A nurse is caring for a client whose partner has recently died. The client ‘’I am learning how to pay my own bills.’’ The nurse should identify that the client is experiencing which of the following tasks in Worden’s Four Tasks of Grieving?

Experiencing the pain of grief

Finding an enduring connection while embarking on a new life

Accepting the reality of the loss

Adjusting to an environment without the deceased

Answer and Explanation

The Correct Answer is D

A) Experiencing the pain of grief:
Experiencing the pain of grief is one of the early stages of mourning, according to Worden's tasks of grieving. This task involves confronting and processing the emotional pain and sorrow that accompany the loss. However, the statement provided by the client — "I am learning how to pay my own bills" — suggests they are adapting to life changes and responsibilities, which is more aligned with the later stages of grieving. This does not reflect the immediate pain of grief, but rather a focus on adjusting to life after the loss.

B) Finding an enduring connection while embarking on a new life:
Finding an enduring connection while embarking on a new life refers to the task of establishing a continued relationship with the deceased, while simultaneously moving forward with one's life. While this task is essential in the long-term grieving process, it does not directly relate to the client's statement, which focuses on practical changes, such as learning to manage finances, rather than a spiritual or emotional connection with the deceased.

C) Accepting the reality of the loss:
Accepting the reality of the loss is another important task in Worden’s model. This involves coming to terms with the fact that the loved one is gone. However, the client's focus on learning practical tasks like paying bills indicates that they are already moving beyond the initial stages of grief, not just accepting the loss. The statement does not clearly indicate that the client is still in the phase of accepting the reality of the loss, but rather adjusting to the changes that the loss has brought.

D) Adjusting to an environment without the deceased:
The client's statement, "I am learning how to pay my own bills," suggests they are taking on new responsibilities and adjusting to the changes brought about by the death of their partner. This aligns with Worden’s task of adjusting to an environment without the deceased, which includes taking on new roles and responsibilities that the deceased partner previously managed, such as financial tasks, household duties, and other life changes.

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Correct Answer is B

Explanation

A) Decreased peripheral pulses:
Increased body temperature typically causes vasodilation rather than vasoconstriction, leading to improved blood flow rather than decreased. As a result, peripheral pulses are more likely to be normal or even increased in response to fever. Decreased peripheral pulses would be more indicative of conditions like shock or hypoperfusion, not fever.

B) Heart rate 108/min:
Fever causes an increase in metabolic demand, which often results in a compensatory increase in heart rate (tachycardia). This phenomenon, known as "fever tachycardia," occurs as the body attempts to circulate blood more rapidly to meet the increased oxygen and nutrient demands caused by elevated body temperature. A heart rate of 108 beats per minute is a normal response to fever, particularly when the temperature reaches 39°C (102.27°F).
C) Respiratory rate 10 breaths/min:
A respiratory rate of 10 breaths per minute is considered bradypnea (abnormally slow breathing), which is typically not associated with fever. Fever usually leads to an increase in respiratory rate (tachypnea) as the body attempts to cool itself through increased evaporation of sweat and breathing. A respiratory rate of 10 breaths/min is more likely to be seen in conditions like drug overdose, head injury, or respiratory depression, rather than fever.
D) Dilated pupils:
Dilated pupils (mydriasis) are typically associated with sympathetic nervous system activation, which can be caused by certain drugs, trauma, or neurological conditions. Fever, however, generally causes only mild changes in pupil size and is more likely to lead to constricted pupils (miosis) in response to certain stress hormones. Dilated pupils are not a typical finding with fever.

A. Crushing the medication would release all the medication at once, rather than over time." B. Crushing the medication might cause you to have a stomachache or indigestion. C. "Crushing the medication is a good idea, and I can mix in some ice cream for you." D. "Crushing is unsafe, as it destroys the ingredients in the medication."

Correct Answer is B

Explanation

A) Crushing the medication would release all the medication at once, rather than over time:. Enteric-coated aspirin is designed to bypass the stomach and release the medication in the small intestine to avoid irritation of the stomach lining. Crushing the tablet could potentially release the entire dose all at once, which could lead to gastrointestinal irritation, but this isn't the primary concern. The key issue is that crushing destroys the enteric coating, which is crucial for protecting the stomach.

B) Crushing the medication might cause you to have a stomachache or indigestion:
Enteric-coated medications are specifically designed to protect the stomach lining by delaying the release of the drug until it reaches the small intestine. Crushing the medication would destroy the enteric coating, which can lead to stomach irritation, upset, or even ulcer formation due to the direct exposure of the stomach lining to the medication. Therefore, crushing could cause significant discomfort or damage to the digestive system.

C) "Crushing the medication is a good idea, and I can mix in some ice cream for you.":
Crushing enteric-coated medications, such as aspirin, can lead to adverse effects like stomach irritation, ulceration, and poor absorption. The nurse should not recommend this method of administration without first consulting with the prescribing provider or pharmacist to explore alternatives.

D) "Crushing is unsafe, as it destroys the ingredients in the medication.":
Crushing does not destroy the active ingredients in the medication, but it does destroy the enteric coating, which is the key concern. The enteric coating's function is to prevent the aspirin from irritating the stomach. While it's important to recognize that crushing is unsafe, the reason is more about the loss of this protective coating rather than the destruction of the medication's active ingredients themselves.

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A nurse is caring for a client whose partner has recently died. The client ‘’I am learning how to pay my own bills.’’ The nurse should identify that the client is experiencing which of the following tasks in Worden’s Four Tasks of Grieving?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has an oral temperature of 39 C (102.27 F). Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

A nurse is caring for client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

Correct Answer is B

Explanation

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