A nurse is contributing to the plan of care for a client who has severe depression following the loss of her spouse. When identifying client goals, which of the following goals should the nurse identify as the highest priority?

A. This response acknowledges the client's feelings of helplessness, which can validate her experience and promote further discussion about her emotions and challenges related to her eating disorder. It shows empathy and encourages the client to explore her feelings.

B. While this question is open-ended and invites the client to explore the underlying reasons for her behavior, it might inadvertently suggest that the client should have insights or control over her behavior that she may not currently possess. It could potentially make the client feel blamed or misunderstood if she cannot provide a clear answer.

C. This response is directive and judgmental, which can lead to the client feeling criticized or defensive. It does not acknowledge the complexity of the client's experience and may not be effective in building rapport or promoting trust between the nurse and client.

D This response acknowledges the client's self-awareness and validates her recognition of the problem, which can be empowering and supportive. It reinforces the positive step the client has taken in acknowledging the issue without placing blame or judgment.

D. Denial is a defense mechanism where individuals refuse to acknowledge or accept a painful or distressing reality. In this case, despite objective medical evidence (biopsy results and MRI findings), the client persists in believing that the diagnosis of terminal cancer is incorrect. This refusal to accept the reality of the situation is characteristic of denial.

A. Anger typically involves feelings of frustration, resentment, or hostility towards others or the situation. While anger can be a reaction to receiving a terminal diagnosis, it is not reflective of refusing to accept the diagnosis itself.

B. Anxiety involves feelings of worry, fear, or unease about future events or uncertainties. While anxiety can accompany a terminal diagnosis, it does not manifest as outright refusal or disbelief in the diagnosis itself.

C. Withdrawal refers to a retreat or disengagement from social interactions or activities. It can be a coping mechanism in response to stress or difficult emotions. However, withdrawal does not specifically relate to refusing to accept a diagnosis like terminal cancer.