The nurse is caring for a patient who has been diagnosed as having a terminal illness.
Which statement by the patient is the best example of the first stage of grief described by Kubler-Ross?

Choice A rationale

A physician's license is primarily concerned with their medical practice, diagnosis, and treatment of patients. While medication security is important in patient care, the direct responsibility for the secure storage and accurate documentation of narcotics in a facility, according to its policies, falls on the nursing staff. Disciplinary actions related to these specific failures would typically target those directly involved in the lapse of protocol.

Choice B rationale

A pharmacist's license governs the dispensing and management of medications within a pharmacy setting. While pharmacists play a crucial role in the supply chain and providing information about medications, the day-to-day secure storage and inventory control of narcotics within a long-term care facility, as per the facility's policies, is the responsibility of the nurses on duty.

Choice C rationale

A facility's license pertains to the operational standards and overall compliance of the healthcare institution. While the failure to secure narcotics and maintain proper documentation could potentially lead to issues with the facility's licensing if it reflects systemic problems, the initial disciplinary actions for direct violations of nursing policies regarding medication handling would likely target the individual nurses involved.

Choice D rationale

Nurses are directly responsible for adhering to the policies and procedures of the healthcare facility regarding the handling and documentation of medications, especially controlled substances like narcotics. Failing to keep narcotics in a locked, secure location and neglecting to document counts before and after each shift are direct violations of these professional responsibilities and institutional guidelines, potentially leading to disciplinary actions against their nursing licenses.

Choice A rationale

Discouraging the family from talking about death can hinder their grieving process and may prevent the dying client from having important conversations and finding closure. Open communication about death and dying is often therapeutic for both the client and their family members, allowing them to express emotions and support each other.

Choice B rationale

Informing the family that the client may soon be out of danger when the client is actively dying of renal failure is providing false reassurance and can erode trust between the nurse and the family. It is crucial to be honest and compassionate about the client's prognosis, preparing the family for the impending death rather than offering false hope.

Choice C rationale

While rest is important for a dying client, encouraging the family to leave the client alone may deprive both the client and the family of valuable time for connection and saying goodbye. The presence and support of loved ones can provide comfort to the dying person and begin the grieving process for the family.

Choice D rationale

Informing the family that it is time to bid farewell acknowledges the reality of the situation and provides an opportunity for the family to express their love, say their goodbyes, and find closure. This supportive action respects the dying process and the emotional needs of the family members as they face the imminent loss of their loved one. .