A terminally ill patient is angry and belligerent. He yells at the nurses and his family for not coming quickly enough when he calls, and he states that he isn't receiving the care he needs. The nurse's most informative response would be:
"Don’t let him get away with this abuse. He doesn’t need to yell at you."
"I'm afraid he is having a bad day and feels neglected."
"This may be how he feels best in dealing with this illness. You'll just have to ignore it."
"Anger is a reaction that dying people experience. You may be feeling some anger yourselves."
The Correct Answer is D
A. "Don’t let him get away with this abuse. He doesn’t need to yell at you": This response is dismissive of the patient's emotions and fails to address the underlying issues causing the anger. It may escalate the situation and create conflict rather than fostering understanding and support.
B. "I'm afraid he is having a bad day and feels neglected": While this response acknowledges the patient's feelings, it does not provide a broader context for understanding the patient's behavior. It may also inadvertently minimize the patient's emotions and the impact of his terminal illness.
C. "This may be how he feels best in dealing with this illness. You'll just have to ignore it": This response dismisses the patient's behavior as acceptable without exploring its underlying causes. It does not promote therapeutic communication or help address the patient's needs and concerns.
D. "Anger is a reaction that dying people experience. You may be feeling some anger yourselves": This response acknowledges the patient's emotions as a common reaction to terminal illness, normalizing his experience. It also recognizes the emotions of the nurses and family, encouraging empathy and understanding. By validating the patient's feelings and providing context, the nurse can facilitate a supportive environment and promote effective communication and care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. and B. Both options involve getting the patient out of bed for specified periods during the day to prevent excessive sleep during the day and wakefulness at night. However, these options may not align with the patient's preferences and comfort.
C. This option respects the patient's autonomy and acknowledges his preference to remain in bed due to feeling tired and weak. It also recognizes that comfort is a priority in end-of-life care. The nurse will assess the patient's strength and desire to get out of bed but will permit him to remain in bed if he chooses, as that is his position of comfort.
D. Leaving the patient in bed while encouraging active exercises may be physically demanding for the patient and may not be appropriate, especially considering the patient's terminal condition and desire to remain in bed.
Correct Answer is C
Explanation
"Bringing on your death in this manner would be a subject you should discuss with your family and primary care provider" (Option A): While discussing end-of-life wishes with family and healthcare providers is important, this response does not directly address the ethical issue at hand. It may be appropriate to encourage open communication and advance care planning, but administering a deliberate overdose is not ethically permissible.
"Let me have a while to consider your request" (Option B): Delaying a response to the patient's request for deliberate overdose could potentially lead to confusion and distress for the patient. Additionally, this response does not address the ethical concerns raised by the request.
"I cannot ethically give you a deliberate overdose" (Option C): This response aligns with the ethical principle of nonmaleficence, which obligates healthcare providers to avoid causing harm to patients. Administering a deliberate overdose to hasten death would violate this principle and go against the nurse's ethical obligations.
"I can contact the primary care provider and request an order for a drug that could be used as you request" (Option D): This response suggests a willingness to facilitate the patient's request for deliberate overdose, which is not ethically permissible. Administering a drug with the intention of ending a patient's life is contrary to the ethical principles of beneficence and nonmaleficence.
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