The nurse is speaking with the spouse of a client following a family discussion with the healthcare provider about the client’s terminal condition and eligibility for hospice care. The spouse states, "I don't think I can make this decision right now. What would you do?" How should the nurse respond?
"I find it helpful to investigate the options. I will get you a pamphlet about hospice care."
"You seem overwhelmed. I’ll contact a chaplain to come and talk with you about the options."
"It’s hard to say what the best decision is, but know hospice provides wonderful care."
"These decisions are challenging. Tell me your spouse’s beliefs about end-of-life."
The Correct Answer is D
Choice A reason: Offering information is supportive, but this does not address the spouse’s emotional needs or encourage discussion about the client’s values.
Choice B reason: Calling a chaplain might be supportive later, but it avoids addressing the spouse’s statement directly and risks shifting responsibility away from the nurse.
Choice C reason: Reassurance without exploring the client’s and family’s values minimizes the spouse’s need for deeper reflection and personal decision-making.
Choice D reason: Encouraging the spouse to reflect on the client’s beliefs and values promotes autonomy and supports decision-making that honors the client’s wishes, making it the most therapeutic response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: When anxiety is severe, the client cannot focus or process complex discussions. Asking them to explore worries may overwhelm them further.
Choice B reason: Providing extensive information is inappropriate in crisis moments because the client’s concentration and comprehension are impaired.
Choice C reason: Clear, calm, and brief communication helps reduce overstimulation, provides structure, and reassures the client during high anxiety. This is the most therapeutic choice.
Choice D reason: Rapid statements can escalate the client’s sense of being overwhelmed, increasing anxiety rather than calming it.
Correct Answer is A
Explanation
Choice A reason: This presentation is consistent with neuroleptic malignant syndrome (NMS), a rare but life-threatening reaction to antipsychotics characterized by severe muscle rigidity, hyperthermia, altered mental status, and autonomic dysfunction. Immediate discontinuation of the drug and emergency treatment are required.
Choice B reason: Restlessness and inability to sit still are signs of akathisia, an extrapyramidal side effect of antipsychotics. While distressing and requiring management, it is not life-threatening compared to NMS.
Choice C reason: A flat affect and reduced speech are negative symptoms of schizophrenia and may persist despite treatment. These are concerning for quality of life but do not require urgent medical intervention.
Choice D reason: Mild weight gain is a known side effect of many antipsychotics. It should be monitored and managed with lifestyle modifications but does not represent an immediate threat.
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