The nurse is caring for a patient recently diagnosed with a terminal illness. The patient says, “There’s no way this is right. I’m going to get another opinion—this doctor doesn’t know what they’re talking about.” The nurse recognizes that the patient is in which stage of grief?

Bargaining

Denial

Anger

Depression

Answer and Explanation

The Correct Answer is B

Choice A reason: Bargaining involves negotiating to alter the outcome, such as promising behavior changes to avoid loss. The patient’s rejection of the diagnosis reflects disbelief, not negotiation, aligning with denial, not bargaining, making this choice incorrect.

Choice B reason: Denial, the first stage of grief, involves refusing to accept a painful reality, like a terminal diagnosis. The patient’s insistence on another opinion reflects disbelief, a protective mechanism to avoid emotional distress, making this the correct choice.

Choice C reason: Anger involves frustration or resentment, often directed at others, like blaming the doctor. The patient’s statement focuses on disbelief, not hostility, aligning with denial rather than anger, making this choice incorrect for the described stage.

Choice D reason: Depression in grief involves sadness and despair over the loss. The patient’s rejection of the diagnosis indicates denial, not acceptance of the reality leading to sadness, making this choice incorrect for the current stage of grief.

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Correct Answer is ["D","E"]

Explanation

Choice A reason: A crowded room creates distractions and compromises patient confidentiality, hindering open communication during a psychosocial assessment. Effective assessments require a private, calm environment to foster trust and focus, as external stimuli can exacerbate anxiety or disrupt emotional disclosure, making this choice incorrect.

Choice B reason: Avoiding eye contact can signal disengagement or discomfort, undermining the therapeutic alliance needed for a psychosocial assessment. Appropriate eye contact fosters trust and encourages patients to share sensitive information, as it reflects attentiveness and empathy, making this choice incorrect for an effective assessment environment.

Choice C reason: A television on for background noise introduces auditory distractions, reducing the patient’s ability to focus and share openly during a psychosocial assessment. A quiet environment is essential to ensure clear communication and minimize sensory overload, which can affect emotional regulation, making this choice incorrect.

Choice D reason: Adequate lighting creates a comfortable, non-threatening environment for a psychosocial assessment, allowing the nurse to observe nonverbal cues like facial expressions, which are critical for assessing emotional states. Proper lighting supports patient comfort and accurate observation, making this a correct choice for the assessment setting.

Choice E reason: A quiet and private area ensures confidentiality and minimizes distractions, fostering a safe space for patients to discuss sensitive psychosocial issues. This environment supports emotional disclosure and reduces anxiety, enabling accurate assessment of mental health status, making this a correct choice for effective assessments.

A. The patient is demonstrating signs of ineffective coping and should be referred for psychiatric evaluation B. The patient is showing symptoms of major depressive disorder and requires immediate intervention C. The patient is noncompliant with medical care due to unresolved emotional issues D. The patient is progressing through the normal stages of grief

Correct Answer is A

Explanation

Choice A reason: Withdrawn behavior and avoiding eye contact suggest ineffective coping, as the patient struggles to process missing a treatment. Psychiatric evaluation can assess underlying emotional distress, such as anxiety or depression, and provide targeted interventions, making this the correct choice for addressing the patient’s needs.

Choice B reason: Symptoms like withdrawal could suggest depression, but diagnosing major depressive disorder requires more criteria, such as persistent low mood or anhedonia, not evident here. Immediate intervention assumes severity not supported by the scenario, making this choice less accurate than a referral.

Choice C reason: Labeling the patient as noncompliant assumes intentional refusal, but the scenario suggests emotional distress, not deliberate nonadherence. Withdrawal and avoidance indicate psychological barriers, not noncompliance, making this choice incorrect for the described behavior.

Choice D reason: Normal grief involves stages like denial or sadness, but the scenario lacks evidence of a loss triggering grief. Withdrawal and avoidance suggest coping difficulties, not a clear grief process, making this choice incorrect for the patient’s presentation.

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The nurse is caring for a patient recently diagnosed with a terminal illness. The patient says, “There’s no way this is right. I’m going to get another opinion—this doctor doesn’t know what they’re talking about.” The nurse recognizes that the patient is in which stage of grief?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing to perform a psychosocial assessment on a patient. Which of the following should be included in the environment to promote an effective assessment? (Select all that apply)

Correct Answer is ["D","E"]

Explanation

A patient missed a treatment option. Later, the patient appears withdrawn and avoids eye contact when discussing calling loved ones. Which is the best nursing action?

Correct Answer is A

Explanation

A patient diagnosed with schizophrenia tells the nurse, “I hear voices sometimes, but they don’t bother me.” Which of the following is the most appropriate open-ended response by the nurse to further assess the patient’s experience?

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