decreased from 32/min to 22/min, showing reduced work of breathing.
Blood pressure: Unchanged. BP remained stable at 112/56 mm Hg.
Mucous membrane color: Improved. Color changed from pale to pink, indicating improved oxygenation and perfusion.

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During a cardiac assessment, a patient begins to express concern about experiencing shortness of breath and chest pain. The patient says, "I'm so scared that something is really wrong with my heart." Which of the following is the best therapeutic communication response by the nurse?

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a class about the function of cells in the epidermis. The nurse should include that which of the following cells determine skin color?

Correct Answer is D

Explanation

A nurse is caring for a client. For each finding at 1100, click to specify if the finding indicates that the client's condition has improved, worsened, or is unchanged.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"A"}}

Explanation

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