You are assuming the care of a patient admitted for a fetal demise at 30 weeks gestation. Which is the most therapeutic response to the patient? (Select onE.:
At least you are young and can have another chilD.
I am so sorry for your loss. My heart hurts for you. Can you tell me a little bit about your baby?
There was probably something wrong and God has a way of taking care of these things.
Don't cry, be strong for your family.
The Correct Answer is B
Choice A: At least you are young and can have another child is not a therapeutic response, as it minimizes the patient's grief and implies that the baby is replaceablE. The nurse should acknowledge the patient's loss and avoid making assumptions or judgments.
Choice B: I am so sorry for your loss. My heart hurts for you. Can you tell me a little bit about your baby? is a therapeutic response, as it expresses empathy and compassion and invites the patient to share their feelings and memories. The nurse should listen actively and respectfully and use the baby's name if the patient has given onE.
Choice C: There was probably something wrong and God has a way of taking care of these things is not a therapeutic response, as it rationalizes the patient's loss and imposes the nurse's religious beliefs. The nurse should respect the patient's spirituality and avoid making statements that may cause guilt or anger.
Choice D: Don't cry, be strong for your family is not a therapeutic response, as it discourages the patient from expressing their emotions and places unrealistic expectations on them. The nurse should support the patient's coping and encourage them to seek help from their family and friends.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A: Placing a soft pillow under the client's buttocks is not an effective action, as it can increase the pressure and the swelling on the perineal area and worsen the pain. The nurse should avoid placing anything under the client's buttocks and encourage the client to lie on the side or sit on a firm surfacE.
Choice B: Preparing a warm sitz bath is not an appropriate action, as it can increase the blood flow and the inflammation on the perineal area and worsen the pain. The nurse should avoid using heat on the perineum for the first 24 hours after delivery and use cold therapy insteaD.
Choice C: Positioning a heating lamp toward the episiotomy is not an appropriate action, as it can cause burns and infections on the perineal area and worsen the pain. The nurse should avoid using heat on the perineum for the first 24 hours after delivery and use cold therapy insteaD.
Choice D: Applying an ice pack to the perineum is an effective action, as it can reduce the blood flow and the inflammation on the perineal area and relieve the pain. The nurse should apply an ice pack wrapped in a towel or a disposable cold pack to the perineum for 10 to 20 minutes every 2 to 4 hours for the first 24 hours after delivery.
Correct Answer is C
Explanation
Choice A: Prolapsed cord is not a likely complication, as it is characterized by a sudden onset of severe variable decelerations of the fetal heart rate and a visible or palpable cord in the vaginA. The nurse should identify a prolapsed cord as a medical emergency and perform immediate interventions to relieve the cord compression and deliver the fetus.
Choice B: Premature rupture of membranes is not a likely complication, as it is characterized by a gush or a trickle of clear or yellowish fluid from the vagina and a positive nitrazine or fern test. The nurse should identify premature rupture of membranes as a risk factor for infection and monitor the fetal heart rate and the maternal temperaturE.
Choice C: Abruptio placentae is a likely complication, as it is characterized by continuous abdominal pain and dark red vaginal bleeding and a board-like abdomen. The nurse should identify abruptio placentae as a life-threatening condition that involves the premature separation of the placenta from the uterine wall and can cause fetal distress and maternal hemorrhagE.
Choice D: Placenta previa is not a likely complication, as it is characterized by painless bright red vaginal bleeding and a soft and relaxed uterus. The nurse should identify placenta previa as a condition that involves the abnormal implantation of the placenta near or over the cervical os and can cause fetal hypoxia and maternal hemorrhagE.
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