During the preparation phase of a therapeutic relationship with a client, what is the main task to be completed by the nurse?
a. To establish with the client the purpose of the relationship
b. To gather and review all possible information regarding the client
c. To build trust with the client
d. To obtain agreement from the client to work in conjunction with the nurse
B
The main task during the preparation phase is to gather and review all possible information regarding the client; this can be accomplished by obtaining data from past and current medical records and from the client's significant others. The other options are tasks that occur during the orientation phase.
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An 84-year-old patient who has returned from the PACU is oriented to name only and has been diagnosed with delirium. The nurse should explain the following to the patient's family:
A) There is nothing to worry about. B) Delirium involves a progressive decline in memory loss. C) Delirium may only last a short time. D) Delirium is generally more prevalent in women.
Which are appropriate focuses for the health history collected by the nurse?
1. Physical status. 2. Patterns of daily living. 3. Wellness practices. 4. Self-care activities. 5. Medical diagnoses.
A 65-year-old female admitted with a fractured hip tells the nurse that she was unaware that she has osteoporosis. What is the nurse's best response?
1. "Sometimes the first sign of the disorder is a fracture." 2. "It is rare for someone your age to have osteoporosis." 3. "There is no way to prevent the disorder." 4. "Everyone has it now."
What are indications for a referral regarding a communication impairment in a school-age child? (Select all that apply.)
a. Barely audible voice quality b. Vocal pitch inappropriate for age c. Intonation noted during speaking d. Maintains a rhythm while speaking e. Distortion of sounds after age 7 years