A nurse suspects prolonged grief disorder (PGD). Which finding supports this concern?

A. A family starting a walking routine: This represents a group or interpersonal level of health promotion within a specific micro-system. While beneficial for the health of the individuals involved, it lacks the scale and infrastructure of a national initiative. It is a private behavioral change rather than a structured strategy designed to impact the health of an entire country.

B. A nurse reviewing medications with a client: This action is a clinical, individual-level intervention focused on secondary or tertiary prevention. It occurs within a specific therapeutic encounter to ensure the safety and education of one particular patient. It does not constitute a broad strategy aimed at shifting the health indicators of the general national population.

C. Healthy People 2030 goals and objectives: This is a comprehensive national roadmap designed by the U.S. Department of Health and Human Services to improve the health of all Americans. It sets specific, data-driven targets for health promotion and disease prevention over a 10 year period. This framework guides national policy, funding, and public health efforts to address social determinants of health.

D. Teaching one patient how to read a food label: This is a direct patient education intervention categorized at the individual level of care. While it promotes health literacy, its impact is limited to the person receiving the instruction during the clinical visit. It lacks the systematic, population-wide scope required to be considered a national-level health promotion strategy.

A. "You are already home. Stop worrying.": This response employs a confrontational reality orientation that often increases agitation in patients with dementia. By dismissing the patient's perceived reality, the nurse creates a power struggle that can lead to further distress. Invalidating the patient's feelings shuts down communication and fails to address the underlying emotional need for safety.

B. "Your family told me you have to stay here.": Shifting the blame to the family can damage the patient's trust in their loved ones and the healthcare team. This response may cause the patient to feel betrayed or abandoned, exacerbating their anxiety and desire to leave. It avoids addressing the patient's current emotional state and offers no comfort or meaningful engagement.

C. "We've talked about this already. Sit down.": This impatient response serves as a verbal barrier that can make the patient feel belittled or ignored. Repeating that the conversation has already occurred is ineffective because the patient likely lacks the short-term memory to recall previous interactions. It focuses on the nurse's frustration rather than the patient's need for therapeutic support and redirection.

D. “I can see you're worried. Tell me about your home.": This response utilizes validation therapy and redirection by first acknowledging the patient's feelings of anxiety. By asking the patient to describe their home, the nurse shifts the focus from a distressing thought to a comforting long-term memory. This technique de-escalates the situation while maintaining the patient's dignity through meaningful, non-confrontational dialogue.