The nurse is caring for client who is experiencing extreme sadness after the passing of a companion of 30 years. The client describes not being able to think of other things and finds it difficult to control emotions. Which action should the nurse take first?

Offer a referral to pastoral counseling.

Suggest the need for a psychiatric consultation.

Explore changes in life that have occurred after the loss.

Encourage attending a local support group.

Answer and Explanation

The Correct Answer is C

A) Offering a referral to pastoral counseling can be helpful, but it may not address the immediate emotional needs of the client who is experiencing extreme sadness and difficulty controlling emotions. This option can be considered later in the therapeutic process.

B) Suggesting the need for a psychiatric consultation might be appropriate, but it could be premature at this point. The focus should first be on understanding the client’s current emotional state and helping them process their grief.

C) Exploring changes in life that have occurred after the loss is the first and most important action. This approach allows the nurse to facilitate the client’s expression of feelings, which is crucial in the grieving process. By discussing the impact of the loss, the nurse can provide emotional support and help the client begin to process their grief.

D) Encouraging attendance at a local support group can be beneficial, but it may not be the most immediate action. The client needs to be heard and understood in their current emotional state before considering additional resources or support systems.

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Correct Answer is C

Explanation

(A) Explain that these beliefs are related to her illness:While it is important to educate the client about their illness, directly challenging their delusions may increase distrust and anxiety. This approach might make the client feel misunderstood and less likely to trust the nurse.

(B) Explain that distrust is related to feeling anxious:This explanation might not be well-received by the client and could be perceived as dismissive of their concerns. It may not effectively address the client’s immediate need for trust and reassurance.

(C) Initiate short, frequent contacts with the client:This approach helps build trust through consistent and reliable interactions. It allows the nurse to establish a rapport without overwhelming the client, thereby promoting a sense of safety and trust. Regular, brief interactions can help the client feel more comfortable and secure.

(D) Offer to keep the belongings at the nurse’s desk:This action might be perceived as an attempt to take control of the client’s belongings, which could reinforce their delusions and decrease trust. It is important to respect the client’s need to keep their belongings close to them.

A. Clarifying the nurse's role and clients' responsibilities. B. Discussing ways to use new coping skills learned. C. Helping clients identify areas of problem in their lives. D. Establishing a rapport with group members.

Correct Answer is B

Explanation

A) Clarifying the nurse's role and clients' responsibilities is important but is typically more relevant during the initial stages of group development, specifically in the forming phase. By the working phase, roles should already be established.

B) Discussing ways to use new coping skills learned is the most appropriate approach during the working phase of group development. This phase is characterized by active engagement and collaboration among group members as they explore and practice the skills they’ve learned. It encourages growth and fosters a supportive environment for applying new strategies.

C) Helping clients identify areas of problem in their lives is an essential aspect of group therapy but is often emphasized during earlier phases when members are becoming familiar with each other and establishing trust. In the working phase, the focus shifts toward solutions and skill application.

D) Establishing rapport with group members is crucial in the forming phase of group development. By the working phase, rapport should be well established, allowing for deeper discussions and engagement in the therapeutic process. Therefore, focusing on new coping skills is more aligned with the goals of this phase.

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The nurse is caring for client who is experiencing extreme sadness after the passing of a companion of 30 years. The client describes not being able to think of other things and finds it difficult to control emotions. Which action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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