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Practice Question

The nurse notices that a client is withdrawn and reluctant to speak during their initial assessment. What action(s) should the nurse take to promote a therapeutic environment? Select all that apply.

Answer Choices:

Correct Answer:

Sit quietly with the client and allow time for them to speak.

Rationale:

🟦 Sitting quietly demonstrates presence, patience, and acceptance, which helps build trust and safety in a therapeutic relationship.

🟦 Allowing silence gives the client control over the pace of communication, which is especially important when a client feels withdrawn or anxious.

🟦 Asking about the client’s preference for timing or support respects autonomy and emotional readiness.

🟦 Offering options empowers the client and reduces feelings of pressure or vulnerability.

🟦 These approaches create a non-threatening, supportive environment that encourages eventual communication.

Begin discussing the client’s medical history to fill the silence.

🟦 Filling silence can feel overwhelming or dismissive to a withdrawn client.

🟦 It prioritizes task completion over emotional connection.

Tell the client, “I’ll come back when you’re ready to talk.”

🟦 This may be perceived as abandonment or rejection.

🟦 It removes the nurse’s therapeutic presence, which is essential early on.

Encourage the client to talk by asking multiple questions quickly.

🟦 Rapid questioning can increase anxiety and withdrawal.

🟦 It limits the client’s ability to process and respond thoughtfully.

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This question is from Chamberlain mastery fundamentals exam which contains 77 questions.

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A nurse is performing a comprehensive health assessment on an older adult female client. The client reports "urine leaking" when sneezing or laughing. Which action should the nurse take?

Answer Choices:

A. Encourage the client to reduce their fluid intake.
B. Document the finding as a normal variation due to age.
C. Refer the client to a urologist for bladder training.
D. Ask the client about the frequency and severity.
A nurse is caring for a group of clients. For which client should the nurse provide education about the Supplemental Nutrition Assistance Program (SNAP)?

Answer Choices:

A. An older adult who lives alone and enjoys grocery shopping and cooking.
B. A single caregiver with an adequate income who lives far from the store.
C. A middle-aged adult who pays for private health insurance.
D. A single parent who has a low income and is living with their parents.
A nurse evaluates a client with benign prostatic hyperplasia (BPH) who voided 60 mL four hours after removal of an indwelling catheter. The client reports suprapubic discomfort. A bladder scan reveals 400 mL of retained urine. Which conclusion should the nurse make from this finding?

Answer Choices:

A. The client’s urinary output is adequate for this period.
B. The client is unable to empty the bladder effectively.
C. The client’s post-catheter urinary retention is normal.
D. The client’s discomfort is unrelated to bladder function.
A nurse is implementing a plan of care for a postoperative client to prevent deep vein thrombosis (DVT). Which intervention(s) should be included to promote circulation? Select all that apply.

Answer Choices:

A. Massage the client's calves vigorously to stimulate blood flow.
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From Exam
Chamberlain mastery fundamentals exam

77 Questions

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Question Details
  • Category: RN Nursing Exam(s)
  • Subcategory: Examplify Exam(s)
  • Domain: Fundamentals
  • Answer Choices: 5
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