An appropriate nursing diagnosis for the family of a client dying of cancer whose members have expressed sorrow over the forthcoming loss would be
Anticipatory Grieving related to the loss of a family member as evidenced by voicing sorrow and crying.
Dysfunctional Grieving related to future loss of family member as evidenced by family's age regression.
Potential for Grieving related to future loss of family member and sorrow as evidenced by crying and insomnia.
Dysfunctional Grieving related to loss of a family member as evidenced by behaviors indicating anxiety.
The Correct Answer is A
Choice A rationale
Anticipatory grieving is a normal psychological process of acknowledging and preparing for an expected loss. The family's expression of sorrow and crying directly indicates their emotional response to the impending death of their loved one, aligning with the defining characteristics of anticipatory grieving. This diagnosis acknowledges the family's current emotional state in relation to the anticipated loss.
Choice B rationale
Dysfunctional grieving implies an abnormal or maladaptive grief response. Age regression, while a potential manifestation of extreme stress, is not a typical or expected behavior in anticipatory grief. Without further evidence of significantly impaired functioning or prolonged, intense reactions disproportionate to the situation, labeling the grieving as dysfunctional is not supported.
Choice C rationale
Potential for grieving suggests a risk for developing grief, but the family members are already actively expressing sorrow, indicating that grieving has commenced, not just a potential for it. While crying is an expression of sorrow associated with grieving, insomnia, without further context, is a non-specific symptom and does not solely indicate anticipatory grieving related to loss.
Choice D rationale
Dysfunctional grieving, as mentioned before, implies a maladaptive response. While anxiety can be a component of grief, behaviors solely indicating anxiety do not necessarily define dysfunctional grieving related to the loss of a family member. The family's primary expression is sorrow, which is a typical component of anticipatory grief, not necessarily dysfunctional.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
The amount of stage 4 (deep, slow-wave) sleep actually decreases as individuals age. Older adults tend to have less deep sleep and more fragmented sleep patterns with increased awakenings.
Choice B rationale
Circadian rhythms, the body's internal clock regulating sleep-wake cycles, tend to become less prominent or more easily disrupted as clients age. This can lead to changes in sleep timing, such as earlier bedtimes and wake times.
Choice C rationale
Older clients typically take longer to fall asleep (increased sleep latency) compared to younger individuals due to various physiological and environmental factors.
Choice D rationale
Total sleep time generally decreases with age. Older adults often require and obtain less sleep per night compared to younger adults. This is a normal physiological change associated with aging.
Correct Answer is D
Explanation
Choice A rationale
Refusing to administer the medication without further investigation could jeopardize the client's timely treatment. While safety is paramount, the nurse's initial action should be to gather more information rather than outright refusal, which could delay necessary care.
Choice B rationale
Administering a medication that appears to be abnormally high without verifying the order is unsafe and could lead to serious adverse effects for the client. Nurses have a professional responsibility to question orders that seem incorrect or potentially harmful.
Choice C rationale
Documenting concerns is an important step in the process, but it is not the best *next* action. While documentation is crucial for legal and communication purposes, directly addressing the potentially erroneous order with the prescriber takes precedence to ensure patient safety.
Choice D rationale
Querying the physician about the order is the most appropriate immediate action. This allows the nurse to clarify the dosage, route, and rationale for the high dose. It opens a dialogue with the prescriber to confirm the order's accuracy or identify a potential error, directly addressing the safety concern.
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