The partner of a client with terminal brain cancer asks the nurse about the client's prognosis.
What is the most appropriate response by the nurse to address the partner's concerns?
Try to stay positive: treatment advances quickly.
Focus on making the most of the time you have left together.
Everything happens for a reason: this is just part of life's journey.
Your loved one's prognosis is not good, but we will do our best to make them comfortable.
The Correct Answer is D
End of life communication requires applying principles of therapeutic honesty and empathy. Knowledge of palliative care communication involves providing clear, realistic information about the prognosis while offering emotional support and ensuring the family understands the focus on comfort and dignity.
Choice A rationale
Offering false hope through vague mentions of medical advances is non-therapeutic. It prevents the family from beginning the grieving process and making necessary end of life decisions. Honesty is essential for maintaining trust between the nurse and the family.
Choice B rationale
This response is dismissive and minimizes the partner's distress. While well intentioned, it provides unsolicited advice rather than addressing the actual question about prognosis. It fails to acknowledge the clinical reality of terminal brain cancer and impending loss.
Choice C rationale
Using platitudes or religious generalizations is insensitive and non-therapeutic. It shuts down further communication and may offend the partner. The nurse should avoid imposing philosophical beliefs and instead focus on the patient's actual clinical status and comfort.
Choice D rationale
This response is honest, direct, and compassionate. It acknowledges the terminal nature of the illness while redirecting the focus to the goals of care, which are comfort and symptom management. It supports the family through realistic expectations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
This scenario requires understanding acid-base balance and renal pathophysiology. Acute kidney injury impairs the kidneys ability to excrete hydrogen ions and regenerate bicarbonate. Identifying metabolic acidosis with partial respiratory compensation is necessary based on the interpretation of arterial blood gas values.
Choice A rationale
Metabolic acidosis occurs in kidney injury due to decreased acid excretion. The pH is low at 7.26 (7.35 to 7.45) and bicarbonate is low at 14 (22 to 28), while the PaCO2 of 30 shows compensatory hyperventilation.
Choice B rationale
A pH of 7.26 indicates acidosis, but the normal bicarbonate level of 24 and elevated PaCO2 of 46 indicate respiratory acidosis. This occurs with hypoventilation and carbon dioxide retention rather than the metabolic issues seen in kidney failure.
Choice C rationale
The pH of 7.49 indicates alkalosis. A high bicarbonate of 30 with a normal PaCO2 of 40 represents uncompensated metabolic alkalosis. This is typical of excessive acid loss or base gain, which is opposite of kidney failure.
Choice D rationale
The pH of 7.49 and low PaCO2 of 30 suggest respiratory alkalosis. Bicarbonate is normal at 24. This state results from hyperventilation and excessive carbon dioxide loss, which does not characterize the pathophysiology of acute kidney injury.
Correct Answer is B
Explanation
End-of-life care involves applying principles of bereavement support and cultural sensitivity. Knowledge of post-mortem care and therapeutic communication is necessary. Providing a respectful environment for the family to process their loss is a core nursing responsibility in the hospice setting.
Choice A rationale
. Dismissing visitors due to being busy violates the core tenets of hospice care and bereavement support. The needs of the family are a priority following the death of a patient. Nurses must manage time to allow for family grieving and closure.
Choice B rationale
. Allowing the family to view the body in the room provides a private, familiar, and dignified setting for saying goodbye. This action supports the grieving process and is a standard of care. The room should be prepared to appear peaceful.
Choice C rationale
. Moving the body to the morgue before the family arrives is impersonal and can be distressing. The clinical environment of a morgue is not conducive to healthy grieving. Most facilities allow a period of viewing in the room first.
Choice D rationale
. Telling the family not to come is ethically inappropriate and emotionally harmful. Family presence at the time of death or shortly after is a critical component of the mourning process. Hospice philosophy emphasizes support for the entire family unit..
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