When a patient admitted for terminal care is asked by the admitting nurse, "What has your doctor told you about your illness?" the patient states, "She says that I have a terminal illness, but I know she’s wrong." The nurse recognizes that:

the patient has a doctor Who does not tell patients when they have a terminal illness.

the patient is in denial and is unable to consciously admit what he has been told by the doctor.

the patient needs to be told that he doesn’t have long to live so that he can make his final arrangements.

she will have to avoid all conversation that refers to his disease or symptoms so as not to increase his anxiety.

Answer and Explanation

The Correct Answer is B

A. This option assumes that the doctor does not inform patients about terminal illnesses, which may not necessarily be the case. It is more likely that the patient is in denial rather than the doctor not disclosing the diagnosis.

B. Denial is a common defense mechanism in response to distressing or overwhelming information. The patient's statement suggests denial of the terminal diagnosis despite being informed by the doctor. Denial allows individuals to avoid confronting the reality of their situation and can serve as a protective mechanism to cope with the emotional impact of the diagnosis.

C. While it may be important for the patient to have an understanding of their prognosis in order to make informed decisions and final arrangements, pushing the patient to accept the reality of their terminal illness before they are ready may not be helpful and can cause distress.

D. Avoiding conversation about the disease or symptoms may not address the underlying issue of denial and may hinder open communication between the patient and healthcare team. It is important for the nurse to provide support and opportunities for the patient to discuss their feelings and concerns about their illness, while also respecting their coping mechanisms.

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Correct Answer is B

Explanation

Answer: B

Rationale:

A) "Tell me why you want to take your child home."

This response could be perceived as questioning or challenging the parents' decision, potentially causing them to feel defensive or unsupported. It does not provide immediate assistance or support for their decision.

B) "I will help you get ready to leave."

This response shows support and understanding for the parents' decision. It offers practical assistance, helping the family transition smoothly from the hospital to home care, which is important for their emotional and logistical needs during this difficult time.

C) "You have not given the medication a chance to work."

This response may come across as dismissive of the parents' wishes and could imply that their decision is not valid. It does not acknowledge the parents' right to make decisions about their child's care, especially in a palliative context.

D) "The pediatrician is the only one who can discharge your child."

While it is true that discharge typically requires a physician's order, this response does not offer the supportive tone needed in this situation. It places an unnecessary barrier between the parents and their goal without providing assistance or comfort.

A. Anger B. Depression C. Denial D. Bargaining E. Acceptance

Correct Answer is E

Explanation

In Kübler-Ross's stages of dying, acceptance is the final stage characterized by a sense of peace, tranquility, and readiness to confront death. The statement "She’ll soon be at peace" reflects an acknowledgment and acceptance of the impending death of the individual, as well as a recognition of the relief or comfort that may come with the end of suffering. This behavior aligns with the acceptance stage of Kübler-Ross's model.

A. Anger: Anger is typically characterized by feelings of frustration, resentment, and hostility. In Kübler-Ross's model, anger often arises as individuals struggle to come to terms with their diagnosis or prognosis. However, the statement provided does not express anger but rather a sense of acceptance and tranquility. Therefore, this choice is less appropriate.

B. Depression: Depression in the context of Kübler-Ross's stages of dying involves feelings of sadness, hopelessness, and despair. It often occurs as individuals confront the reality of their situation and the impending loss. The statement "She’ll soon be at peace" does not reflect the pervasive sadness and despair associated with depression. Instead, it conveys a sense of acceptance and readiness for the end of suffering, making this choice less fitting.

C. Denial: Denial is a defense mechanism characterized by a refusal to accept reality or acknowledge the truth of a situation. In Kübler-Ross's model, denial is often one of the initial stages of coping with a terminal diagnosis. However, the statement provided does not reflect denial, as the individual acknowledges the reality of the impending death and the potential for peace. Therefore, this choice is not the most appropriate.

D. Bargaining: Bargaining involves attempting to negotiate or make deals to postpone or mitigate the inevitable outcome. In Kübler-Ross's model, individuals may bargain with themselves, others, or a higher power in an attempt to avoid facing the reality of death. The statement "She’ll soon be at peace" does not indicate bargaining, as there is no attempt to negotiate or make deals to avoid death. Instead, it reflects acceptance of the situation and readiness for the end of suffering. Therefore, this choice is less suitable compared to others.

E. Acceptance: Acceptance is the final stage in Kübler-Ross's model, characterized by a sense of peace, tranquility, and readiness to confront death. The statement "She’ll soon be at peace" reflects an acknowledgment and acceptance of the impending death, as well as a recognition of the potential for relief or comfort that comes with the end of suffering. This behavior aligns most closely with the acceptance stage of Kübler-Ross's model, making it the most appropriate choice.

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When a patient admitted for terminal care is asked by the admitting nurse, "What has your doctor told you about your illness?" the patient states, "She says that I have a terminal illness, but I know she’s wrong." The nurse recognizes that:

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Naxlex Comprehensive Predictor Exams

A nurse in an acute care facility is caring for a preschool-age child who is terminally ill and receiving palliative care. The parents tell the nurse that they have decided to take their child home. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

Directions: Correlate the behavior with Kübler-Ross's stages of dying from the choices below. "She’ll soon be at peace"

Correct Answer is E

Explanation

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The nurse is aware that in order to provide effective support to grieving patients and families, the nurse must?

When the nurse notes an increase in the level of daily function in the terminal patient, the nurse assesses that this patient has reached Kübler Ross's level of:

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When a patient admitted for terminal care is asked by the admitting nurse, "What has your doctor told you about your illness?" the patient states, "She says that I have a terminal illness, but I know she’s wrong." The nurse recognizes that:

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