Nokea
A patient's fianc?© died in an automobile accident several days ago. The patient reports crying and experiencing feelings of guilt and anger. This behavior is characteristic of which aspect of grief?
- A. Denial
- B. Reorganization
- C. Development of awareness
- D. Preoccupation with the loss
Correct Answer: C
Rationale: As denial fades, an awareness of the finality of the loss develops and is accompanied by painful feelings of loss, anger with others, and guilt for taking or not taking specific actions.
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As death approaches, a patient diagnosed with acquired immunodeficiency syndrome (AIDS) says, 'I don't want to see a lot of visitors anymore. Just my parents and my sibling can come in for a while each day.' What action should the nurse take?
- A. Ask the patient to reconsider the decision because many interested and caring friends can be sources of support.
- B. Discuss the request with the parents and sibling. Suggest that they explain the patient's decision to friends.
- C. Suggest that the patient discuss these wishes with the health care provider.
- D. Place a 'no visitors' sign on the patient's door.
Correct Answer: B
Rationale: As many patient's approach death, they begin to withdraw. The correct response demonstrates the nurse's advocacy for the patient's preferences.
After the death of his wife, a man tells the nurse, 'I can't live without her. She was my whole life.' Which is the nurse's most therapeutic reply?
- A. Each day will get a little better.'
- B. Her death is a terrible loss for you.'
- C. Remember, she's no longer suffering.'
- D. Your friends will help you cope with this.'
Correct Answer: B
Rationale: The correct response demonstrates the use of reflection, a therapeutic communication technique. A statement that validates the bereaved person's loss is more helpful than clich?©s and it signifies understanding.
Which actions by a nurse contribute to protecting the rights of patients who are terminally ill? (Select all that apply.)
- A. Maintain hope for a positive prognosis.
- B. Hug the patient when sadness is expressed.
- C. Offer choices that promote personal control.
- D. Provide interventions that convey respect.
- E. Support the patient's quest for spiritual growth.
Correct Answer: C,D,E
Rationale: The answers support the rights of the individual who is dying. Offering choices, providing respectful interventions, and supporting spiritual growth respect the patient's autonomy and dignity.
A nurse manager notices that a staff member spends minimal time with a patient diagnosed with AIDS who is terminally ill. The patient says, 'I'm having intense emotional reactions to this illness. Sometimes I feel angry, but other times I feel afraid or abandoned.' The nurse manager can correctly hypothesize that the most likely reason for the staff member's avoidance is triggered by what?
- A. Fear of infection transmission.
- B. Feelings of inadequacy in dealing with complex emotional needs.
- C. Belief that the patient needs time alone with family and friends.
- D. Knowledge that the patient's former lifestyle included high-risk behaviors.
Correct Answer: B
Rationale: Many nurses tend to be more comfortable with meeting physical needs than in focusing on complex emotional needs.
A woman whose husband is terminally ill says, 'I don't want to cry in front of him. I don't want him to know how soon death will occur or how sad I am.' Which response by the nurse would be most therapeutic?
- A. I'm glad you are protecting him at a time when he is so vulnerable.'
- B. He might be more comforted than disturbed by your tears.'
- C. It's important for you to know that time is running out.'
- D. You definitely need to be honest about your feelings.'
Correct Answer: B
Rationale: Emotional honesty is important to both the patient and the family. The patient may be comforted to know that the family is facing the inevitable.