Nokea
An outcome for a patient experiencing anticipatory grieving for a spouse diagnosed with terminal cancer would be that the patient will:
- A. Continue to be emotionally involved with the dying spouse
- B. Develop protective mental mechanisms to allay the pain of spousal loss
- C. Not voice threats of physical violence that is either self or others directed
- D. Agree to stay at home and care for the spouse with appropriate assistance
Correct Answer: A
Rationale: The correct answer is A because anticipatory grieving involves emotional involvement with the dying spouse. This allows the patient to process emotions, express love, and make meaningful connections before the actual loss. Choice B is incorrect as it suggests avoidance of pain through mental mechanisms, which is not conducive to healthy grieving. Choice C is incorrect as it focuses on a specific behavior (violence) rather than the emotional process of grieving. Choice D is incorrect as it assumes the patient's agreement to care for the spouse is the primary outcome, overlooking the emotional aspect of anticipatory grief.
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What is the priority nursing diagnosis for a catatonic patient?
- A. Ineffective coping
- B. Impaired physical mobility
- C. Risk for deficient fluid volume
- D. Impaired social interaction
Correct Answer: C
Rationale: The priority nursing diagnosis for a catatonic patient is Risk for deficient fluid volume (C) because catatonic patients are at risk for dehydration due to decreased fluid intake or inability to meet fluid needs. This diagnosis takes precedence over others as dehydration can lead to serious complications. Ineffective coping (A) may be secondary to the catatonic state but addressing fluid volume is more urgent. Impaired physical mobility (B) and Impaired social interaction (D) are important but not as critical as addressing the risk of dehydration in a catatonic patient.
The common element seen in every type of bereavement is:
- A. Bereavement is a predictable process that is a result of loss.
- B. The individual has experienced the loss of something of importance.
- C. Acute depression is generally experienced by all who grieve for a loss.
- D. Yearning or longing for the deceased
Correct Answer: B
Rationale: The correct answer is B because it captures the essence of bereavement - the experience of loss. This choice acknowledges that bereavement involves losing something significant, which is a universal aspect of grieving. Other choices are incorrect - A is not always predictable, C is not always acute depression, and D focuses on a specific aspect of grief rather than the core element of loss. Therefore, B is the most comprehensive and inclusive choice.
Which patient would the nurse determine to be at highest risk for dysfunctional grief? The patient:
- A. Whose 16-year-old daughter was raped and killed while going on an errand for the patient
- B. Whose 86-year-old mother, with whom she has shared her home, died after a long illness.
- C. Who attended a support group and had been assisted by hospice to care for her terminally
- D. Who attended a bereavement group, where she learned to express feelings after the deaths of her twin daughters
Correct Answer: A
Rationale: The correct answer is A because the patient whose 16-year-old daughter was raped and killed while going on an errand for the patient is at highest risk for dysfunctional grief. This traumatic and unexpected loss of a child to a violent act can lead to complicated or prolonged grief reactions. The sudden and violent nature of the death, along with the added trauma of rape, can significantly impact the grieving process. The intense emotions and feelings of guilt, anger, and helplessness may complicate the bereavement process and lead to dysfunctional grief reactions.
Summary:
Choice B is incorrect because the death of an 86-year-old mother after a long illness, although sad, does not necessarily indicate a higher risk of dysfunctional grief. Choice C is incorrect as attending a support group and receiving assistance from hospice are positive factors that can support healthy grieving. Choice D is incorrect as attending a bereavement group and learning to express feelings after the deaths of twin daughters indicate active engagement in the grieving process, which is
Which physical disturbance is commonly assessed in patients experiencing acute grief?
- A. Tightness in the chest
- B. Hypersomnia
- C. Increased appetite
- D. Cardiovascular problems
Correct Answer: A
Rationale: The correct answer is A: Tightness in the chest. This physical disturbance is commonly associated with acute grief due to the emotional pain experienced. It is a manifestation of the intense feelings of sadness and loss that accompany grief. Tightness in the chest can be a result of the stress response triggered by grief, leading to physical symptoms such as chest pain and difficulty breathing.
Summary:
B: Hypersomnia and C: Increased appetite are more commonly associated with conditions like depression, while D: Cardiovascular problems may be a long-term consequence of chronic stress but are not typically assessed as a primary physical disturbance in acute grief.
The nurse is collecting the paintings from the patients after the art session is over. After art therapy, a patient hands the nurse a paper that consists of several black scribbles. Which statement demonstrates the nurse understands the goals and objectives of the therapy?
- A. “I see that you don’t take this very seriously.”
- B. “Can you tell me what happened to prompt such work?”
- C. “Do you want to complete your painting?”
- D. “That’s interesting. It looks like you’re frustrated.”
Correct Answer: B
Rationale: The correct answer is B because it shows empathy and encouragement for the patient to express their feelings. By asking what prompted the artwork, the nurse demonstrates understanding and willingness to explore the patient's emotions. Choice A is judgmental and dismissive, not fostering a therapeutic relationship. Choice C is directive and may pressure the patient. Choice D makes an assumption about the patient's emotions without allowing them to share their perspective.