A terminal patient in a skilled nursing home has stated that he does not want to get out of bed, because he is too tired and weak to sit in a chair. He sleeps on and off all day and night, his position is changed every 2 hours, and he is comfortable on his pain regimen. The next day the nurse will:
Get him out of bed for an hour in the morning and afternoon and for a short time (15 minutes) before bedtime so that he does not sleep all day and stay awake at night.
Get him out of bed for 2 hours in the morning and afternoon and for a short time (15 minutes) before bedtime so that he does not sleep all day and Stay awake at night.
Assess his strength and desire to get out of bed, but permit him to remain in bed if he chooses, because that is his position of comfort.
Leave him in bed if he wishes, but have him do active exercises of his legs and arms to prevent further muscle weakness.
The Correct Answer is C
A. and B. Both options involve getting the patient out of bed for specified periods during the day to prevent excessive sleep during the day and wakefulness at night. However, these options may not align with the patient's preferences and comfort.
C. This option respects the patient's autonomy and acknowledges his preference to remain in bed due to feeling tired and weak. It also recognizes that comfort is a priority in end-of-life care. The nurse will assess the patient's strength and desire to get out of bed but will permit him to remain in bed if he chooses, as that is his position of comfort.
D. Leaving the patient in bed while encouraging active exercises may be physically demanding for the patient and may not be appropriate, especially considering the patient's terminal condition and desire to remain in bed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The patient's statement reflects the stage of bargaining in Kübler-Ross's model of the five stages of grief and dying. During the bargaining stage, individuals may negotiate with a higher power or express desires to postpone or mitigate the inevitable outcome, such as death. In this case, the patient is expressing a wish to live long enough to witness the birth of their first grandchild, indicating a form of negotiation or bargaining with fate or circumstances.
A. Bargaining: Bargaining is characterized by attempts to negotiate or make deals in an effort to postpone or change the outcome of a situation, often involving a plea for more time or specific circumstances. The patient's statement about wanting to live long enough to see their first grandchild born exemplifies this stage, as they are expressing a desire to prolong their life to experience a significant event.
B. Anger: Anger involves feelings of frustration, resentment, or rage directed towards oneself, others, or the situation. The patient's statement does not reflect anger but rather a hopeful desire to witness a significant life event, indicating a different stage of grieving and acceptance.
C. Denial: Denial involves refusing to accept the reality of a situation or diagnosis, often accompanied by disbelief or avoidance of the truth. The patient's statement does not suggest denial, as they are acknowledging their impending death but expressing a desire for a specific experience before it occurs.
D. Depression: Depression in the context of Kübler-Ross's model involves feelings of sadness, hopelessness, and withdrawal in response to the impending loss or death. While the patient's statement may evoke emotions related to the significance of the event, it does not necessarily reflect depression as the primary stage of grief being experienced. Instead, it aligns more closely with bargaining, as the patient is expressing a desire for a particular outcome before facing death.
Correct Answer is E
Explanation
The statement "My family will be fine after I'm gone" reflects a sense of acceptance of the situation and an acknowledgment of the inevitability of death. Here's how it correlates with Kübler-Ross's stages of dying:
Anger (Option A): Anger is characterized by feelings of frustration, resentment, and hostility. The statement does not express any anger towards the situation or others; instead, it conveys a sense of resignation and acceptance.
Depression (Option B): Depression involves feelings of sadness, hopelessness, and despair. While the statement could potentially be interpreted as reflecting sadness about leaving loved ones behind, it primarily conveys a sense of acceptance rather than depression.
Denial (Option C): Denial involves refusing to accept the reality of the situation. The statement provided does not reflect denial as it acknowledges the reality of the individual's impending death rather than denying it.
Bargaining (Option D): Bargaining involves attempting to negotiate with a higher power or others to change the outcome of the situation. The statement does not reflect bargaining as it does not involve any attempt to change the inevitable outcome of death.
Acceptance (Option E): Acceptance is the final stage in Kübler-Ross's model and involves coming to terms with one's impending death. The statement "My family will be fine after I'm gone" suggests that the individual has accepted their fate and believes that their loved ones will be able to cope without them. Therefore, this behavior correlates most closely with the stage of acceptance.
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