A nurse is caring for a client diagnosed with end-stage liver cancer. Which response is an indication the client is in the denial phase of the grief process?
“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 the doctor graduated from medical school. He doesn’t know a thing about treating cancer!”
“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 Correct Answer is A
Choice A reason: This statement reflects denial, which is a common initial reaction in the grief process. The client is not accepting the reality of their prognosis and believes the doctor is exaggerating. Denial serves as a defense mechanism to protect the individual from the emotional impact of the diagnosis. It is a way for the client to cope with the overwhelming news by rejecting its truth.
Choice B reason: This statement reflects anger, another stage in the grief process. The client is expressing disbelief and frustration towards the doctor’s competence. Anger often follows denial and is directed towards others as a way to cope with the emotional pain. It is not indicative of denial but rather a progression in the grieving process.
Choice C reason: This statement reflects acceptance of the physical symptoms and the reality of the client’s condition. The client acknowledges their lack of energy and the impact of the illness on their daily life. This is not a sign of denial but rather an acceptance of their current state.
Choice D reason: This statement reflects acceptance and gratitude towards the doctor. The client recognizes the efforts made by the healthcare team and accepts that their time is limited. This is a sign of acceptance, the final stage in the grief process, where the individual comes to terms with their situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Losing weight is one of the most effective ways to reduce the severity of obstructive sleep apnea (OSA). Excess weight, especially around the neck, can increase the risk of airway obstruction during sleep. Studies have shown that losing even 5-10% of body weight can significantly improve OSA symptoms. Therefore, the statement about losing 50 pounds indicates a good understanding of how weight loss can help manage sleep apnea.
Choice B Reason:
Taking a sleeping pill at night is not recommended for individuals with obstructive sleep apnea. Many sleeping pills, especially those that are sedatives or muscle relaxants, can worsen sleep apnea by relaxing the muscles of the throat, leading to increased airway obstruction. Therefore, this statement does not indicate an understanding of the appropriate management of sleep apnea.
Choice C Reason:
Using a humidifier can help alleviate some symptoms associated with sleep apnea, such as dry mouth and nasal congestion, but it does not directly reduce the number of apneic episodes. While a humidifier can improve comfort, it is not a primary treatment for reducing apneic episodes in OSA patients.
Choice D Reason:
Sleeping on the back is generally not recommended for individuals with obstructive sleep apnea. This position can cause the tongue and soft tissues to collapse to the back of the throat, worsening airway obstruction. Side sleeping is usually recommended to help keep the airway open. Therefore, this statement does not indicate an understanding of the best sleep practices for managing sleep apnea.
Correct Answer is A
Explanation
Choice A reason: Encouraging the patient to drink more fluids is a primary intervention for managing thick respiratory secretions. Adequate hydration helps to thin the mucus, making it easier to expectorate. Fluids such as water, herbal teas, and clear broths are particularly effective. The normal daily fluid intake for an adult is about 2-3 liters, depending on individual needs and health conditions.
Choice B reason: Getting a prescription for an antitussive agent is not the best initial approach for managing thick respiratory secretions. Antitussive agents are used to suppress coughing, which can be counterproductive when trying to clear mucus from the respiratory tract. Instead, expectorants or mucolytics are more appropriate as they help to thin and loosen the mucus.
Choice C reason: Teaching effective deep breathing is beneficial for overall lung health and can help in mobilizing secretions. However, it is not as immediately effective as increasing fluid intake for thinning thick secretions. Deep breathing exercises can be part of a comprehensive respiratory care plan but should be combined with other interventions like hydration.
Choice D reason: Changing the patient’s position every 2 hours is a good practice for preventing complications such as pressure ulcers and promoting lung expansion. However, it is not specifically targeted at thinning thick respiratory secretions. Positional changes can aid in the drainage of secretions but are secondary to ensuring adequate hydration.
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