The nurse is interviewing a client who says. "Today is the two-month anniversary of my wife's death from cancer". Select the most therapeutic response by the nurse
"Would you like to discuss this with the doctor?"
"How long were you married?"
"What type of cancer did your wife have?"
"How does that make you feel?"
The Correct Answer is D
A) "Would you like to discuss this with the doctor?": This response may imply that the nurse is not equipped to handle the emotional aspect of the conversation, potentially minimizing the client's feelings and discouraging further sharing.
B) "How long were you married?": While this question seeks to gather more information, it does not directly address the client's emotional experience or feelings related to their wife's death, which is the primary concern in this context.
C) "What type of cancer did your wife have?": This question may shift the focus to medical details rather than the client's emotional state, which is crucial in a therapeutic conversation about grief and loss.
D) "How does that make you feel?": This response is the most therapeutic as it invites the client to express their emotions and thoughts about their loss. It acknowledges their pain and encourages them to explore their feelings, which is essential for processing grief.
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Correct Answer is D
Explanation
A) The patient has asthma: While asthma can lead to respiratory symptoms and issues, it is not typically associated with clubbing of the fingernails. Asthma primarily affects airway constriction and inflammation, rather than causing the long-term changes in nail morphology seen with clubbing.
B) The patient has cardiovascular disease: Although some cardiovascular conditions can lead to clubbing, it is more commonly associated with chronic lung diseases. Cardiovascular disease might cause other signs or symptoms, but clubbing alone is not a definitive indicator of this condition.
C) The patient has emphysema: Emphysema, a type of chronic obstructive pulmonary disease (COPD), is characterized by the destruction of lung tissue and impaired airflow. While it can contribute to hypoxemia, clubbing is not a common finding specifically associated with emphysema.
D) The patient has chronic hypoxemia: Clubbing of the fingernails is a classic sign of chronic hypoxemia, often resulting from long-term respiratory conditions like COPD, interstitial lung disease, or lung cancer. It indicates a prolonged lack of oxygen in the blood, leading to changes in the nail bed and digit shape. Given the patient's long smoking history, chronic hypoxemia is the most likely explanation for this finding.
Correct Answer is B
Explanation
A) "Attempt to rotate your head in a circular manner": This instruction is focused on rotation rather than lateral flexion. While rotation assesses different neck movements, it does not specifically evaluate lateral flexion.
B) "Lean your head to the side and attempt to touch your ear to your shoulder": This instruction directly assesses lateral flexion of the neck. It encourages the client to bend their head to the side, effectively demonstrating the range of motion in that direction.
C) "Attempt to raise your shoulders up toward your ears": This instruction assesses shoulder elevation and shrugging rather than lateral flexion of the neck. It does not provide information about the lateral movement of the head.
D) "Tilt your head back and look at the ceiling": This instruction assesses extension of the neck rather than lateral flexion. It evaluates the ability to move the head backward.