A patient with blindness related to conversion (functional neurological) disorder says, "All the doctors and nurses in the hospital stop by often to check on me. Too bad people outside the hospital don't find me as interesting."
Which nursing diagnosis is most relevant?
a. Social isolation
b. Chronic low self-esteem
c. Interrupted family processes
d. Ineffective health maintenance
ANS: B
The patient mentions that the symptoms make people more interested. This indicates that the patient feels uninteresting and unpopular without the symptoms, thus supporting the nursing diagnosis of chronic low self-esteem. Defining characteristics for the other nursing diagnoses are not present in the scenario.
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Which of the following interventions would be appropriate for a faith community nurse who bases care on the CIRCLE Model of Spiritual Care? (Select all that apply.)
a. Giving a mini sermon based on the specific client problem b. Listening and showing respect without any actual intervention c. Suggesting to the client what would be an appropriate response to the situation d. Showing love and empathy toward the client and the situation e. Calling the client by name during the conversation f. Allowing time for prayer during the client interaction
An elderly patient with Alzheimer's disease begins supplemental tube feedings through a gastrostomy tube to provide adequate calorie intake. The nurse should be concerned most with the potential for:
A) Hypoglycemia B) Fluid volume excess C) Aspiration D) Constipation
The nurse is caring for a patient who has major depressive disorder. The patient tells the nurse, "I sometimes wonder what my family would think if I killed myself. I wonder if they would even care." What is the nurse's best response?
1. "Are you thinking about killing yourself right now?" 2. "Why would you think that killing yourself is the answer?" 3. "Are you thinking that killing yourself would solve your problems?" 4. "Why would you think your family wouldn't care if you killed yourself?"
When conducting nasotracheal suctioning of a client, what will the nurse do?
1. Apply suction for 5–10 seconds. 2. Plan to suction for 10 minutes. 3. Apply suction while inserting the catheter. 4. Apply suction for 20–30 seconds.