The nurse is caring for a patient with a new mobility deficit due to a recent stroke (CVA). The patient states, "I hate not being able to do simple things like walking by myself anymore." Which of the following responses provides the best support for the patient?

"You sound frustrated, tell me more about this feeling."

"You remind me of my mother, she is always frustrated when she is ill."

"I am concerned about your mental health; I will call your family."

"You need to be more careful after this stroke or you could fall."

Answer and Explanation

The Correct Answer is A

A. "You sound frustrated, tell me more about this feeling." This response validates the patient’s feelings and opens up a discussion about their emotions, which provides support and helps address their psychological needs.

B. "You remind me of my mother, she is always frustrated when she is ill." This response is not focused on the patient’s needs and shifts attention away from their concerns.

C. "I am concerned about your mental health; I will call your family." While mental health is important, calling the family without first addressing the patient’s immediate concerns might feel intrusive or premature.

D. "You need to be more careful after this stroke or you could fall." This response addresses safety but does not provide emotional support or acknowledge the patient’s feelings of frustration.

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Correct Answer is A

Explanation

A. The client with a left lower extremity fracture. Somatic pain is related to damage to body tissues, such as fractures. This type of pain is typically localized and can be acute or chronic.

B. The client with a bowel obstruction. Pain from a bowel obstruction is typically visceral rather than somatic, as it involves internal organs.

C. The client with a skin tear to the upper extremity. While this involves the skin, it is typically considered superficial somatic pain, but the context of the question suggests a deeper musculoskeletal issue.

D. The client with pneumonia. Pain from pneumonia is usually visceral due to inflammation in the lungs.

A. "Addressing organ donation and autopsy issues." B. "Naming a durable power of attorney for my health care needs." C. "Addressing who gets my personal items if I should die." D. "Naming which life sustaining treatments, I want and do not want."

Correct Answer is ["B","D"]

Explanation

A. "Addressing organ donation and autopsy issues." Advanced directives typically address preferences about medical treatment and end-of-life care, but organ donation and autopsy decisions are not always included in these directives. Organ donation often involves a separate document or registration.

B. "Naming a durable power of attorney for my health care needs." An advanced directive often includes designating a durable power of attorney (DPOA) for healthcare decisions. This person is authorized to make medical decisions on the patient’s behalf if they become unable to do so themselves.

C. "Addressing who gets my personal items if I should die." The distribution of personal items is typically covered in a will, not an advanced directive. Advanced directives focus on healthcare decisions rather than the distribution of personal property.

D. "Naming which life-sustaining treatments I want and do not want." Advanced directives often include instructions about specific medical treatments and interventions that the patient does or does not want, such as resuscitation, mechanical ventilation, or tube feeding.

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The nurse is caring for a patient with a new mobility deficit due to a recent stroke (CVA). The patient states, "I hate not being able to do simple things like walking by myself anymore." Which of the following responses provides the best support for the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a group of clients for somatic pain. Which of the following client's would be experiencing this type of pain?

Correct Answer is A

Explanation

The nurse is caring for a patient diagnosed with a terminal illness who is interested in signing a healthcare Advanced Directive. Which of the following are included in this type of end-of-life planning? Select all that apply.

Correct Answer is ["B","D"]

Explanation

The nurse is caring for a patient with a new mobility deficit due to a recent stroke (CVA). The patient states, "I hate not being able to do simple things like walking by myself anymore." Which of the following responses provides the best support for the patient?

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