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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Have no friends among the unit staff: While having friends among the unit staff can provide emotional support, it is not directly related to a nurse's ability to cope with patient deaths. Support from colleagues can be helpful, but it is not the primary factor influencing a nurse's response to patient deaths.
B. Have not come to terms with their own mortality: This option addresses a significant factor in how nurses cope with patient deaths. Nurses who have unresolved issues or anxiety about their own mortality may find it challenging to deal with the deaths of their patients. Facing one's mortality is an essential aspect of developing resilience in the face of death and dying.
C. Did not foresee that the illness was terminal: While it can be emotionally challenging when a patient's illness unexpectedly becomes terminal, nurses are trained to provide care and support regardless of the prognosis. The ability to cope with patient deaths extends beyond foreseeing the terminal nature of an illness.
D. Cared for the patient for several days: The duration of care provided to a patient may influence the depth of the nurse's emotional connection but does not necessarily determine their ability to cope with patient deaths. Nurses develop coping mechanisms and emotional resilience through experience, training, and self-awareness, rather than simply through the length of time caring for a patient.
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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