Holly is a 53-year-old female with terminal breast cancer. Holly's nurse in the hospital brings up the subject of hospice care. Holly becomes upset and states, 'I am not ready to give up and die.' You respond that hospice is:

Correct Answer: A

Rationale: The correct answer is A because hospice care focuses on enhancing the quality of life for patients with terminal illnesses and their families. It provides holistic support, including pain management, emotional and spiritual care, and practical assistance. By bringing up hospice care, the nurse is offering a compassionate approach that aims to ensure comfort and dignity for Holly during her end-of-life journey. Choice B is incorrect because hospice care does not necessarily mean the end of all treatments. It shifts the focus from curative treatments to palliative care, but it still provides medical support to manage symptoms and improve comfort. Choice C is incorrect as hospice care does not provide curative treatment. It focuses on comfort care and symptom management rather than trying to cure the terminal illness. Choice D is incorrect because hospice care is not about hastening death. It aims to provide support and comfort during the natural end-of-life process, not to aggressively end life.

Correct Answer: A

Rationale: The correct answer is A: Implement suicide precautions. This is the highest priority intervention because the patient has a plan for suicide, which poses an immediate risk to their safety. Implementing suicide precautions involves ensuring the patient's safety by removing any potential means of self-harm, closely monitoring their behavior, and providing constant supervision to prevent any suicide attempts. Choice B is incorrect because offering high-calorie snacks and fluids frequently does not address the immediate risk of suicide. Choice C is incorrect because assisting the patient to identify personal strengths is important for building self-esteem but is not the highest priority when the patient is at risk of suicide. Choice D is incorrect because observing the patient for therapeutic effects of antidepressant medication is important but ensuring the patient's safety takes precedence when there is a risk of suicide.

Correct Answer: B

Rationale: The correct answer is B: the client's cultural background. Before touching the client to offer comfort, the nurse should consider the client's cultural background to ensure that the gesture is appropriate and respectful. Different cultures have varying attitudes towards touch, and what may be comforting in one culture could be inappropriate or invasive in another. Understanding the client's cultural background helps the nurse provide culturally sensitive care. Incorrect choices: A: the client's recent vital signs - Vital signs are important for assessing physical health, but they are not directly relevant to offering comfort through touch in this situation. C: if the doctor should be notified - Notifying the doctor is not necessary before offering comfort through touch. It is more important to consider the client's needs and preferences. D: if the client has been sad recently - While the client's emotional state is important, it is not the primary consideration before offering comfort through touch. Cultural background plays a more crucial role in determining the appropriateness of touch.

Correct Answer: D

Rationale: The correct answer is D because the client requiring a sterile dressing change for a burn has the highest priority due to the risk of infection and potential complications. Sterile technique is crucial to prevent infections in burn wounds. Burn injuries can lead to sepsis if not properly managed. Clients receiving chemotherapy (Choice A) may require careful monitoring but do not have an immediate risk of infection like the burn client. A client who has had an appendectomy and has diminished bowel sounds (Choice B) may indicate a potential complication but is not as urgent as managing a burn wound. A client with hypothyroidism and stupor (Choice C) may require intervention but does not pose an immediate threat to life like a burn wound needing a sterile dressing change.

Correct Answer: A

Rationale: The correct answer is A because cognitive behavioral therapy focuses on changing thoughts and behaviors, not necessarily on events as the underlying issue. The therapist would be least likely to include this as it does not align with the core principles of CBT. Choice B is correct as CBT acknowledges that beliefs can exist irrespective of their origin. Choice C is correct as CBT emphasizes the role of practice in changing beliefs. Choice D is correct as CBT involves challenging and replacing negative thoughts with more accurate ones.