A client’s spouse has just learned of the client’s terminal illness. The spouse is sitting in the corner of the client’s room crying and says to the nurse, “I feel as if I’m already so alone.” Which action should the nurse take first?

Explain that alternative treatment options may be helpful.

Encourage the spouse to share their feelings.

Remind the spouse that the client may still live a long time.

Offer reassurance that the spouse is not alone.

Answer and Explanation

The Correct Answer is B

Choice A reason: Explaining treatment options is premature and clinical, not addressing the spouse’s emotional loneliness. Encouraging feelings validates their distress, building trust. Treatment discussions can follow after emotional support, ensuring family-centered care, per palliative care and therapeutic communication principles in terminal illness scenarios.

Choice B reason: Encouraging the spouse to share feelings directly addresses their expressed loneliness, promoting therapeutic communication. This validates emotions, assesses coping needs, and fosters rapport, prioritizing psychosocial support in terminal illness. It aligns with family-centered care and palliative nursing principles, ensuring emotional needs are met first.

Choice C reason: Reminding the spouse of potential longevity dismisses their current grief, minimizing feelings. Encouraging emotional expression better supports their immediate needs. This response risks invalidating the spouse’s experience, delaying emotional processing, per psychosocial support and grief management principles in palliative care settings.

Choice D reason: Offering reassurance that the spouse is not alone is supportive but less immediate than exploring feelings. Encouraging emotional expression better assesses their needs, guiding tailored support. Reassurance may seem dismissive without first validating emotions, per therapeutic communication and family support standards in palliative care.

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Correct Answer is C

Explanation

Choice A reason: Waiting for visible blood is incorrect, as occult blood tests detect microscopic bleeding not visible to the eye. Soft, light brown stool is suitable for testing. Delaying risks missing early gastrointestinal bleeding, per diagnostic testing and colorectal screening protocols in nursing practice.

Choice B reason: Withholding collection until tarry black stool appears is wrong, as occult blood tests identify hidden blood, not overt melena. Light brown stool is appropriate for testing. Waiting delays diagnosis of potential bleeding sources, per gastrointestinal assessment and occult blood testing standards in medical care.

Choice C reason: Obtaining the specimen from the current soft, solid, light brown stool is correct, as occult blood tests detect microscopic blood in normal-appearing feces. This ensures timely screening for gastrointestinal bleeding, guiding diagnosis and treatment, per evidence-based practice and diagnostic testing protocols in nursing.

Choice D reason: Contacting the provider before collecting the specimen is unnecessary, as soft, light brown stool is suitable for occult blood testing. Routine collection is within nursing scope, and delays may miss early bleeding. This aligns with standard diagnostic procedures, per gastrointestinal and nursing care guidelines.

A. Document HCP’s refusal to honor client’s wishes. B. Notify the hospital ethical committee to assist with client’s wishes. C. Facilitate a meeting between the HCP and the spouse. D. Have resuscitation equipment readily available.

Correct Answer is B

Explanation

Choice A reason: Documenting the HCP’s refusal is necessary but passive, not addressing the ethical conflict. Notifying the ethics committee actively advocates for the client’s wishes, ensuring the living will is reviewed. Documentation alone delays resolution, per ethical decision-making and patient autonomy standards in nursing.

Choice B reason: Notifying the hospital ethics committee is the priority, as it ensures an impartial review of the HCP’s refusal to honor the living will. This advocates for the client’s autonomy, resolving ethical conflicts and upholding advance directives, per bioethics and patient rights standards in healthcare.

Choice C reason: Facilitating a meeting may help communication but does not resolve the HCP’s refusal to honor the living will. The ethics committee provides formal mediation, ensuring the client’s wishes are upheld. A meeting alone risks ongoing conflict, per ethical conflict resolution and nursing advocacy principles.

Choice D reason: Having resuscitation equipment available contradicts the client’s natural death wish in the living will. Notifying the ethics committee supports the client’s autonomy, preventing unwanted interventions. This action disregards advance directives, per end-of-life care and ethical nursing practice standards.

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A client’s spouse has just learned of the client’s terminal illness. The spouse is sitting in the corner of the client’s room crying and says to the nurse, “I feel as if I’m already so alone.” Which action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While preparing to obtain a stool specimen for occult blood, the nurse observes that the client’s feces is soft, solid, and light brown. Which action should the nurse implement?

Correct Answer is C

Explanation

Correct Answer is B

Explanation

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