The home health nurse is caring for a patient with tactile and visual deficits. The nurse is concerned about injury related to inability to feel harmful stimuli and teaches the patient safety strategies to maintain independence. Which action by the patient indicates successful learning?

Choice A reason: Jumping in to provide patient comfort, while well-intentioned, implies reactive or task-oriented actions rather than the intentional, empathetic engagement of presence. Presence involves being emotionally available, fostering trust and connection, not just addressing immediate physical needs. This choice risks misrepresenting the holistic, relational aspect of presence critical for patient and family support.

Choice B reason: Being there without an identified goal does not fully capture presence, which is purposeful in fostering emotional and spiritual support. Presence involves intentional closeness and caring, not aimless attendance. This choice underestimates the nurse’s role in creating a therapeutic environment, potentially diminishing the impact of presence on patient and family well-being.

Choice C reason: Focusing on tasks prioritizes technical care over emotional connection, contrary to presence, which emphasizes being with the patient holistically. Task-oriented care may address physical needs but neglects the relational support central to presence. This choice misaligns with the concept, risking a purely functional approach that overlooks emotional and spiritual care needs.

Choice D reason: Providing closeness and a sense of caring defines presence, a nursing action rooted in Watson’s caring theory. It involves empathetic engagement, active listening, and emotional availability, fostering trust and comfort for patients and families. This intentional connection supports holistic care, enhancing psychological well-being and coping during challenging moments like illness or end-of-life care.

Choice A reason: Low blood pressure is not typically associated with prolonged stress. Chronic stress elevates cortisol, which can increase blood pressure via sympathetic activation. Hypotension may occur in acute stress response (e.g., shock), but prolonged stress more commonly causes hypertension, making this an incorrect condition to monitor.

Choice B reason: Prolonged stress suppresses immune function by elevating cortisol, reducing lymphocyte activity and increasing infection risk. Conditions like respiratory or urinary tract infections become more likely. Monitoring for infections is essential, as stress weakens the body’s ability to fight pathogens, making this a correct condition to assess.

Choice C reason: Alopecia, or hair loss, can result from prolonged stress due to elevated cortisol disrupting hair follicle cycles, leading to telogen effluvium. Stress-induced autoimmune conditions like alopecia areata may also occur. Monitoring for hair loss is appropriate, as it reflects stress’s physiological impact, making this a correct choice.

Choice D reason: Prolonged stress increases diabetes risk by raising cortisol and catecholamines, which elevate blood glucose and impair insulin sensitivity. This can exacerbate or precipitate type 2 diabetes. Monitoring glucose levels is critical, as stress contributes to metabolic dysregulation, making this a correct condition to assess.

Choice E reason: Chronic stress is linked to cancer through immune suppression and inflammation, which may promote tumor growth. Elevated cortisol and stress hormones can impair DNA repair mechanisms. Monitoring for cancer risk, especially in high-stress patients, is warranted, as stress is a known risk factor, making this a correct choice.