A nurse is caring for a patient who has been diagnosed with end-stage liver cancer.
Which statement by the patient indicates that the patient is in the denial phase of the grief process?

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

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

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

“I can’t believe that doctor graduated from medical school. He doesn’t know a thing about treating cancer.”.

Answer and Explanation

The Correct Answer is C

Choice A rationale
This statement indicates fatigue and lack of energy, which are common symptoms in patients with end-stage liver cancer. However, it does not necessarily indicate denial.
Choice B rationale

This statement suggests acceptance rather than denial. The patient acknowledges the doctor’s efforts and seems to accept their own mortality.
Choice C rationale
This statement indicates denial. The patient is dismissing the doctor’s prognosis and expressing disbelief about the severity of their condition.
Choice D rationale
This statement suggests anger or frustration towards the doctor, but it does not necessarily indicate denial.

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Correct Answer is C

Explanation

Choice A rationale
Assuring the patient that the problem is temporary may not be accurate. Postoperative dysphagia could indicate a complication from the surgery, such as the stomach fundus being wrapped too tight around the esophagus, causing food obstruction. It’s important to not dismiss the patient’s concerns without proper assessment.
Choice B rationale
Cutting the food into small pieces might help the patient swallow easier, but it does not address the underlying issue. The patient’s difficulty in swallowing could be a sign of a serious problem that needs medical attention.
Choice C rationale
Reporting the observation to the healthcare provider (HCP) is the correct action. After the repair of a paraesophageal hernia, dysphagia should be reported to the HCP. The corrective fundoplication surgery may have the stomach fundus wrapped too tight around the esophagus, causing food obstruction.
Choice D rationale

Offering the patient liquids instead might alleviate the symptom temporarily, but it does not solve the potential problem. The healthcare provider needs to be informed about the dysphagia to assess and treat the possible complication.

A. Bulging at the hernia site. B. Reports of mild discomfort. C. A bulge that disappears when lying down. D. Reports of nausea and vomiting.

Correct Answer is D

Explanation

Choice A rationale

While a bulge at the hernia site is a common symptom of an umbilical hernia, it is not typically a cause for immediate concern or a reason to alert the healthcare provider.
Choice B rationale
Mild discomfort may be associated with an umbilical hernia, but it is not typically a cause for immediate concern or a reason to alert the healthcare provider.
Choice C rationale
A bulge that disappears when lying down is a common characteristic of an umbilical hernia and is not typically a cause for immediate concern or a reason to alert the healthcare provider.
Choice D rationale
Nausea and vomiting could indicate that the hernia has become strangulated, which is a medical emergency. Strangulation occurs when the blood supply to the herniated tissue is cut off. This is a serious complication that requires immediate medical attention.
Question 50.

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A nurse is caring for a patient who has been diagnosed with end-stage liver cancer. Which statement by the patient indicates that the patient is in the denial phase of the grief process?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing care for a patient who had surgical repair of a paraesophageal (rolling) hernia. The nurse observes that the patient is having difficulty swallowing during the first postoperative meal.What action should the nurse take?

Correct Answer is C

Explanation

The nurse is caring for a patient with an umbilical hernia. Which symptom should prompt the nurse to alert the healthcare provider?

Correct Answer is D

Explanation

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A nurse is caring for a patient who has been diagnosed with end-stage liver cancer. Which statement by the patient indicates that the patient is in the denial phase of the grief process?

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A nurse is caring for a patient who has been diagnosed with end-stage liver cancer.
Which statement by the patient indicates that the patient is in the denial phase of the grief process?