A nurse is caring for a client who has a new diagnosis of bladder cancer. Which of the following interventions should the nurse take to promote comfort?

Choice A reason : Denial is the first stage of the Kübler-Ross model of grief. In this stage, individuals believe the diagnosis is somehow mistaken, and cling to a false, preferable reality. It is a defense mechanism that buffers the immediate shock of the loss, numbing us to our emotions.

Choice B reason : Anger is the second stage of grief. As the masking effects of denial begin to wear off, reality and its pain re-emerge. The intense emotion is deflected from our vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends, or family.

Choice C reason : Bargaining is the third stage. It involves the hope that the individual can avoid a cause of grief. Usually, the negotiation for an extended life is made with a higher power in exchange for a reformed lifestyle.

Choice D reason : Acceptance is the final stage of grief. In this stage, individuals embrace mortality or the inevitable future, or that of a loved one, or other tragic event. People dying may precede the survivors in this state, which typically comes with a calm, retrospective view for the individual, and a stable condition of emotions.

Choice A reason : Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. While the causes of ADHD are not fully understood, current research does not establish childhood obesity as a direct risk factor for developing ADHD. ADHD is thought to be linked to genetic factors and certain environmental exposures during pregnancy.

Choice B reason : Hypotension, or low blood pressure, is generally not associated with childhood obesity. In fact, obesity, especially in the long term, is more commonly linked to hypertension (high blood pressure) due to increased strain on the heart and blood vessels, and not hypotension.

Choice C reason : Rheumatoid arthritis is an autoimmune condition that causes joint inflammation and damage. It is not typically considered a direct complication of childhood obesity. While obesity can contribute to joint problems due to increased mechanical stress, it is not a known cause of autoimmune conditions like rheumatoid arthritis.

Choice D reason : Diabetes mellitus, particularly type 2 diabetes, is a well-documented potential complication of childhood obesity. Obesity increases the risk of developing insulin resistance, which can lead to elevated blood sugar levels and eventually type 2 diabetes. The excess fat, particularly visceral fat, is associated with chronic inflammation and metabolic changes that contribute to the development of diabetes⁴.