A client with terminal cancer has been told he has 3–4 months to live. Which of the following would indicate to the nurse that further interventions are needed?
The client is reviewing his life and talking about death.
The client says he wants to live life to the fullest.
The client hopes for a peaceful and dignified death.
The client says he is well and is making future plans.
The Correct Answer is D
Choice A reason: Reviewing life and discussing death are signs of acceptance and psychological processing. These behaviors are consistent with the tasks of dying, such as life review and meaning-making. They do not indicate denial or maladaptive coping, and thus do not require urgent intervention.
Choice B reason: Expressing a desire to live life to the fullest reflects a positive coping strategy. It suggests that the client is engaging with the time remaining in a meaningful way. This attitude supports emotional well-being and does not signal a need for corrective intervention.
Choice C reason: Hoping for a peaceful and dignified death is a realistic and healthy expectation for someone with terminal illness. It reflects acceptance and a desire for comfort-focused care. This statement aligns with palliative goals and does not indicate psychological distress.
Choice D reason: Saying he is well and making future plans may suggest denial or lack of acceptance of the prognosis. While hope is important, unrealistic expectations can interfere with end-of-life planning, emotional preparation, and appropriate use of palliative resources. This response warrants further assessment to ensure the client understands his condition and is emotionally supported.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Displaying one type of expression, such as a serious or somber look, may suggest a restricted affect, but it does not capture the slowed or minimal responsiveness seen in blunted affect. Blunted affect involves more than just limited variety—it includes reduced intensity and delayed emotional expression.
Choice B reason: A full range of emotional expressions indicates a normal affect. This is the opposite of blunted affect, which is characterized by diminished emotional responsiveness. Therefore, this choice is incorrect.
Choice C reason: Showing no facial expression is more consistent with flat affect, which is a more severe reduction in emotional expression than blunted affect. Blunted affect allows for minimal or slow responses, not complete absence.
Choice D reason: Blunted affect refers to a noticeable reduction in the intensity and speed of emotional expression. The client may show delayed or minimal facial responses to emotional stimuli. This is a hallmark of certain psychiatric conditions such as schizophrenia or major depressive disorder.
Correct Answer is D
Explanation
Choice A reason: Referring the client to a rape crisis hotline is an important part of the long-term support plan, but it is not the initial nursing action. At the moment of presentation, the client is likely in acute psychological distress and may not be ready to process external resources. Immediate emotional stabilization and safety are prioritized before referrals.
Choice B reason: Encouraging the client to file charges immediately may be perceived as coercive and can further traumatize the individual. Legal decisions should be client-led and made when the person feels emotionally safe and supported. Pushing for legal action prematurely can compromise therapeutic rapport and the client's sense of control.
Choice C reason: Performing a nursing history and physical is necessary, especially for forensic and medical documentation. However, it should only be done after establishing trust and emotional safety. Jumping into assessments without first addressing the client’s emotional state can be retraumatizing and may hinder cooperation.
Choice D reason: Providing emotional support is the most appropriate initial nursing action. It helps stabilize the client, validates their experience, and builds trust. Emotional support includes active listening, nonjudgmental presence, and reassurance of safety. This foundation allows for subsequent steps like medical evaluation and legal options to be introduced in a trauma-informed manner.
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