A client with end-stage alcoholic cirrhosis of the liver is hesitant to talk about the illness and the impending loss of life from their alcohol use disorder. Which action by the nurse can promote the client's ability to express their feelings?

Option D is the most helpful statement when working with a client who has frequent angry outbursts. It acknowledges that anger is a normal emotion that everyone experiences at times. Additionally, it provides a positive perspective on anger, suggesting that it can be used constructively to solve problems.

Anger itself is not a negative emotion; it becomes problematic when it is expressed inappropriately or disruptively. By validating the client's feelings and reframing anger as a potential tool for problem-solving, the nurse can help the client explore healthier ways to cope with and express their emotions.

Options A, B, and C are not as helpful in this situation:

A. "You can reduce your anger by hitting a punching bag." - While physical activity can help release pent-up emotions, this statement focuses solely on a physical outlet for anger and does not address the underlying issues causing the frequent angry outbursts.

B. "You need to learn how to be less assertive in your communications." - This statement suggests that the client's assertiveness is the problem, which may not be the case. Instead, the nurse should focus on helping the client develop healthier ways to express their emotions and communicate effectively.

C. "You need to learn to suppress these angry feelings." - Encouraging the suppression of emotions is not a healthy coping mechanism. Suppressing anger can lead to increased stress and may result in more intense outbursts later on. The nurse should help the client learn constructive ways to manage and express their anger.

The nurse's feelings of sadness, poor sleep, and mild depression after the death of the terminally ill client indicate that the nurse is experiencing grief, which is a normal reaction to loss. However, if the nurse is finding it difficult to cope with the grief or if the grief is significantly impacting the nurse's daily life and well-being, seeking therapy is the best action.

Option B suggests seeking therapy for dysfunctional grief, which can provide the nurse with professional support and coping strategies to navigate through the grieving process. Therapeutic interventions can help the nurse process the emotions associated with the loss and provide a safe space to express and explore feelings of grief and loss.

Options A, C, and D may be helpful in certain situations, but they may not directly address the nurse's unresolved grief:

A. Taking a leave of absence to pursue healing can be considered if the nurse's grief is severely impacting their ability to function and provide safe patient care. However, it may not be necessary for everyone, and seeking therapy would be a more specific and targeted approach to address the grief.

C. Using stress reduction strategies can be beneficial for managing stress and promoting overall well-being, but it may not directly address the specific grief experienced by the nurse after the client's death.

D. Seeking an informal forum for discussing death can be helpful in processing feelings and emotions related to death and loss. However, it may not provide the level of support and guidance that therapy can offer in resolving grief.