The patient has a colostomy but has not yet been able to look at it. The nurse teaches the patient how to care for the colostomy. The nurse sits with the patient and together they form a plan on how to approach dealing with colostomy care. Which caring process is the nurse performing?
Knowing.
Doing for.
Enabling.
Maintaining belief.
The Correct Answer is C
Choice A reason: Knowing involves understanding the patient’s experiences and needs, not actively forming a care plan together. Enabling focuses on empowering the patient through collaboration, as seen here. Assuming knowing risks underemphasizing the patient’s active role, potentially limiting empowerment and self-efficacy critical for colostomy care acceptance and management.
Choice B reason: Doing for involves performing tasks for the patient, not collaborating on a plan, as with enabling. The nurse’s joint planning empowers the patient to manage colostomy care. Assuming doing for overlooks patient autonomy, risking dependency and reduced confidence in self-care, critical for long-term colostomy management and adaptation.
Choice C reason: Enabling, per Swanson’s caring theory, involves facilitating the patient’s capacity to manage their care through collaboration, as seen in forming a colostomy care plan together. This empowers the patient, fostering confidence and acceptance. Enabling supports self-efficacy, critical for psychological adjustment and practical management of a new colostomy, enhancing patient outcomes.
Choice D reason: Maintaining belief sustains hope and values but doesn’t involve collaborative planning, unlike enabling. The nurse’s focus is empowering practical colostomy care, not spiritual support. Assuming maintaining belief misaligns with the action, potentially neglecting the patient’s need for active involvement in learning and adapting to colostomy self-care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Immediate intubation is premature without first reversing opioid-induced respiratory depression with naloxone. Morphine’s rapid onset of lethargy and shallow breathing (7 breaths/min) indicates overdose, reversible by naloxone. Intubation is invasive and reserved for non-responsive cases, risking unnecessary complications when reversal is feasible, delaying targeted treatment in this acute scenario.
Choice B reason: Administering naloxone is the priority for opioid overdose, as evidenced by lethargy and respiratory depression (7 breaths/min) post-morphine. Naloxone, an opioid antagonist, rapidly reverses these life-threatening effects, restoring breathing and consciousness. Prompt administration is critical in older adults, who are more sensitive to opioids, ensuring patient safety and preventing hypoxia or death.
Choice C reason: Observing for opioid tolerance is inappropriate in this acute situation. Lethargy and shallow breathing indicate overdose, not tolerance, requiring immediate naloxone. Monitoring tolerance delays critical intervention, risking prolonged hypoxia, brain damage, or death, especially in an elderly patient with increased opioid sensitivity post-surgery, where respiratory depression is life-threatening.
Choice D reason: Assessing pain level is irrelevant when the patient exhibits opioid overdose symptoms like lethargy and respiratory depression. Pain assessment is secondary to reversing life-threatening respiratory compromise with naloxone. Delaying intervention for pain evaluation risks patient deterioration, as immediate action is needed to restore breathing and stabilize the patient post-morphine administration.
Correct Answer is D
Explanation
Choice A reason: Culture and ethnicity influence pain perception but are not easily modifiable. They shape attitudes toward pain expression, not pain itself. Focusing on these risks overlooking modifiable factors like anxiety, which directly amplify pain. Interventions targeting modifiable psychological factors are more effective in reducing pain intensity and improving patient coping strategies.
Choice B reason: Previous pain experiences and cognitive abilities are relatively fixed, shaping pain perception but not easily altered. Modifiable factors like anxiety have a greater immediate impact on pain. Focusing on these risks delaying interventions like relaxation techniques, which directly reduce pain amplification, improving outcomes in acute or chronic pain management.
Choice C reason: Age and gender are non-modifiable factors influencing pain sensitivity but not amenable to change. Anxiety and fear, which exacerbate pain through stress responses, are modifiable and more relevant for intervention. Prioritizing age or gender misdirects focus, delaying strategies like cognitive therapy that effectively mitigate pain in clinical settings.
Choice D reason: Anxiety and fear are modifiable factors that amplify pain via heightened stress responses, increasing muscle tension and pain perception. Interventions like relaxation, mindfulness, or counseling can reduce these, lowering pain intensity. Focusing on these targets psychological contributors, improving pain management and patient comfort, especially in acute or chronic pain scenarios.
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