The practical nurse (PN) accompanies a healthcare provider (HCP) when the client receives the diagnosis of stage 4 metastatic cancer. The client's spouse immediately responds, "You must have made a mistake. We want to get a second opinion." The PN should consider which stage of the grieving process in order to respond best to the spouse's comments?
Denial,
Intellectualization.
Conversion reaction,
Bargaining
The Correct Answer is A
Rationale:
A. This option is correct because the spouse’s statement reflects denial, the first stage of the grieving process described by Elisabeth Kübler-Ross. Denial serves as a protective mechanism, allowing the individual time to absorb and process overwhelming news. The spouse is refusing to accept the reality of the terminal diagnosis by insisting that a mistake has occurred or requesting a second opinion. The PN should respond with empathy, patience, and support, acknowledging the spouse’s feelings without reinforcing the denial.
B. This option is incorrect because intellectualization is a defense mechanism in which a person focuses on facts and logic to avoid emotional distress. The spouse’s reaction is emotional rather than rational, so this does not apply.
C. This option is incorrect because a conversion reaction refers to expressing psychological stress through physical symptoms (e.g., paralysis, seizures) without a physiological cause. The spouse is verbalizing disbelief, not displaying psychosomatic symptoms.
D. This option is incorrect because bargaining involves attempts to negotiate or make deals, often with a higher power, to postpone or alter an undesirable outcome (e.g., "If you let them live, I’ll do…"). Requesting a second opinion is denial, not bargaining.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. This option is incorrect because using a plastic barrier can trap excessive heat and moisture, increasing the risk of burns and skin breakdown. A cloth or towel barrier is recommended instead.
B. This option is incorrect because heat therapy for comfort and pain relief is a noninvasive nursing intervention and does not require a provider’s prescription when used safely and appropriately.
C. This option is incorrect because skin should be assessed more frequently than every 30 minutes, especially during the initial application. Waiting 30 minutes may delay detection of redness, burns, or irritation.
D. This option is correct because demonstrating the use of temperature control helps ensure the client applies heat safely, reducing the risk of burns or injury. Client education on safe temperature settings is a key nursing responsibility when implementing heat therapy.
Correct Answer is []
Explanation
Rationale:
• Malnutrition: Laboratory results show low prealbumin (10 mg/dL), low albumin (3.3 g/dL), and low serum transferrin (180 mg/dL), indicating protein-calorie malnutrition. The client also has significant weight loss (9 kg/20 lb) and refuses oral intake, reinforcing the diagnosis.
• Elevate head of bed to 45 degrees: Reduces risk of aspiration during enteral feeding.
• Check gastric pH: Confirms proper placement of the nasogastric tube and ensures safety before feeding; helps prevent complications like aspiration or feeding intolerance.
• Weight: Monitoring weight helps assess nutritional status and effectiveness of enteral feeding interventions.
• Gastric residual: Monitoring residual volume ensures tolerance to feeding, prevents overfeeding, and reduces risk of aspiration.
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