A nurse is collecting data from a middle-aged client whose partner died seven months ago.
Which of the following findings indicate that the client is experiencing maladaptive grieving?

The client has lost 10 lb.

The client visits his partner’s grave each month.

The client has been unable to return to work.

The client has difficulty sleeping

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Losing 10 lb after the death of a loved one is not uncommon, especially within the first few months of grieving. It can be due to decreased appetite, changes in eating habits, or increased physical activity. While it's important to monitor weight loss and ensure adequate nutrition, it doesn't necessarily indicate maladaptive grieving on its own.

Grief can often lead to changes in appetite and weight. Some people may experience a loss of appetite and unintentional weight loss, while others may find themselves overeating or gaining weight. These changes are often temporary and subside as the grieving process progresses.

It's important to consider the client's overall health and well-being when assessing weight loss. If the client is experiencing significant weight loss, it's important to rule out any underlying medical conditions that may be contributing to it.

Choice B rationale:

Visiting a loved one's grave is a common way to grieve and remember them. It can be a way to feel connected to the deceased, express love and sorrow, and find solace. It's a normal part of the grieving process and doesn't necessarily indicate maladaptive grieving.

Grieving individuals often find comfort in visiting the gravesite of their loved one. It can be a place to reflect, remember, and feel close to the deceased. Visiting a gravesite can also be a way to honor the loved one's memory and express continued love and respect.

The frequency of grave visits can vary from person to person. Some individuals may visit frequently, while others may only visit on special occasions or anniversaries. There is no right or wrong way to grieve, and what matters most is that the individual finds a way to express their grief in a way that feels right for them.

Choice D rationale:

Difficulty sleeping is a common symptom of grief. It can be caused by a variety of factors, including anxiety, sadness, and changes in sleep patterns. While it can be distressing, it's not always a sign of maladaptive grieving.

Grief can disrupt sleep patterns in a number of ways. It can make it difficult to fall asleep, stay asleep, or both. It can also lead to nightmares, night sweats, and early morning awakenings. These sleep disturbances can be both physically and emotionally draining.

There are a number of things that can be done to improve sleep during grief. These include establishing a regular sleep schedule, creating a relaxing bedtime routine, avoiding caffeine and alcohol, and getting regular exercise. If sleep problems persist, it's important to seek professional help.

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Correct Answer is B

Explanation

Choice A rationale:

Hemoglobin (Hgb) of 11 g/dL is slightly below the normal range for adult females (12-16 g/dL) but is not considered a critical value.

It may indicate mild anemia, which is common in bulimia nervosa due to factors such as poor nutrition and blood loss from self-induced vomiting. However, it would not typically be the most urgent finding requiring immediate intervention.

Choice B rationale:

Potassium of 2.8 mEq/L is significantly below the normal range (3.5-5.0 mEq/L) and is considered a critical value, indicating severe hypokalemia.

Hypokalemia is a potentially life-threatening electrolyte imbalance that can lead to cardiac arrhythmias, muscle weakness, respiratory failure, and even death.

It is a common complication of bulimia nervosa due to excessive vomiting and/or laxative abuse, which can lead to significant potassium loss.

Therefore, this finding would be the nurse's priority, necessitating immediate intervention to correct the hypokalemia and prevent potentially life-threatening complications.

Choice C rationale:

Serum chloride of 96 mEq/L is slightly below the normal range (98-106 mEq/L) but is not considered a critical value.

It may be associated with hypokalemia, as chloride and potassium are often lost together in conditions like bulimia nervosa.

However, it would not typically be the most urgent finding requiring immediate intervention.

Choice D rationale:

Serum amylase of 240 units/L is elevated above the normal range (30-110 units/L) but is not considered a critical value.

It may indicate inflammation of the pancreas (pancreatitis), which can be a complication of bulimia nervosa due to recurrent vomiting and/or alcohol abuse.

However, it would not typically be the most urgent finding requiring immediate intervention, especially in comparison to severe hypokalemia.

A. “I tense and release my muscles, starting with my feet.” B. “I sleep in in the mornings.” C. “I think about being on my favorite beach vacation.” D. “I isolate myself in my room for a few hours when things get overwhelming.” E. Social support

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

Explanation

Choice A rationale:

Progressive muscle relaxation (PMR) is a well-established technique for stress reduction. It involves systematically tensing and releasing different muscle groups throughout the body. This process helps to release physical tension, promote relaxation, and decrease feelings of stress and anxiety.

PMR has been shown to be effective in reducing stress and anxiety in various populations, including individuals with chronic pain, anxiety disorders, and sleep difficulties.

It is a simple, safe, and accessible technique that can be practiced independently without any special equipment or training.

Choice B rationale:

While sleeping in can provide temporary relief from stress, it is not considered an adaptive coping strategy in the long term.

Oversleeping can disrupt sleep patterns and circadian rhythms, which can actually worsen stress and anxiety in the long run.

It can also lead to social isolation and decreased productivity, further compounding stress.

Choice C rationale:

While distraction techniques, such as thinking about a favorite vacation, can provide temporary relief from stress, they do not address the underlying causes of stress.

Overreliance on distraction can prevent individuals from developing more effective coping strategies for managing stress in the long term.

Choice D rationale:

Social isolation is generally considered a maladaptive coping strategy. While it may provide temporary relief from overwhelming situations, it can lead to increased feelings of loneliness, disconnection, and rumination.

It can also prevent individuals from seeking support and developing more effective coping strategies.

Choice E rationale:

Social support is a crucial factor in stress management. Connecting with supportive friends and loved ones can provide emotional comfort, reduce feelings of isolation, and promote a sense of belonging.

Positive social interactions can also buffer the negative effects of stress and promote resilience.

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A nurse is collecting data from a middle-aged client whose partner died seven months ago. Which of the following findings indicate that the client is experiencing maladaptive grieving?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the admission laboratory values for a client who has a history of bulimia nervosa. Which of the following findings is the nurse’s priority?

Correct Answer is B

Explanation

A nurse facilitating a group therapy session is listening to clients discuss their coping strategies when feeling stressed. Which of the following statements indicate adaptive coping? (Select all that apply.)

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

Explanation

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A nurse is collecting data from a middle-aged client whose partner died seven months ago.
Which of the following findings indicate that the client is experiencing maladaptive grieving?