A nurse is caring for a client who has been diagnosed with end-stage liver cancer. Which of the following responses is an indication the client is in the denial phase of the grief process?

I need someone near me all the time, l am very tired.

The doctor has been so good to me. I know he has tried everything he can. It is just my time.

The doctor says only have a few months to live, but know he is exaggerating to get me to take my medication.

Even though am not hurting right now, I don't feel like I have the energy to get out of bed.

Answer and Explanation

The Correct Answer is C

This statement shows that the client is not accepting the reality of their prognosis and is dismissing the doctor's professional opinion. Denial is a common stage in the grief process where individuals may refuse to believe or accept a difficult reality, often as a coping mechanism to avoid the pain and sadness of the situation. Options a, b, d, and e do not indicate denial and instead may suggest fatigue, acceptance, physical weakness, and anger or frustration, respectively.

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Correct Answer is C

Explanation

A systolic blood pressure of 62 mm Hg indicates severe hypotension and is a medical emergency. This is a life-threatening situation that requires immediate hospitalization for stabilization and treatment. Clients with eating disorders are at risk of electrolyte imbalances, cardiac complications, and other medical complications due to malnutrition and dehydration. While the other options are also abnormal findings, they are not as severe as the critically low blood pressure measurement. Therefore, the priority for hospitalization would be the client with severe hypotension.

A. Others are being distracted; Please, quiet down and go to your room. B. You seem pretty upset. Tell me about it C. Please go to your room to get control of yourself. D. What’s going on? Be quiet.

Correct Answer is B

Explanation

This response acknowledges the client's distress and opens the opportunity for the client to express their feelings and concerns. It also demonstrates empathy and a willingness to listen, which can help deescalate the situation and build trust between the nurse and client.

Option a ("Others are being distracted; Please, quiet down and go to your room") is dismissive of the client's feelings and may further escalate the situation.

Option c ("Please go to your room to get control of yourself") is directive and may be perceived as confrontational, potentially increasing the client's agitation.

Option d ("What's going on? Be quiet") is insensitive and dismissive of the client's distress and may further agitate the client.

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A nurse is caring for a client who has been diagnosed with end-stage liver cancer. Which of the following responses is an indication the client is in the denial phase of the grief process?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which assessment finding for a client diagnosed with an eating disorder meets a criterion for hospitalization? Select one:

Correct Answer is C

Explanation

A client is agitated and pacing in the hall near the nurses' station and swearing loudly. What response is the best for the registered nurse to provide? Select one:

Correct Answer is B

Explanation

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