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NCLEX QUESTION TYPE TUTORIAL
A nurse is speaking with a client who is at risk of hypertension (HTN). What is the nurse’s role in helping this client?
The question mentions a nurse (you) and one client that the nurse cares for.
The only information about the client is that they are at risk of hypertension – they don’t have it yet, but are at an increased risk.
Since the client does not currently have hypertension yet, the nurse’s main role is prevention and patient education.
Multiple-choice questions on the NCLEX are best answered in a 2-step process:
Reviewing medications and ensuring adherence to the plan is generally a nurse’s responsibility, so this answer choice does not need to be eliminated immediately. Keep for now.
Health coaching is definitely an important responsibility of the nurse when it comes to prevention. Keep for now.
This statement can immediately be identified as non-therapeutic. Scare tactics should never be used with patients, even if with the goal of preventing more harm to them. It is not helpful to the client. This answer should be eliminated.
From the tone of this statement, it is apparent that this is also not a therapeutic statement.
Therapeutic communication does not involve telling clients what to do. Effective communication encourages and educates clients to make the best decisions, such as strategies using motivational interviewing. Being authoritative and judgmental like the answer choice sounds, will likely make the client push back and won’t help them ultimately.
This answer should therefore also be eliminated in the first pass through the answer choices.
C and D were eliminated due to being non-therapeutic communication, so it comes down to answer A and B:
Remember, the stem does not state the client has hypertension, it says the client is at risk for hypertension. There is a risk of the client developing hypertension. So, knowing that even for people who already have hypertension, the first treatment step is diet and exercise, not medication, it is likely this client may not even be on any medication yet. As detailed above, there are a lot of modifiable risk factors for hypertension that can and should be addressed before turning to medication. In this scenario, the answer that focuses on health coaching and educating the client to try and prevent or delay hypertension would be the most fitting: Answer B is the best choice and the correct answer.
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