The nurse is caring for client who is experiencing extreme sadness after the passing of a companion of 30 years. The client describes not being able to think of other things and finds it difficult to control emotions. Which action should the nurse take first?

Offer a referral to pastoral counseling.

Suggest the need for a psychiatric consultation.

Explore changes in life that have occurred after the loss.

Encourage attending a local support group.

Answer and Explanation

The Correct Answer is C

A) Offering a referral to pastoral counseling can be helpful, but it may not address the immediate emotional needs of the client who is experiencing extreme sadness and difficulty controlling emotions. This option can be considered later in the therapeutic process.

B) Suggesting the need for a psychiatric consultation might be appropriate, but it could be premature at this point. The focus should first be on understanding the client’s current emotional state and helping them process their grief.

C) Exploring changes in life that have occurred after the loss is the first and most important action. This approach allows the nurse to facilitate the client’s expression of feelings, which is crucial in the grieving process. By discussing the impact of the loss, the nurse can provide emotional support and help the client begin to process their grief.

D) Encouraging attendance at a local support group can be beneficial, but it may not be the most immediate action. The client needs to be heard and understood in their current emotional state before considering additional resources or support systems.

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Correct Answer is D

Explanation

A) Regression involves reverting to earlier developmental behaviors in response to stress. While the client’s current behaviors may reflect regression, her inability to remember specific events points more directly to another mechanism.

B) Denial is the refusal to accept reality or facts. The client acknowledges that her mother ran her father off, so she is not completely denying her past; instead, she seems to lack memory about certain aspects, which suggests a different mechanism.

C) Projection involves attributing one’s own unacceptable feelings or thoughts to someone else. The client is not projecting her feelings onto others; she is reflecting on her own experiences, so this is not the most accurate descriptor.

D) Repression is the unconscious blocking of unacceptable thoughts or memories. The client’s statement about not remembering possible abuse suggests that she may have repressed those memories as a way to cope with the emotional pain associated with her past. This aligns well with the client’s history of chronic depression and suicidal behavior.

A. Perform the dressing change in a non-judgmental manner. B. Provide detailed thorough explanations when cleansing the wound. C. Ask in a non-threatening manner why the client cut own abdomen. D. Request another staff member assist with the dressing change.

Correct Answer is A

Explanation

A) Performing the dressing change in a non-judgmental manner is crucial when caring for a client with borderline personality disorder. Clients with this diagnosis often have intense emotions and may feel vulnerable, so approaching the situation without judgment fosters a sense of safety and respect. This supportive attitude can help build trust and encourage open communication.

B) While providing thorough explanations when cleansing the wound can be beneficial, excessive detail may overwhelm the client or create anxiety. It is important to communicate effectively, but the focus should be on providing care in a compassionate manner rather than on the specifics of the procedure, especially given the client’s emotional state.

C) Asking the client in a non-threatening manner why they cut their abdomen could be perceived as intrusive or confrontational, potentially leading to defensiveness or escalation of emotions. This approach may not be appropriate during a dressing change; instead, it may be more effective to address the reasons for self-harm in a separate therapeutic context when the client is more stable.

D) Requesting another staff member to assist with the dressing change might be necessary in certain situations, but it could also convey a sense of fear or discomfort regarding the client’s behavior. In this case, it is essential for the nurse to manage the situation confidently and compassionately, rather than distancing themselves from the client’s needs. Fostering a supportive environment is more important than involving additional staff at this moment.

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The nurse is caring for client who is experiencing extreme sadness after the passing of a companion of 30 years. The client describes not being able to think of other things and finds it difficult to control emotions. Which action should the nurse take first?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

The nurse is providing care for a client diagnosed with a borderline personality disorder who has self-inflicted lacerations on the abdomen. Which approach should the nurse use when changing this client's dressings?

Correct Answer is A

Explanation

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