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 D
Explanation
Choice A Reason:
Leaving a transfer belt in place until the client returns from radiology is not recommended. The transfer belt is used to assist in moving the client safely, but it should be removed once the client is securely seated in the wheelchair to prevent discomfort or potential injury.
Choice B Reason:
Positioning the client so their weight is shifted forward is not a standard practice for transferring a client to a wheelchair. Proper positioning involves ensuring the client is seated comfortably and securely, with their weight evenly distributed to prevent falls or injuries.
Choice C Reason:
Lowering the footplates before transferring the client from the bed is incorrect. The footplates should be raised to allow the client to safely transfer from the bed to the wheelchair without tripping or getting their feet caught.
Choice D Reason:
Backing the wheelchair into the elevator is the correct action. This ensures that the client enters the elevator facing forward, which is safer and more comfortable for the client. It also allows the nurse to maintain better control of the wheelchair during the transition.
Correct Answer is D
Explanation
Choice A Reason:
Logrolling is a technique used to turn a patient while maintaining the alignment of the spine. It is particularly important for patients with spinal injuries or those who have undergone spinal surgery. While preventing friction is a benefit, the primary purpose of logrolling is to maintain spinal alignment and prevent further injury.
Choice B Reason:
Keeping the arms at the sides while logrolling is not a standard recommendation. In fact, it is often suggested that patients cross their arms over their chest to minimize lateral spinal displacement during the roll. This helps in maintaining the alignment of the spine and preventing any twisting or bending.
Choice C Reason:
The head of the bed should be flat during logrolling to ensure proper spinal alignment. Elevating the head of the bed can cause misalignment and increase the risk of injury. The bed should be positioned flat and at a comfortable working height for the caregivers performing the logroll.
Choice D Reason:
Logrolling is specifically designed to keep the spine in alignment. This technique involves turning the patient in one smooth motion without twisting or bending the body. It is crucial for patients with spinal injuries to prevent further damage and ensure safe repositioning.
