A nurse is assisting with the care of a client whose partner died suddenly in a motor vehicle accident. The partner states, "If only I had another day with them." The nurse should identify the client is experiencing which of the following reactions to the loss?

Anger

Bargaining

Denial

Depression

Answer and Explanation

The Correct Answer is B

Rationale:

A. Anger: Anger is typically characterized by blaming others, expressing frustration, or resentment toward the situation, self, or those perceived to be responsible. It often follows denial and precedes bargaining in the stages of grief.

B. Bargaining: The statement "If only I had another day with them" reflects bargaining, a grief stage where individuals dwell on what could have been done differently to prevent the loss. This often includes hypothetical thinking or “what if” scenarios as a way to cope with the pain.

C. Denial: Denial involves refusing to accept the reality of the loss. It may manifest as disbelief or numbness, rather than expressing a desire to have more time or change past events, as seen in this client’s statement.

D. Depression: Depression in grief involves deep sadness, withdrawal, or feelings of hopelessness. While the client may be experiencing sorrow, the focus on "if only" thinking indicates bargaining more than the full emotional weight of depression.

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Correct Answer is ["A","C"]

Explanation

Rationale:

• Naloxone: The client received fentanyl and is now showing signs of opioid-induced respiratory depression. Respiratory rate has decreased to 10/min and oxygen saturation to 87%. Naloxone will reverse the opioid’s effects and restore adequate respiratory effort.

• An additional dose of propofol: The client’s level of sedation is already too deep, as shown by low respiratory rate and blood pressure. Additional propofol would worsen central nervous system depression. It may cause complete apnea or cardiac compromise in this situation.

• Oxygen 10 L/min via face mask: The current oxygen flow via nasal cannula is insufficient given the client's low oxygen saturation. A face mask delivers higher oxygen concentration and flow. This is critical to correct hypoxia until the cause is reversed.

• Acetaminophen: There is no fever or current complaint of pain requiring antipyretics or analgesics. Administering acetaminophen now would not address the acute respiratory issue. It would delay more urgent and appropriate interventions.

• An additional dose of fentanyl: Administering more opioid would increase the risk of further respiratory depression. The client is already showing hypoventilation and declining oxygenation. More fentanyl would worsen sedation and endanger airway and breathing.

• Propranolol: The client is already hypotensive with a BP of 80/51 mm Hg and a heart rate of 68/min. Giving a beta blocker could severely depress cardiac output. This would increase the risk of organ hypoperfusion and cardiac arrest.

A. Measles, mumps, and rubella (MMR) B. Varicella (VAR) C. Tetanus diphtheria and pertussis (Tdap) D. Inactivated influenza (IV)

Correct Answer is D

Explanation

Rationale:

A. Measles, mumps, and rubella (MMR): MMR is a live attenuated vaccine and is contraindicated during pregnancy due to the risk of fetal harm. It should be given at least one month prior to conception or postpartum if immunity is needed.

B. Varicella (VAR): Like MMR, the varicella vaccine is live and should not be administered during pregnancy. Pregnant individuals without evidence of immunity should receive it postpartum to protect against future infections.

C. Tetanus diphtheria and pertussis (Tdap): Tdap is recommended during each pregnancy but typically between 27 and 36 weeks of gestation to maximize passive antibody transfer to the fetus. At 16 weeks, it would not yet be indicated.

D. Inactivated influenza (IV): The inactivated flu vaccine is recommended for all pregnant clients during flu season, regardless of the trimester. It protects both the pregnant individual and the fetus from complications related to influenza infection.

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A nurse is assisting with the care of a client whose partner died suddenly in a motor vehicle accident. The partner states, "If only I had another day with them." The nurse should identify the client is experiencing which of the following reactions to the loss?

Nursing Test Bank

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Explanation

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