nclex review basic psychosocial care
A client has just lost her husband to an apparent suicide. In the emergency department, the client tells the nurse that she has never lost an immediate family member and "feels so numb right now." Which response by the nurse is best? "He is no longer suffering." "Maybe you can take a trip somewhere he didn't want to go." "It's better this way—that he is not on a ventilator." "His death is a terrible loss."
"His death is a terrible loss." Explanation: The statement that his death is a terrible loss validates the bereaved person's sense of loss and communicates the message that she is understood and supported. The other statements are unhelpful and banal responses at the time of a loss. The statement that the deceased is no longer suffering does not respond to the emotional pain the client is feeling.
A client has entered a smoking cessation program to quit a two-pack-a-day cigarette habit. The client has not smoked a cigarette for 3 weeks and tells the nurse about fears of starting smoking again because of current job pressures. What would be the most appropriate reply for the nurse to make in response to the client's comments? "Do not worry about it. Everybody has difficulty quitting smoking, and you should expect to as well." "If you increase your self-control, I am sure you will be able to avoid smoking." "Try taking a couple of days of vacation to relieve the stress of your job." "It is good that you can talk about your concerns. Try calling a friend when you want to smoke."
"It is good that you can talk about your concerns. Try calling a friend when you want to smoke." Explanation: It is important for individuals who are engaged in smoking cessation efforts to feel comfortable with sharing their fears of failure with others and seeking support.Although fewer than 5% of smokers successfully quit on their first attempt, it is not helpful to tell a client to anticipate failure.Telling the client to exercise more self-control does not provide support.Taking a vacation to avoid job pressures does not address the issue of how to manage the desire to smoke when in a stressful situation.
A client of Anglo-Saxon descent (e.g., Anglo-American or English Canadian) reports to the primary healthcare facility with symptoms of fever, cough, and running nose. While interviewing the client, which points should the nurse keep in mind? Do not probe into emotional issues. Do not ask very personal questions. Maintain eye contact while talking. Sit at the other corner of the room.
Maintain eye contact while talking. Explanation: While interviewing a client of Anglo descent, the nurse should maintain eye contact because it indicates openness and sincerity. Such clients freely express positive and negative feelings; therefore, the nurse may probe into emotional issues. Anglo culture is an open culture and members of this culture don't mind providing personal information. Also, clients of Anglo descent are not threatened by closeness so the nurse does not have to sit in another corner of the room.
Which is an important consideration when the nurse is providing culturally competent care in a community clinic? knowing about different cultural practices and generalizing when caring for clients from that culture asking about cultural beliefs related to health, illness, treatments, and dietary practices informing the client about preferred health interventions and making decisions for the client explaining that multiculturalism means all cultures melding to assimilate into one culture
asking about cultural beliefs related to health, illness, treatments, and dietary practices Explanation: It is a nursing obligation to practice in a culturally sensitive and competent manner. This answer elicits key information regarding the client's beliefs, values, and cultural practices. This also indicates willingness to learn and be respectful of different beliefs and practices. Knowledge is important, but individualizing rather than generalizing is critical. The other choices are inaccurate because they involve making decisions for the client and explaining that the aim is for all cultures to become one.
Before clients can learn, they must believe that they need to learn the information. The nurse recognizes that this is an example of which learning principle? maturation relevance initiative motivation
relevance Explanation: Clients are more receptive and ready to learn if they believe that information being presented is real and relevant to them.
A nurse is giving a bed bath to a terminally ill client. The client tells the nurse that the client has great respect and faith in a particular spiritual leader. Which is the best response by the nurse? "It's good to have something to believe in." "It sounds like that offers you a sense of security." "People with strong beliefs have better outcomes." "Think about your leader when you have moments of doubt."
"It sounds like that offers you a sense of security." Explanation: Spiritual or religious beliefs give meaning to life, illness, other crises, and death; contribute a sense of security for present and future; guide daily living habits; drive acceptance or rejection of other people; furnish psychosocial support within a group of like-minded people; provide strength in meeting life's crises; and give healing strength and support. The nurse can respond to the client by validating the client's sense of security. It is not therapeutic for the nurse to judge whether a spiritual belief is good or bad. It is false hope to tell the client that people with strong beliefs have better outcomes. It is not the nurse's place to tell the client to think about the client's spiritual leader in times of doubt.
