High Acuity Nursing 6th Edition by Kathleen Dorman Wagner - Test Bank

Wagner, High Acuity Nursing, 6e
Chapter 2

Question 1

Type: MCSA

The spouse of a patient recently diagnosed with terminal cancer has voiced concerns about her husband's continual denial of his disease. What should the nurse consider when planning a response to this concern?

1. It may be helpful for the patient's emotional state at this time to be in a state of denial.

2. Denial is abnormal and the patient needs to have a consultation with a therapist.

3. It will be helpful to plan an intervention to force the patient to acknowledge his disease.

4. There is a limited amount of time left in the patient's life so the denial must be rapidly worked through.

Correct Answer: 1

Rationale 1: It is believed that denial may be therapeutic as it allows the patient to have a removal from worry.

Rationale 2: Denial is a normal state experienced by patients having critical diagnoses.

Rationale 3: It is not therapeutic to force the patient to acknowledge his disease.

Rationale 4: Each patient will work through denial at an individualized pace. It is not therapeutic to rush this stage.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2-1

Question 2

Type: MCSA

A patient in Suchman's awareness stage has become argumentative and demanding. The nursing staff is becoming frustrated with the behaviors. What actions by the nurse are indicated?

1. The nurse should accept the behaviors and attempt to open the lines of communication.

2. Rotate the nursing assignments frequently to limit each nurse's exposure to the behaviors.

3. Confront the patient about his demeanor.

4. Consolidate care so the nurse is in the room for shorter periods.

Correct Answer: 1

Rationale 1: The patient is acting in a manner consistent with the stage of awareness. The patient is attempting to exert control over the situation and will benefit most from a supportive environment.

Rationale 2: Rotating nursing assignments interrupts the therapeutic environment this patient requires.

Rationale 3: Confrontation is not indicated at this time. The patient needs to move through this stage of illness with support and understanding.

Rationale 4: This patient needs support to work through these feelings. Reducing the amount of time the nurse is in the room does not allow for interactions that may help with this process.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-1

Question 3

Type: MCMA

A patient says, “I’ve been hearing about aromatherapy as part of treatment for serious illness. What do you think about me trying it?” Which nursing responses are indicated?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “Some studies have shown that using lavender oil can reduce anxiety.”

2. “I would focus my energy on more traditional forms of healing.”

3. “Other than jasmine oil, you are probably safe using aromatherapy.”

4. “You should discuss this plan with your physician before purchasing anything.”

5. “I know that some massage therapists use essential oils.”

Correct Answer: 1,5