Nokea
A client diagnosed with incurable cancer has a life expectancy of a few weeks. Which response indicates that the client's partner is reacting with an expected coping response?
- A. Refusing to visit the client
- B. Expresses anger with his God
- C. Not allowing the death to occur at home
- D. Sending the children to live with relatives
Correct Answer: B
Rationale: Anger is a normal stage of the grieving process and is an expected coping response when facing the imminent loss of a loved one. Expressing anger toward a spiritual entity, such as God, is a common way for individuals to process their grief. Refusing to visit the client indicates avoidance or denial, which may not be constructive. Not allowing the death to occur at home or sending children to live with relatives may reflect practical decisions but do not directly indicate an expected emotional coping response related to grief.
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The nurse is caring for a depressed, withdrawn client who was responsible for an automobile accident that recently resulted in the death of a child. What is the nurse's initial action?
- A. Allow the client to have some time alone to grieve over the loss.
- B. Reinforce to the client that the child's death was a result of an accident.
- C. Communicate in a manner that acknowledges and respects the client's depressed state.
- D. Inform the primary health care provider of the client's possible need for medication to cope.
Correct Answer: C
Rationale: The nurse's initial intervention is to encourage the client to express feelings, which is facilitated by establishing a nurse-client relationship that is based upon respect. The correct option validates the perception that the client is depressed. This action also allows the nurse to assess the situation. Options 1, 2, and 4 address interventions before assessing the situation and identifying the client's actual needs.
A client and her infant have been diagnosed as being positive for human immunodeficiency virus (HIV). When the mother is observed crying, the nurse determines that which intervention will meet the client's initial needs?
- A. Discussing how the mother was exposed to HIV
- B. Sitting quietly with the mother as she talks and cries
- C. Describing the progressive stages and treatments of HIV
- D. Calling an HIV counselor to make an appointment for the mother and infant
Correct Answer: B
Rationale: This client has just received devastating news and needs to have someone present with her as she begins to cope with this issue. The nurse needs to sit and actively listen while the mother talks and cries. Examining the mother and describing the progression and treatment of HIV is not appropriate for this stage of coping. Calling an HIV counselor may be helpful, but it is not what the client needs initially.
The nurse admits a client who is demonstrating right-sided weakness, aphasia, and urinary incontinence. The woman's daughter states, 'If this is a stroke, it's the kiss of death.' What initial response should the nurse make?
- A. Why would you think like that?'
- B. You feel your mother is dying?'
- C. These symptoms are reversible.'
- D. A stroke is not the kiss of death.'
Correct Answer: B
Rationale: Option 2 allows the daughter to verbalize her feelings, begin coping, and adapt to what is happening. By restating, the nurse seeks clarification of the daughter's feelings and offers information that potentially helps ease some of the fears and concerns related to the client's condition and prognosis. Option 1 is a disapproving comment that is likely to interfere with communication. Option 3 is potentially misleading and offers false hope. The nurse could reflect back the statement in option 4 to the daughter to promote communication. However, as it stands, option 4 is a barrier to communication that contradicts the daughter's feelings.
The nurse cared for a client who died a few minutes ago. Which event supports the nurse's belief that the client died with dignity?
- A. The family thanks the nurse for facilitating such a peaceful death.
- B. The nurse states that it is difficult to give that kind of care to a dying client.
- C. The primary health care provider acknowledges that all of the prescriptions were carried out.
- D. The nurse kept the client's last hours comfortable with increasing doses of pain medication.
Correct Answer: A
Rationale: The family response is an external perception, and it is extremely important. Families derive a great deal of comfort from knowing that their loved one received the best care possible. The correct option provides external validation that the client received comprehensive, quality care. Option 2 focuses on the feelings of the nurse, who may be expressing his or her own anxiety. Option 3 focuses on the provider's prescriptions rather than client care. Option 4 reflects on only one aspect of the care of a dying client.
A community health nurse is caring for a group of homeless people. What is the most immediate concern when planning for the potential needs of this group?
- A. Finding affordable housing for the group
- B. Setting up a 24-hour crisis center and hotline
- C. Providing peer support through structured support groups
- D. Ensuring that adequate food, shelter, and clothing are available
Correct Answer: D
Rationale: The question asks about the situation's most immediate concern. The initial community health concern is always attending to people's basic physiological needs of food, shelter, and clothing. Finding affordable housing and providing crisis intervention and peer support are meaningful interventions that may be completed at a later time.