Exhibits

Complete the following sentence by using the list of options.

Mrs. Thompson is at high risk for developing

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evidenced by the client's

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Mrs. Thompson is at high risk for developing pressure sores evidenced by the client's end-of-life stage and deteriorating condition.

Emotional distress. While emotional distress is common in end-of-life patients, Mrs. Thompson has already expressed her wishes for a peaceful, pain-free death and has family support for decision-making. Emotional distress is not the primary risk factor for physical complications such as pressure sores.

Dehydration. Decreased oral intake is expected in the end-of-life stage, but dehydration does not directly cause pressure sores. While maintaining comfort is important, forced hydration is often avoided as it may not improve the patient’s quality of life.

Pressure sores. Mrs. Thompson’s declining condition and decreased mobility put her at high risk for developing pressure sores. Limited movement reduces circulation to pressure points such as the heels and sacrum, leading to tissue breakdown. Preventive measures such as repositioning and skin care should be prioritized.

Frequent movement and activity. This is incorrect because frequent movement reduces the risk of pressure sores by promoting circulation and relieving pressure on bony areas. Mrs. Thompson's deteriorating condition likely limits her mobility, making this choice inappropriate.

Ability to communicate their needs. This is incorrect because even if a patient can verbalize discomfort, they may still be unable to move independently. Pressure sores develop primarily due to immobility rather than communication barriers.

End-of-life stage and deteriorating condition. This is correct because patients nearing the end of life experience profound weakness, reduced circulation, and prolonged immobility, all of which increase the risk of pressure sores. These factors make skin breakdown prevention a key nursing priority.

The nurse identifies that the client is currently in Kübler-Ross's anger stage of grief as evidenced by feeling like life is not fair.

Anger. In this stage, individuals express frustration, resentment, or questioning of fairness. The client’s statement, "Why is this happening to me? I have always been healthy," reflects anger and a sense of injustice regarding their diagnosis. The refusal of medications and care further supports emotional distress and resistance.

Denial and Isolation. This stage is characterized by disbelief regarding the diagnosis or refusal to accept reality. On Day 1, the client questioned the accuracy of their test results, suggesting denial. However, by Day 3, their emotions had shifted to frustration, making denial no longer the most fitting condition.

Bargaining. This stage involves making deals with a higher power or attempting to negotiate for more time or a different outcome. The client has not displayed behaviors indicative of bargaining, such as promising to change habits or seeking alternative treatments.

Acceptance. Acceptance is marked by established methods of coping and coming to terms with the diagnosis. The client is still struggling emotionally, refusing care, and expressing frustration, which indicates they have not yet reached this stage.

Depression. This stage is characterized by feelings of deep sadness for potential missed experiences. The client’s emotional response is more aligned with anger rather than deep sorrow, withdrawal, or despair, which are typical signs of depression in the grieving process.