A home health nurse is visiting a client who has a terminal illness.
Which of the following statements by the client indicates a feeling of loss of control?
"I hope I have enough money saved to pay for the medications I need.”.
"I should feel more grateful for my family and friends who are coming to visit.”.
"I don't think I did anything to deserve this.
I tried to live a good life.”.
"I don't have much say in what's happening anymore.”.
The Correct Answer is D
Choice A rationale
While financial concerns are stressful, they represent a concrete problem to be solved and don't necessarily reflect a loss of personal agency or autonomy. This statement indicates worry about a specific external resource rather than a global feeling of powerlessness. The client retains control over how they manage their finances, even if the situation is challenging.
Choice B rationale
Expressing gratitude, or a perceived lack thereof, points toward an emotional or spiritual struggle. The client feels they are not meeting an internal standard, but this is a self-evaluation, not a statement of being controlled by external forces. They still have the ability to choose how they feel and how they express their emotions.
Choice C rationale
This statement reflects a spiritual or existential crisis, questioning the fairness of their situation. It is a search for meaning and a struggle with the concept of justice. The client is reflecting on past actions and their current circumstances, but this does not directly indicate a loss of control over their present life.
Choice D rationale
This statement directly addresses a lack of personal autonomy and agency. A feeling of "not having much say" is a direct expression of being controlled by external forces, which is a hallmark of the psychological experience of loss of control. This feeling is particularly common in terminal illness where the disease process dictates many outcomes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C"]
Explanation
Choice A rationale
A history of alcohol use disorder in a parent is a significant risk factor for child abuse. Substance abuse can impair judgment, increase impulsivity, and reduce the parent's ability to cope with stress, leading to a higher potential for neglect or physical abuse. The chronic nature of the disorder creates an unstable and often dangerous home environment.
Choice B rationale
The child spending weekends with grandparents provides a protective factor, not a risk factor. It offers the child a safe and nurturing environment away from potential stressors or abuse at home. It also allows for an extended support system that can provide stability and an opportunity for the child to disclose any abuse, which is a key protective mechanism.
Choice C rationale
When one parent appears frightened of the other, it can indicate a dynamic of domestic violence within the home. This creates an atmosphere of instability and fear, which can be a direct risk factor for both emotional and physical abuse of the child. A child exposed to intimate partner violence is also at increased risk for direct abuse.
Choice D rationale
While financial instability can cause stress, it is not a direct and sole indicator of child abuse. Many financially unstable families provide a safe and loving environment. However, when combined with other risk factors, financial stress can exacerbate existing family dysfunctions and increase the risk for abuse, but on its own, it is not a primary finding.
Choice E rationale
Having an indoor cat that sleeps with the child is a normal household dynamic and does not pose a risk for child abuse. This finding is unrelated to the family's psychosocial stressors or potential for violence. It is an innocuous detail about the family's living situation and does not align with established indicators of child abuse or neglect.
Correct Answer is D
Explanation
Choice A rationale
Imaginary play, or parallel play, is a developmental milestone that typically emerges in toddlers. However, they usually engage in solitary play alongside other children, but without direct interaction. Collaborative imaginary play with other children is a more advanced social skill that typically develops during the preschool years, not during the toddler stage.
Choice B rationale
Toddlers require a significant amount of sleep to support their rapid physical and cognitive development. They typically need 11 to 14 hours of sleep per 24-hour period. This usually includes a long overnight sleep and one or two short nap periods during the day, which are essential for rest and consolidation of learning.
Choice C rationale
The ability to use safety scissors to cut out simple shapes is a fine motor skill that requires more advanced dexterity and hand-eye coordination than a typical toddler possesses. This developmental milestone is usually achieved by preschoolers, around 4 to 5 years of age. Toddlers have not yet developed the necessary coordination for this task.
Choice D rationale
The ability to feed oneself with a spoon is a common developmental milestone for toddlers, typically emerging around 15 to 18 months of age. This skill reflects improvements in their fine motor control and hand-eye coordination. Toddlers are still learning and may be messy, but they are generally capable of this self-feeding behavior.
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