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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

A.

"Would you like to discuss this with the doctor?"

B.

"How long were you married?"

C.

"What type of cancer did your wife have?"

D.

"How does that make you feel?"

Answer and Explanation

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 ["A","C","D"]

Explanation

A) Texture: Assessing the texture of the skin is an important part of a comprehensive skin assessment. It provides insights into the health and hydration status of the skin. Normal skin texture should feel smooth and even, while changes can indicate issues such as dryness or conditions like eczema or psoriasis.

B) Tachypnea: This term refers to an increased respiratory rate and is not a characteristic assessed in the skin. While it can indicate a physiological response to various conditions, it does not relate to skin health or characteristics and therefore is not relevant in this context.

C) Turgor: Skin turgor refers to the elasticity and hydration status of the skin, which can be assessed by pinching the skin. Proper turgor indicates adequate hydration, while decreased turgor can signal dehydration or other health issues. This is an essential component of skin assessment.

D) Temperature: Assessing the temperature of the skin can provide information about circulation and potential inflammation or infection. Normal skin temperature should feel warm and consistent, while variations can suggest underlying conditions such as fever or shock.

E) Tympany: Tympany is a term used in percussion assessments of the abdomen and is not applicable to skin assessment. It refers to a hollow sound produced by tapping on a body surface and does not pertain to skin characteristics.

Correct Answer is D

Explanation

A) Inflammation of the lamina of the involved vertebra: While inflammation can contribute to pain, it is not the primary cause in the context of a herniated disc. The pain associated with a herniated disc is typically related to nerve compression rather than inflammation of the lamina itself.

B) Shifting of two adjacent vertebrae out of alignment: This describes a different condition, such as spondylolisthesis. A herniated disc primarily involves the displacement of disc material, rather than a significant misalignment of the vertebrae.

C) Increased pressure of cerebral spinal fluid within the vertebral column: Increased cerebrospinal fluid pressure is not typically associated with herniated discs and does not directly cause the pain related to this condition.

D) Compression of the spinal cord by the extruding disc: This is the most accurate explanation for the patient's pain. A cervical herniated disc can protrude and compress nearby nerve roots or the spinal cord itself, leading to significant pain, weakness, and other neurological symptoms. This compression is the primary cause of pain in patients with this diagnosis.

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