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 A

Explanation

A) Increase in the startle reflex:
As people age, many of their physiological responses become less efficient, but some reflexes, such as the startle reflex, may actually become more pronounced or exaggerated. This occurs due to changes in the nervous system and decreased inhibition of certain reflex pathways. The startle reflex, which is an automatic response to sudden stimuli, can become more sensitive in older adults as a result of slower processing in the central nervous system.

B) Increase in muscle mass:
With aging, there is typically a decrease in muscle mass, a condition called sarcopenia, which leads to reduced strength and physical endurance. This loss of muscle mass starts around the age of 30 and accelerates after age 60. Therefore, muscle mass generally decreases rather than increases in older adults.

C) Decrease in body fat:
In older adults, body fat generally increases, particularly in the abdominal area, as muscle mass decreases and metabolism slows. While there may be some loss of subcutaneous fat in the face and extremities, visceral fat often increases, contributing to a higher body fat percentage.

D) Decrease in systolic blood pressure:
As people age, systolic blood pressure tends to increase, not decrease. This is due to the stiffening of the arteries and reduced elasticity of the vascular walls, which makes it harder for blood vessels to expand and contract with each heartbeat. This leads to a rise in systolic blood pressure while diastolic blood pressure may remain stable or decrease slightly.

A. The client demonstrated proper technique when drawing up 8 units of insulin. B. The client stated ‘’I struggle to see those little lines on the syringe’’ C. The client FBS was 95 mg/dl D. The client seems to be more comfortable performing self-administration of insulin.

Correct Answer is D

Explanation

Choice D:

The client seems to be more comfortable performing self-administration of insulin: The use of the term “seems” introduces subjectivity, which weakens the clarity and objectivity of the documentation. It’s better to describe specific observations or objective findings. For instance, instead of using “seems,” the nurse could note how the client demonstrated confidence or performed the task with ease, providing concrete evidence of improvement.

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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?

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