A hospice nurse is caring for a client who has a terminal illness. Which of the following client statements should the nurse identify as an indication that the client is experiencing the bargaining stage of grief?

A. Position the seat of the wheelchair at a right angle to the bed: Proper wheelchair positioning is important to facilitate a safe pivot transfer and reduce the distance the client must move. However, ensuring environmental safety by stabilizing equipment must occur before positioning. The wheelchair can be placed correctly after confirming both surfaces are secure.

B. Lock the wheels on the bed: Safety is the priority before initiating any transfer. Locking the wheels on the bed prevents unintended movement that could result in loss of balance or falls, particularly in a client with unilateral weakness. Stabilizing the bed establishes a secure foundation prior to assisting the client to sit or stand.

C. Have the client sit at the edge of the bed: Dangling at the bedside allows assessment for orthostatic hypotension and balance, but this step should occur only after ensuring the bed is secure. Assisting the client to sit before locking the wheels increases fall risk if the bed shifts.

D. Place a gait belt around the client's waist: A gait belt enhances stability and control during transfer, especially for a client with left-sided weakness. However, it is applied after environmental safety measures, such as locking the bed and wheelchair, are completed.

A. Pull the auricle upward and outward: While pulling the auricle upward helps straighten the external auditory canal in adults, directing it outward does not fully align the canal’s natural S-shaped curve. Proper straightening requires a backward motion to allow the medication to flow toward the tympanic membrane effectively.

B. Pull the auricle downward and backward: Pulling the auricle downward and backward is the technique used for children younger than 3 years of age. In young children, the ear canal is more horizontal, and this maneuver helps straighten it appropriately. This method is not correct for adults.

C. Pull the auricle upward and backward: In adults, the external auditory canal curves upward and posteriorly. Pulling the auricle upward and backward straightens the canal, facilitating proper instillation of the medication and ensuring it reaches the intended area near the tympanic membrane.

D. Pull the auricle downward and outward: This technique does not effectively straighten the adult ear canal. Incorrect positioning can result in medication pooling in the outer canal rather than reaching the deeper structures where therapeutic action is needed.