A nurse is caring for a client who was recently diagnosed with a terminal illness. The client tells the nurse, “I am looking forward to seeing my grandchildren grow up.” The nurse should identify that the client is experiencing which of the following stages of grief?
Denial
Anger
Bargaining
Acceptance
The Correct Answer is A
Choice A Reason:
Denial is the first stage of grief, where individuals refuse to accept the reality of their situation. In this case, the client is looking forward to a future event (seeing their grandchildren grow up) despite being diagnosed with a terminal illness. This indicates that the client is not acknowledging the severity of their condition and is instead holding onto a hopeful but unrealistic outcome. Denial serves as a defense mechanism to protect the individual from the immediate shock and pain of their diagnosis.
Choice B Reason:
Anger is the second stage of grief, characterized by feelings of frustration and helplessness. Individuals in this stage may direct their anger towards themselves, others, or the situation. The client’s statement does not reflect anger or frustration but rather an unrealistic hope for the future, which aligns more with denial than anger.
Choice C Reason:
Bargaining is the third stage of grief, where individuals attempt to negotiate or make deals to alter their situation. This stage often involves “if only” or “what if” statements as the person tries to regain control. The client’s statement does not indicate any form of negotiation or deal-making but rather a refusal to accept the reality of their terminal illness.
Choice D Reason:
Acceptance is the final stage of grief, where individuals come to terms with their situation and begin to plan for the future realistically5. In this stage, there is an acknowledgment of the loss and a gradual adjustment to the new reality. The client’s statement about looking forward to seeing their grandchildren grow up does not reflect acceptance but rather a denial of the terminal nature of their illness.
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Correct Answer is B
Explanation
Choice A Reason:
A family whose only child recently died due to cancer is experiencing a significant and traumatic loss. This type of loss is categorized as a situational loss because it is unexpected and not part of the normal life cycle. Situational losses are typically sudden and can cause profound grief and disruption in the family’s life. The death of a child is one of the most devastating events a family can endure, leading to intense emotional pain and a long grieving process.
Choice B Reason:
A family whose oldest child is moving away for college is experiencing a maturational loss. Maturational losses are those that occur as part of normal life transitions and developmental stages. These losses are anticipated and expected as individuals grow and progress through different phases of life. The transition of a child moving away for college is a common maturational loss, as it signifies a significant change in the family dynamic and the child’s development into adulthood.
Choice C Reason:
A family whose house was destroyed in a fire is dealing with a situational loss. This type of loss is unexpected and can have a severe impact on the family’s sense of security and stability. The destruction of a home involves not only the loss of physical property but also the emotional attachment and memories associated with the home. Recovering from such a loss requires significant emotional and practical adjustments.
Choice D Reason:
A family whose head of household lost their job is experiencing a situational loss. Job loss can lead to financial instability and stress, affecting the entire family’s well-being. This type of loss is not part of the normal developmental process and can create significant challenges for the family as they navigate the uncertainty and potential changes in their lifestyle.
Correct Answer is A
Explanation
Choice A Reason:
Tuberculosis (TB) is a highly contagious bacterial infection that primarily affects the lungs and is spread through airborne particles. When a person with active TB coughs, sneezes, or talks, they release tiny droplets containing the bacteria into the air, which can be inhaled by others1. Therefore, placing a client with TB in airborne precautions is essential to prevent the spread of the infection. This involves using a negative pressure room and requiring healthcare workers to wear N95 respirators or higher-level protection.
Choice B Reason:
Pneumonia is an infection that inflames the air sacs in one or both lungs, which can fill with fluid or pus. While pneumonia can be caused by bacteria, viruses, or fungi, it is typically spread through respiratory droplets rather than airborne particles. Therefore, droplet precautions, rather than airborne precautions, are usually sufficient for managing clients with pneumonia. This includes wearing masks and maintaining a safe distance from the infected person.
Choice C Reason:
Shigella is a bacterial infection that primarily affects the intestines and is spread through the fecal-oral route. It is not transmitted through the air, so airborne precautions are not necessary. Instead, contact precautions are recommended to prevent the spread of Shigella, which involves wearing gloves and gowns when handling the patient or their environment and practicing good hand hygiene.
Choice D Reason:
Strep throat is a bacterial infection caused by group A Streptococcus. It is spread through respiratory droplets when an infected person coughs or sneezes. Similar to pneumonia, droplet precautions are sufficient for managing clients with strep throat. This includes wearing masks and maintaining a safe distance from the infected person to prevent the spread of the bacteria.