The client was diagnosed with diabetes three years ago but has failed to integrate regular blood glucose monitoring or dietary modifications into his lifestyle.
He has been admitted to the hospital for treatment of acute renal failure secondary to diabetic nephropathy, an event that has prompted him to reassess his values.
Which of the following actions most clearly demonstrates that this client is engaging in the step of prizing within his valuing process?
The client expresses remorse at how his failure to make lifestyle changes has adversely affected his health.
The client is now able to explain how his choices have contributed to his renal failure.
The client states he will now begin to check his blood glucose before each meal and at bedtime.
The client expresses pride that he now has the knowledge and skills to take control of his diabetes management.
The Correct Answer is D
Choice A rationale
Expressing remorse indicates an awareness of the negative consequences of past actions, which aligns with the valuing process step of choosing, where the individual recognizes the value and impact of different choices. However, it doesn't fully demonstrate prizing, which involves cherishing and affirming the value.
Choice B rationale
Explaining how past choices contributed to the renal failure demonstrates understanding and cognitive processing of the situation, aligning with the choosing step of the valuing process, where the individual intellectually recognizes the value. However, it doesn't necessarily indicate an emotional investment or affirmation of new values.
Choice C rationale
Stating an intention to adopt new behaviors reflects the acting step of the valuing process, where the individual commits to and implements the chosen values in their actions. While important for change, it doesn't directly demonstrate the internal valuing or cherishing of these new actions.
Choice D rationale
Expressing pride in gaining knowledge and skills to manage diabetes signifies that the client now holds this self-management in high regard and finds personal worth in it. This aligns with the prizing step of the valuing process, where the individual emotionally embraces and values the new belief or behavior, leading to a sense of satisfaction and affirmation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Relying solely on written communication can be time-consuming and may not be suitable for all situations or for clients with low literacy. While it can be a useful adjunct, it shouldn't replace verbal communication entirely.
Choice B rationale
Reducing time spent with the client can hinder effective communication and relationship building. It doesn't address the communication barrier and may leave the client feeling unheard and uncared for.
Choice C rationale
Speaking loudly can distort sounds and make it harder for someone with a hearing deficit to understand. It can also be perceived as disrespectful or condescending. The approach should focus on clarity, not volume.
Choice D rationale
Background noise, such as a television, can significantly interfere with a hearing-impaired person's ability to understand speech. Reducing or eliminating such distractions creates a clearer auditory environment, facilitating better comprehension of verbal communication.
Correct Answer is D
Explanation
Choice A rationale
Hypokalemia, a deficiency of potassium in the blood (normal range: 3.5-5.0 mEq/L), typically leads to metabolic alkalosis due to intracellular hydrogen ion shifts. While respiratory and metabolic acid-base balances are interconnected, hypokalemia itself does not directly cause the retention of carbon dioxide, which is the hallmark of respiratory acidosis.
Choice B rationale
A high fever increases the metabolic rate, leading to increased oxygen consumption and carbon dioxide production. However, the body usually compensates for this by increasing the respiratory rate to expel the excess carbon dioxide. Therefore, while fever affects gas exchange, it is more likely to cause respiratory alkalosis due to hyperventilation, not acidosis.
Choice C rationale
Extreme anxiety can lead to hyperventilation, causing an excessive exhalation of carbon dioxide and a subsequent decrease in the partial pressure of carbon dioxide in the arterial blood (PaCO2). This results in respiratory alkalosis, not respiratory acidosis, where the PaCO2 is elevated (normal range: 35-45 mmHg).
Choice D rationale
Sedative overdose depresses the central nervous system, including the respiratory center in the brainstem. This depression leads to a decrease in both the rate and depth of breathing (hypoventilation). Inadequate ventilation causes the retention of carbon dioxide, leading to an increase in PaCO2 and a decrease in blood pH (normal range: 7.35-7.45), resulting in respiratory acidosis.
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