When providing nursing care to a client, the nurse provides family-centered nursing care. What is the best rationale for this nursing action?

The nurse does not want the client to feel lonely.

The client will be more compliant with medical instructions.

The family will be more willing to listen to instructions.

Illness in one family member can affect the other family members.

Answer and Explanation

The Correct Answer is D

Illness in one family member can affect the other family members. This is because family-centered nursing care recognizes that the family is the basic unit of society and that each member's health influences the whole family's health. Family-centered nursing care also involves collaborating with the family to provide care that meets their needs, preferences, and values.

Choice A is wrong because the nurse does not provide family-centered nursing care to avoid the client’s loneliness. Loneliness is a psychosocial need, not a physiologic one, and it can be addressed by other means than involving the family.

Choice B is wrong because the client’s compliance with medical instructions is not the primary goal of family-centered nursing care. Compliance is influenced by many factors, such as motivation, education, culture, and trust, and it may not always depend on the family’s involvement.

Choice C is wrong because the family’s willingness to listen to instructions is not the main reason for providing family-centered nursing care. The nurse should respect the family’s autonomy and decision-making, and not impose instructions that may conflict with their beliefs or values.

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Correct Answer is B

Explanation

A 40-year-old client who has a blood pressure of 138/98 mm Hg should be referred for immediate treatment. This is because this client has grade 1 hypertension according to the International Society of Hypertension (ISH) guidelines, which define hypertension as a systolic blood pressure (SBP) of 140 mm Hg or higher and/or a diastolic blood pressure (DBP) of 90 mm Hg or higher in the office or clinic. This client also has a high risk of cardiovascular complications due to their age and elevated DBP.

Choice A is wrong because a 20-year-old client who has a blood pressure of 125/60 mm Hg does not have hypertension. This client has normal blood pressure according to the ISH guidelines, which define normal blood pressure as an SBP of less than 130 mm Hg and a DBP of less than 85 mm Hg in the office or clinic. This client also has a low risk of cardiovascular complications due to their age and low DBP.

Choice C is wrong because a 55-year-old client who has a blood pressure of 142/68 mm Hg does not need immediate treatment. This client has grade 1 hypertension according to the ISH guidelines, but their DBP is normal. The ISH guidelines recommend lifestyle interventions for three to six months before medication in patients with grade 1 hypertension and no comorbidities.

This client may have other risk factors that need to be assessed, such as obesity, diabetes, or smoking, but they do not require urgent referral.

Choice D is wrong because a 70-year-old client who has a blood pressure of 150/78 mm Hg does not need immediate treatment. This client has grade 1 hypertension according to the ISH guidelines, but their DBP is normal. The ISH guidelines recommend a target blood pressure of less than 140/90 mm Hg within three months for patients older than 65 years, and after three months reduce the target to less than 130/80 mm Hg.

This client may have other risk factors that need to be assessed, such as chronic kidney disease, heart failure, or atrial fibrillation, but they do not require urgent referral.

A. Eyes, ears, lips, and scalp. B. Palms, soles and nails. C. Head, neck and trunk. D. Lower legs and back.

Correct Answer is B

Explanation

Palms, soles and nails.

Melanoma is a type of skin cancer that can develop in any color skin, including dark or black skin.

However, melanoma on dark skin is not related to sun exposure and can start in places that get little sun. That includes the palms of your hands, soles of your feet, nails, and inside your mouth, anal, and genital areas.

Choice A is wrong because eyes, ears, lips, and scalp are not common areas for melanoma in people of color.

Choice C is wrong because head, neck and trunk are more likely to be affected by sun exposure and other types of skin cancer than melanoma in people of color.

Choice D is wrong because lower legs and back are also more exposed to sun and other types of skin cancer than melanoma in people of color.

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When providing nursing care to a client, the nurse provides family-centered nursing care. What is the best rationale for this nursing action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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