A client has been recently diagnosed with terminal cancer. The client states, "This cannot be happening to me." The nurse identifies that the client is in what stage of grieving process?
Depression
Anger
Bargaining
Denial
The Correct Answer is D
D. Denial is often the initial stage of the grieving process, characterized by disbelief or avoidance of the reality of the situation. Clients may refuse to accept the diagnosis or its implications, clinging to the hope that it is not true. The client's statement of "This cannot be happening to me" is consistent with denial, as they are expressing disbelief or resistance to the reality of their diagnosis.
A. This stage involves feelings of sadness, despair, and hopelessness. While depression is a common response to a terminal diagnosis, the client's statement of "This cannot be happening to me" suggests that they may still be in an earlier stage of grief.
B. Anger is another common stage of the grieving process, characterized by feelings of frustration, resentment, and hostility. Clients may direct their anger towards themselves, others, or even a higher power. While anger can be a prominent reaction to a terminal diagnosis, the client's statement does not explicitly express anger but rather disbelief or resistance.
C. Bargaining is a stage in which individuals may attempt to negotiate or make deals in an effort to change or postpone the inevitable outcome. For example, a client may pray for more time or promise to change their behavior in exchange for a better outcome. The client's statement of "This cannot be happening to me" does not reflect bargaining but rather denial or disbelief.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. Consuming alcoholic beverages, especially close to bedtime, can disrupt sleep patterns and exacerbate insomnia. While alcohol may initially have a sedative effect and induce drowsiness, it can lead to fragmented and poor-quality sleep later in the night, resulting in worsened insomnia symptoms. Therefore, this statement indicates a need for further education by the nurse regarding the negative impact of alcohol consumption on sleep and the importance of avoiding alcohol before bedtime to improve sleep quality.
A. Keeping the bedroom cool (around 65 degrees Fahrenheit) is generally recommended for promoting sleep because a cooler temperature can help facilitate the body's natural temperature drop, which occurs during sleep onset.
B. Engaging in regular physical activity, such as taking a long walk during the day, can be beneficial for promoting better sleep. Physical activity during the day can help regulate the sleep-wake cycle, reduce stress, and improve overall sleep quality. Therefore, this statement reflects a positive sleep hygiene practice and does not indicate a need for further education.
C. This statement suggests an understanding of the importance of associating the bed with sleep and avoiding activities that may interfere with sleep, such as paying bills or working in bed. Maintaining the bed as a place primarily for sleep and intimacy can help condition the mind and body to associate the bed with relaxation and sleep.
Correct Answer is C
Explanation
C. Excessive noise in the hospital environment, including alarms, conversations, and equipment noises, can disrupt sleep and negatively impact sleep quality. Therefore, limiting unnecessary noise on the unit is a crucial nursing intervention for improving sleep quality in the acute care setting. This may involve implementing quiet hours, reducing unnecessary conversations and activities during nighttime hours, and using noise-reducing strategies such as earplugs or white noise machines.
A. While providing a bedtime snack may help alleviate hunger and promote comfort, especially if the client is on a restricted diet or experiencing appetite changes, it may not directly address factors affecting sleep quality. Additionally, consuming food close to bedtime may not be suitable for all patients, especially those with dietary restrictions or certain medical conditions. Therefore, while a bedtime snack may be beneficial in some cases, it may not be the most important intervention for improving sleep quality in the acute care setting.
B. Pulling curtains around the bed can help create a sense of privacy and reduce visual distractions, which may contribute to a more conducive sleep environment. Enhanced privacy can also promote relaxation and feelings of security, potentially improving sleep quality. However, while privacy curtains can mitigate some external disturbances, they may not completely eliminate factors that affect sleep, such as noise or light.
D. Providing a backrub can promote relaxation, relieve tension, and enhance comfort, which may contribute to improved sleep quality for some patients. Massage therapy has been shown to reduce stress and promote relaxation, potentially facilitating better sleep. However, while backrubs can be a beneficial adjunct to promoting relaxation and comfort, they may not address all factors that affect sleep quality in the acute care setting.
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