A nurse is caring for a client who has terminal cancer and has decided to stop treatment and enter hospice care. The client's family members express anger and disbelief at the client's decision. How should the nurse respond?

Rationale: The client is showing signs of caregiver stress, which can lead to depression and increased risk of suicide. The priority nursing intervention is to assess the client's mental health status and provide appropriate referrals and interventions as needed.

Incorrect options:

A) Refer the client to a support group for caregivers. - This is an appropriate intervention, as support groups can provide emotional and social support, as well as information and resources, for caregivers. However, this is not the priority intervention, as the client's mental health needs to be addressed first.

B) Educate the client on the stages and progression of Alzheimer's disease. - This is an appropriate intervention, as education can help the client understand and cope with the challenges of caring for a spouse with Alzheimer's disease. However, this is not the priority intervention, as the client's mental health needs to be addressed first.

C) Arrange for respite care services for the client's spouse. - This is an appropriate intervention, as respite care can provide temporary relief and assistance for caregivers, allowing them to rest and attend to their own needs. However, this is not the priority intervention, as the client's mental health needs to be addressed first.

Rationale: The nurse should recognize that the client is in an abusive relationship and may be at risk of harm or retaliation if they try to leave or seek help. The nurse should provide discreet and confidential support to the client, without alerting or provoking the partner. The nurse should also give the client information and resources that may help them escape or cope with their situation.

Incorrect options:

A) Confront the partner and tell them that their behavior is unacceptable and abusive. - This action may be dangerous or counterproductive, as it may escalate the partner's anger or violence towards the client or the nurse. The nurse should avoid confronting or challenging the partner, as this may jeopardize their safety or trust.

B) Ignore the partner and focus on providing education and care to the client and the baby. - This action may be ineffective or unethical, as it may ignore or enable the partner's abuse towards the client. The nurse should not overlook or disregard signs of domestic violence, as this can put the client and the baby at further risk.

C) Report the partner to the authorities for domestic violence and child abuse. - While reporting the partner to the authorities may be necessary in some cases, it is not the most appropriate immediate action for the nurse in this situation. The nurse should prioritize the safety and well-being of the client and the baby and provide them with resources to seek help and support.

The nurse's primary responsibility is to ensure the safety and well-being of the client and the baby. By giving the client a phone number for a domestic violence hotline and asking them to call when they are safe, the nurse provides them with a confidential resource that can offer guidance, support, and help in planning a safe exit from the abusive situation. It allows the client to reach out for assistance when they feel ready and secure enough to do so.