The home care nurse hears an elderly client's spouse tell the ...

[tfester]

The home care nurse hears an elderly client's spouse tell the client, You are good for nothing You insist on living in this huge home which you cannot maintain but expect me to.. The client engages in an argument with the spouse.
 
  The home care nurse identifies which of the following for the client and spouse? 1. Financial struggles within the family
   2. Spousal abuse
   3. Evidence of low blood glucose levels
   4. Possible situational depression for both client and spouse

Question 2

The nurse is caring for a client who asks the nurse to explain a concept about the client's disease process that the nurse does not know the answer to. The best response by the nurse is:
 
  1. I do not know..
   2. I do not know, but I will find out..
   3. Why do you need to know that?
   4. You'll have to ask the doctor that question..

[yasmin]

Answer to Question 1

4. Possible situational depression for both client and spouse

Rationale:
Manifestations associated with situational depression in the elderly include irritability and poor work performance. One spouse is irritable because of overwork and the other spouse is irritable because of the inability to perform household work. The nurse cannot determine if the family is having financial struggles. There is no evidence of spousal abuse at this time. The nurse cannot determine that the arguing is due to low blood glucose levels.

Answer to Question 2

2. I do not know, but I will find out..

Rationale:
The nurse best exhibits integrity by telling the client that the nurse will find out the answer and get back to the client. Honesty by the nurse will build trust with the client. Just saying, I don't know, and leaving it at that will make the nurse appear untrustworthy and possibly uncaring. Questioning the client about the need for the information is defensive and might also be construed as a challenge by the client. Referring the question to the doctor is also not good ethics; nurses need to continue learning throughout their practice.

[tfester]

Excellent

[kjohnson]

TYSM