A nurse is collecting data from a middle-aged client whose partner died seven months ago.
Which of the following findings indicate that the client is experiencing maladaptive grieving?

The client has lost 10 lb.

The client visits his partner’s grave each month.

The client has been unable to return to work.

The client has difficulty sleeping

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Losing 10 lb after the death of a loved one is not uncommon, especially within the first few months of grieving. It can be due to decreased appetite, changes in eating habits, or increased physical activity. While it's important to monitor weight loss and ensure adequate nutrition, it doesn't necessarily indicate maladaptive grieving on its own.

Grief can often lead to changes in appetite and weight. Some people may experience a loss of appetite and unintentional weight loss, while others may find themselves overeating or gaining weight. These changes are often temporary and subside as the grieving process progresses.

It's important to consider the client's overall health and well-being when assessing weight loss. If the client is experiencing significant weight loss, it's important to rule out any underlying medical conditions that may be contributing to it.

Choice B rationale:

Visiting a loved one's grave is a common way to grieve and remember them. It can be a way to feel connected to the deceased, express love and sorrow, and find solace. It's a normal part of the grieving process and doesn't necessarily indicate maladaptive grieving.

Grieving individuals often find comfort in visiting the gravesite of their loved one. It can be a place to reflect, remember, and feel close to the deceased. Visiting a gravesite can also be a way to honor the loved one's memory and express continued love and respect.

The frequency of grave visits can vary from person to person. Some individuals may visit frequently, while others may only visit on special occasions or anniversaries. There is no right or wrong way to grieve, and what matters most is that the individual finds a way to express their grief in a way that feels right for them.

Choice D rationale:

Difficulty sleeping is a common symptom of grief. It can be caused by a variety of factors, including anxiety, sadness, and changes in sleep patterns. While it can be distressing, it's not always a sign of maladaptive grieving.

Grief can disrupt sleep patterns in a number of ways. It can make it difficult to fall asleep, stay asleep, or both. It can also lead to nightmares, night sweats, and early morning awakenings. These sleep disturbances can be both physically and emotionally draining.

There are a number of things that can be done to improve sleep during grief. These include establishing a regular sleep schedule, creating a relaxing bedtime routine, avoiding caffeine and alcohol, and getting regular exercise. If sleep problems persist, it's important to seek professional help.

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Correct Answer is D

Explanation

The correct answer is D. Limit the client’s participation in group activities.

Explanation:

Clients with schizophrenia and paranoia may struggle in large group settings, where they could misinterpret interactions, feel threatened, or become agitated. Gradual integration into smaller, structured groups is typically recommended, rather than full exclusion, but limiting group participation can help reduce anxiety and prevent aggressive behaviors.

Why the other options are incorrect:

A. Place the client in seclusion if she is experiencing visual hallucinations – Seclusion is only used if the client poses a danger to themselves or others. Experiencing hallucinations alone does not warrant seclusion.
B. Minimize staff supervision of the client’s interactions with others – Increased supervision is necessary to ensure safety and monitor behavioral cues that may indicate escalating aggression.
C. Directly tell the client that delusions are not real – Confronting delusions outright can lead to agitation. Instead, acknowledge the client’s feelings while gently redirecting toward reality-based interactions.

A. Meaningless phrases B. Refusal to eat C. Substance use D. Decreased energy level

Correct Answer is A

Explanation

Choice A rationale:

Meaningless phrases are a hallmark symptom of schizophrenia and can indicate a worsening of the client's psychosis. This is a significant finding because it suggests that the client's ability to think clearly and communicate effectively is deteriorating.

Prompt reporting to the provider is crucial to ensure timely assessment and intervention, which may include medication adjustments or other therapeutic measures to address the worsening psychosis.

Early intervention is essential to prevent further decline in the client's mental state and to minimize the risk of harm to self or others.

I'll provide detailed rationales for the other choices, even though they are not the priority to report:

Choice B rationale:

Refusal to eat can be a symptom of schizophrenia, but it is not as immediate of a concern as meaningless phrases. It's important to monitor the client's nutritional intake and address any underlying causes of the refusal to eat, but this can typically be managed through nursing interventions without requiring immediate provider notification.

Choice C rationale:

Substance use can exacerbate schizophrenia symptoms and should be addressed, but it is not the priority to report in this scenario. The nurse should assess the client's substance use history and patterns, provide education and counseling on the risks of substance use, and collaborate with the provider to develop a treatment plan that addresses both the schizophrenia and the substance use.

Choice D rationale:

Decreased energy level can be a symptom of schizophrenia, but it is also a common symptom of many other conditions. It's important to assess the client's overall health and identify any potential causes of the decreased energy level, but it is not typically a priority to report to the provider unless it is severe or accompanied by other concerning symptoms

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A nurse is collecting data from a middle-aged client whose partner died seven months ago. Which of the following findings indicate that the client is experiencing maladaptive grieving?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is contributing to the plan of care for a client who has schizophrenia and experiences paranoia with aggressive behavior. Which of the following interventions should the nurse recommend to be included in the plan of care?

Correct Answer is D

Explanation

Explanation:

Why the other options are incorrect:

A nurse is caring for a client who has schizophrenia and notices changes in the client’s behavior. Which of the following behaviors is the nurse’s priority to report to the provider?

Correct Answer is A

Explanation

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A nurse is collecting data from a middle-aged client whose partner died seven months ago.
Which of the following findings indicate that the client is experiencing maladaptive grieving?