A nurse is assisting with teaching a class about stress. The nurse should include that which of the following is a manifestation of prolonged stress?

Choice A reason : Denial is the first stage of the Kübler-Ross model of grief. In this stage, individuals believe the diagnosis is somehow mistaken, and cling to a false, preferable reality. It is a defense mechanism that buffers the immediate shock of the loss, numbing us to our emotions.

Choice B reason : Anger is the second stage of grief. As the masking effects of denial begin to wear off, reality and its pain re-emerge. The intense emotion is deflected from our vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends, or family.

Choice C reason : Bargaining is the third stage. It involves the hope that the individual can avoid a cause of grief. Usually, the negotiation for an extended life is made with a higher power in exchange for a reformed lifestyle.

Choice D reason : Acceptance is the final stage of grief. In this stage, individuals embrace mortality or the inevitable future, or that of a loved one, or other tragic event. People dying may precede the survivors in this state, which typically comes with a calm, retrospective view for the individual, and a stable condition of emotions.

Choice A reason : Using high-pitched tones is not recommended when speaking to a client with hearing loss. High-pitched sounds can be harder to hear for many people with hearing loss, as these sounds are often the first to be affected by auditory impairment. It's better to use a lower, natural tone and speak clearly.

Choice B reason : Speaking to the client using a loud voice is not advisable. While it might seem helpful, shouting can actually distort speech sounds and make it more difficult for the client to understand. Instead, the nurse should speak in a normal, clear voice and ensure the client's hearing aids are functioning if they use them.

Choice C reason : Talking quickly can make it difficult for a client with hearing loss to understand what is being said. It is important to speak at a moderate pace, enunciating clearly and allowing the client time to process the information. Rapid speech can blend words together, making it challenging for the client to follow the conversation.

Choice D reason : Making eye contact with the client when speaking is an effective communication strategy. It helps to engage the client and allows them to use visual cues such as lip-reading and facial expressions to better understand the conversation. Additionally, it ensures that the nurse has the client's attention before speaking.