A nurse is making a home care visit to a client with a hearing deficit.
What is the best thing she can do to facilitate communication with the client?

Choice A rationale

Anticipatory Grieving is a normal response to an expected loss, such as the impending death of oneself or a loved one. While the client is facing death, her statement "Why me, Lord" and inability to pray suggest a struggle with her spiritual beliefs and meaning in the face of this event, rather than primarily focusing on the emotional preparation for loss.

Choice B rationale

Ineffective Coping refers to an inability to manage stressors effectively. While the client's distress indicates difficulty coping with her situation, the specific mention of spiritual questioning and inability to pray points towards a disturbance in her spiritual well-being, which is more accurately described by spiritual distress.

Choice C rationale

Low Self-Esteem involves negative feelings about oneself and one's worth. While facing death can impact self-esteem, the client's direct questioning of her faith and inability to connect spiritually are the more prominent indicators in this scenario, suggesting a conflict or disruption in her spiritual domain rather than primarily a devaluation of self.

Choice D rationale

Spiritual Distress is characterized by a disruption in one's belief or value system that provides strength, hope, and meaning to life. The client's cry of "Why me, Lord" and her inability to pray indicate a struggle with her faith and a potential feeling of abandonment or questioning of her spiritual beliefs in the face of death. This aligns directly with the defining characteristics of spiritual distress.

Choice A rationale

An older adult client without family support who is uncertain about a significant life change like moving to assisted living is particularly vulnerable. The nurse advocate can help this client understand their options, express their concerns, and ensure their wishes are considered, as they may lack the resources or confidence to navigate this process independently, making advocacy crucial for their well-being and autonomy.

Choice B rationale

A client who makes an informed decision to refuse chemotherapy is exercising their autonomy. While the nurse supports this decision, the client is already empowered and making their own choices based on understanding, thus requiring less direct advocacy in the sense of ensuring their voice is heard or their rights are upheld against potential opposition.

Choice C rationale

A client undergoing a repeat procedure is likely familiar with the process and has presumably consented previously. While the nurse ensures they are still informed and comfortable, the need for strong advocacy to ensure their wishes are respected against external pressures is less pronounced compared to a vulnerable client facing a new and uncertain situation.

Choice D rationale

A client who chooses alternative treatments after being educated on conventional options is also exercising their autonomy based on their values and understanding. The nurse's role is to ensure this decision is informed, but the client is already acting as their own advocate by making a conscious choice, reducing the immediate need for external advocacy.