A nurse is caring for a client whose partner has recently died. The client ‘’I am learning how to pay my own bills.’’ The nurse should identify that the client is experiencing which of the following tasks in Worden’s Four Tasks of Grieving?

Experiencing the pain of grief

Finding an enduring connection while embarking on a new life

Accepting the reality of the loss

Adjusting to an environment without the deceased

Answer and Explanation

The Correct Answer is D

A) Experiencing the pain of grief:
Experiencing the pain of grief is one of the early stages of mourning, according to Worden's tasks of grieving. This task involves confronting and processing the emotional pain and sorrow that accompany the loss. However, the statement provided by the client — "I am learning how to pay my own bills" — suggests they are adapting to life changes and responsibilities, which is more aligned with the later stages of grieving. This does not reflect the immediate pain of grief, but rather a focus on adjusting to life after the loss.

B) Finding an enduring connection while embarking on a new life:
Finding an enduring connection while embarking on a new life refers to the task of establishing a continued relationship with the deceased, while simultaneously moving forward with one's life. While this task is essential in the long-term grieving process, it does not directly relate to the client's statement, which focuses on practical changes, such as learning to manage finances, rather than a spiritual or emotional connection with the deceased.

C) Accepting the reality of the loss:
Accepting the reality of the loss is another important task in Worden’s model. This involves coming to terms with the fact that the loved one is gone. However, the client's focus on learning practical tasks like paying bills indicates that they are already moving beyond the initial stages of grief, not just accepting the loss. The statement does not clearly indicate that the client is still in the phase of accepting the reality of the loss, but rather adjusting to the changes that the loss has brought.

D) Adjusting to an environment without the deceased:
The client's statement, "I am learning how to pay my own bills," suggests they are taking on new responsibilities and adjusting to the changes brought about by the death of their partner. This aligns with Worden’s task of adjusting to an environment without the deceased, which includes taking on new roles and responsibilities that the deceased partner previously managed, such as financial tasks, household duties, and other life changes.

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Correct Answer is D

Explanation

A) Place the client on a low-fiber diet:
A low-fiber diet is not recommended for patients experiencing constipation. Fiber plays a key role in bowel regularity by absorbing water and adding bulk to stool, which promotes movement through the intestines. In fact, a high-fiber diet (from fruits, vegetables, whole grains, and legumes) is usually recommended for clients with constipation. Reducing fiber intake can worsen constipation and should be avoided unless otherwise directed by a healthcare provider for specific conditions (e.g., during acute exacerbations of inflammatory bowel disease).

B) Request a prescription for a mineral oil for the client:
Mineral oil is a laxative that is sometimes used to relieve constipation, but it is typically used only for short-term relief and under specific circumstances. Long-term use of mineral oil can interfere with the absorption of fat-soluble vitamins (A, D, E, and K) and can also lead to a lipid pneumonia if aspirated. It is not the first-line intervention for a patient on bed rest with constipation and should not be used indiscriminately without a provider's recommendation.

C) Encourage the client to drink cold fluids:
While fluid intake is essential for managing constipation, it is not specifically the temperature of the fluid that makes a difference. Both cold and room temperature fluids are effective, but encouraging the client to increase fluid intake overall is the most important action. Water is particularly helpful, as it helps soften stool and aids in the movement through the colon.

D) Increase the client's fluid intake:
Increasing fluid intake is the most effective intervention for constipation, especially for a client on bed rest. Adequate hydration helps to soften stool and can promote more regular bowel movements. Inactive individuals, such as those on bed rest, are more prone to constipation because of decreased physical activity and potentially insufficient fluid intake.

A. Trough B. Peak C. Half-life D. Toxic

Correct Answer is A

Explanation

A) Trough:
The trough level refers to the lowest serum concentration of a medication in the bloodstream, typically measured just before the next dose is administered. This point is crucial for ensuring that drug levels remain within the therapeutic range and for avoiding toxicity. Monitoring the trough level helps healthcare providers determine whether the medication is being cleared appropriately from the system and whether dosage adjustments are needed.

B) Peak:
The peak level is the highest concentration of the medication in the bloodstream, typically measured shortly after the medication is administered. This is the opposite of the trough level. The peak level is important for assessing the maximum therapeutic effect of the medication but does not reflect the lowest concentration.

C) Half-life:
The half-life of a medication is the time it takes for the serum concentration of the drug to decrease by half. While it provides useful information about how long a drug stays in the body, it is not related to the lowest concentration of the drug. The half-life influences dosing intervals but is not directly tied to the concept of trough levels.

D) Toxic:
Toxic levels refer to the concentration of a medication in the blood that is high enough to cause harmful effects or toxicity. This is the opposite of the trough level, which represents the lowest safe level of the drug in the system. Toxicity occurs when drug levels exceed the therapeutic range, posing a risk to the patient’s health.

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A nurse is caring for a client whose partner has recently died. The client ‘’I am learning how to pay my own bills.’’ The nurse should identify that the client is experiencing which of the following tasks in Worden’s Four Tasks of Grieving?

Nursing Test Bank

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Correct Answer is D

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Correct Answer is A

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