A victim of sexual abuse expresses the belief to the nurse that the abuse is a punishment for not having lived a spiritually pure life prior to the event. The nurse:
1. Indicates to the victim that this is an incorrect view.
2. Makes it clear to the client that the rape was not a punishment for the client's own behavior.
3. Acknowledges the client's spiritual frustration and invites the client to express these feelings.
4. Explains that rape can happen even to the most religious people.
3
Rationale: The nurse validates the client's spiritual struggle and at the same time invites the client to express these feelings. This allows the client to grieve and ultimately to heal. The other responses are nontherapeutic, offer judgment, minimize the client's spiritual struggle, and/or may inhibit the client's willingness to work through feelings of guilt and responsibility for the attack.
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A patient has been diagnosed with migraines after experiencing headaches of increasing severity. When providing health education to this patient about her new diagnosis, what should the nurse convey?
A) The etiology of migraines is thought to have a genetic component. B) Migraines are typically the result of prolonged psychosocial stress. C) Migraines can be a precursor to transient ischemic attacks (TIAs) or stroke. D) The pathophysiology of migraine headaches involves a disruption in the limbic system.
The nurse is caring for a client suspected of having a muscle injury in the left upper arm, and anticipates the provider will order what diagnostic test?
1. X-ray 2. MRI 3. Myelogram 4. Arthroscopy
According to the transactional theories on stress, what does a person do first when confronted by stress?
a. Determines coping mechanisms to deal with the stress b. Determines the perceived degree of threat imposed c. Determines what the response will be to the stress d. Denies the stress exists
A client reports pain 8 hours after surgery. The client has already received an opioid within the past 2 hours. What is the nurse's best action?
a. Assess the pain further. b. Administer naloxone (Narcan). c. Call the surgeon. d. Document the finding.