The nurse is caring for a patient who has been diagnosed with a terminal illness. The patient states, “I just don’t feel like going to work. I have no energy, and I can’t eat or sleep.” The patient shows no interest in taking part in the care by saying, “What’s the use?” Which response by the nurse is best?

It sounds like you have lost energy.

It sounds like you have lost hope.

It sounds like you have lost the ability to sleep.

It sounds like you have lost your appetite.

Answer and Explanation

The Correct Answer is B

Choice A reason: Acknowledging lost energy restates a symptom but does not address the patient’s emotional state. The patient’s statement, “What’s the use?” suggests despair beyond physical fatigue. This response misses the opportunity to explore psychological distress, limiting therapeutic communication and failing to support the patient’s emotional needs in a terminal illness.

Choice B reason: Stating “It sounds like you have lost hope” reflects the patient’s despair, as indicated by disinterest in work, care, and the phrase “What’s the use?” This empathetic response opens dialogue about emotional and spiritual needs, fostering trust. It aligns with holistic care, addressing the psychological impact of a terminal diagnosis effectively.

Choice C reason: Focusing on lost sleep restates a symptom without addressing the underlying hopelessness. Sleep issues are secondary to the patient’s emotional distress in a terminal illness. This response fails to engage with the patient’s despair, missing a chance to provide emotional support and explore deeper psychological or spiritual concerns.

Choice D reason: Noting lost appetite acknowledges a physical symptom but ignores the patient’s emotional withdrawal and hopelessness. The statement “What’s the use?” points to existential distress, not just eating issues. This response lacks depth, failing to address the psychological and spiritual dimensions critical in terminal illness care.

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Correct Answer is B

Explanation

Choice A reason: Melatonin, used for sleep regulation, may cause mild drowsiness but is not strongly linked to falls in older adults. Its side effects are minimal, and it does not significantly impair balance or coordination. This medication is unlikely to have caused the fall, making it an incorrect choice.

Choice B reason: Benzodiazepines, used for anxiety or insomnia, increase fall risk in older adults by causing sedation, dizziness, and impaired coordination. These effects, especially at night, can lead to balance issues and falls. Given their known association with falls in the elderly, this is the most likely medication contributing to the incident.

Choice C reason: L-tryptophan, an amino acid supplement for sleep or mood, has minimal side effects and is not associated with significant sedation or balance impairment. It is unlikely to cause falls in older adults, as it does not affect motor function or coordination, making this an incorrect choice.

Choice D reason: Iron supplements treat anemia but do not cause sedation, dizziness, or balance issues linked to falls. Side effects like gastrointestinal upset are unrelated to fall risk. This medication is not a likely contributor to the patient’s fall, making it an incorrect choice compared to benzodiazepines.

A. Provides care to patients that is individualized B. Provides care to restore relationships. C. Provides care to surgical patients. D. Provides care to transgender patients.

Correct Answer is A

Explanation

Choice A reason: Culturally competent care for marginalized patients prioritizes individualized care, respecting unique cultural, social, and personal needs. This approach addresses disparities by tailoring interventions to patients’ beliefs, values, and experiences, reducing bias and improving outcomes. Individualization ensures equitable, patient-centered care, meeting the primary goal of cultural competence.

Choice B reason: Restoring relationships is not a primary goal of culturally competent care. While relationships may improve through trust, the focus is on delivering equitable, culturally sensitive care. This choice is too narrow and does not encompass the broader aim of addressing systemic barriers for marginalized groups.

Choice C reason: Providing care to surgical patients is unrelated to cultural competence, as it focuses on a clinical context, not cultural needs. Culturally competent care applies across all settings, prioritizing sensitivity to diverse identities. This choice lacks specificity to marginalized patients’ cultural needs, making it incorrect.

Choice D reason: Caring for transgender patients is part of cultural competence but is too specific. The primary goal is broader, encompassing individualized care for all marginalized groups, not just one population. This choice limits the scope of cultural competence, making it less accurate than individualized care.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An older-adult patient is visiting the clinic after a fall during the night. The nurse obtains information on what medications the patient takes. Which medication most likely contributed to the patient’s fall?

Correct Answer is B

Explanation

Which action indicates the nurse is meeting a primary goal of culturally competent care for marginalized patients?

Correct Answer is A

Explanation

A nurse is assessing cognitive functioning of a patient. Which action will the nurse take?

The patient is admitted with a diagnosis of chronic anxiety. Which action is most appropriate for the nurse to take when providing holistic care?

A parent is discussing the sleep needs of a preschooler with the nurse. Which information will the nurse share with the parent?

In caring for the patient’s spiritual needs, the nurse asks 20 questions to assess the patient’s relationship with God and a sense of life purpose and satisfaction. Which method is the nurse using?

The nurse is caring for a patient and is focusing on modifiable factors that contribute to pain. Which areas does the nurse focus on with this patient?

The nurse caring for a terminally ill patient sits down and lightly touches the patient’s hand. Which technique is the nurse using?

A nurse is providing presence to a patient and the family. Which nursing action does this involve?