The nurse is talking with the client in an activity room where others are present. The client becomes tearful when talking about his children at home. What is the nurse's best action?
Distract the client by encouraging him to join the group activity
Ask the client to talk more about his children
Take the client into a private area to continue the conversation
Ask the client why he is crying
The Correct Answer is C
Choice A rationale: This is inappropriate since it does not address the client’s feelings about his/her children and may make the client feel that their feelings are not important and have been disregarded.
Choice B rationale: this is inappropriate since the client’s family issues will be exposed if they talk about them in a room full of other patients hence this will potentially increase his distress.
Choice C rationale: taking the client to a private room respects their right to privacy and dignity. Furthermore, it is a form of empathy and would encourage the client to open up with ease to the nurse.
Choice D rationale: asking the client why he is crying sounds judgmental and accusatory hence this may prevent the client from opening up to the nurse concerning his children.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale: this is a type of delusion involving the misinterpretation of random events as having personal significance or reference.
Choice B rationale: flight of ideas refers to a disordered thinking process involving rapid shifts from one topic to another. The client’s speech is often incoherent and difficult to follow.
Choice C rationale: this is a type of memory distortion involving the fabrication of stories or details to fill the gaps in an individual’s memory. Usually occurs in conditions such as dementia, substance abuse, and brain damage.
Choice D rationale: this refers to the repetition of the same word, phrase, or action over and over without being able to stop or switch to something else. Occurs in conditions such as schizophrenia, brain injury, or a stroke.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale: Observation is a method of data collection involving the use of one’s senses to notice the aspects of a client such as their appearance, expressions, and actions.
Choice B rationale: Reviewing diagnostic testing results is a method of collecting data that involves the examination of the findings of laboratory tests, imaging studies, and other procedures. These findings provide objective information about the client's physiological functioning.
Choice C rationale: client interview is a method of data collection involving asking them questions and listening to their responses. This method helps the nurse to obtain subjective data about the client's health history, current problems, expectations, values, and beliefs.
Choice D rationale: Performing physical assessment is a method of collecting data that involves using inspection, palpation, percussion, and auscultation to examine the different body systems of the client. This provides objective information about the patient’s condition.
Choice E rationale: this is incorrect since Interpreting client behaviors is not a method of collecting data but is instead a data analysis method.
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