A patient has been admitted to the critical care unit with a severed spinal cord injury at the T2 level. The patient has been in halo traction with immobilization for the past week
The physician explains to the patient that the spinal cord has been severed and that the patient will not be able to walk again. The patient becomes overtly hostile to everyone. The patient is demonstrating a. regression. c. ineffective coping.
b. loss of autonomy. d. hope.
C
Ineffective coping is defined as an impairment of a person's adaptive behaviors and problem-solving abilities when meeting life's demands and necessary roles. Manifestations of ineffective coping in critical illness include verbalization of an inability to cope, anxiety, and being unable to meet basic needs. Regression is an unconscious defense mechanism characterized by a retreat, in the face of stress, to behaviors characteristic of an earlier developmental level. Hope is a subjective, dynamic internal process essential to life. Considered to be a spiritual process, hope is an energy that arises out of a sense of being meaningfully connected to one's self, others, and powers greater than the self.
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When the nurse cautions a patient to watch his step, the nurse assesses evidence of concrete thinking when the patient:
a. fixedly begins to watch his feet. b. immediately examines his watch. c. begins to watch the nurse's feet. d. stands rigidly in one place without moving.
The client has a benign tumor in the middle ear and is scheduled for surgery to remove it. She asks her nurse whether her hearing will be affected. What is the nurse's best response?
A. "No, benign tumors do not affect hearing function." B. "No, because the tympanic membrane will remain intact." C. "Yes, all critical hearing structures are removed. It is important to remember that you will still have normal hearing in the other ear." D. "That is possible. I'll let the surgeon know you wish to discuss the extent of the surgery and possibility of reconstruction."
Studies have shown that control targets that reduce the HbA1C to less than 7% are associated with fewer long-term complications of diabetes. Patients who should have such a target include:
1. Those with long-standing diabetes 2. Older adults 3. Those with no significant cardiovascular disease 4. Young children who are early in their disease
A home health nurse did not know what to do when a family was home but did not invite the nurse in. Which of the following actions should the nurse take?
a. Leave a note saying the nurse would come back, and return as stated in the note. b. Give care to someone who wants nursing care services. c. Report the incident to the agency supervisor and ask to be reassigned elsewhere. d. Stay for awhile; the family might change their mind and let the nurse in.