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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View Related questions
Correct Answer is D
Explanation
Choice A reason:
“It is not necessary to tell the doctor about the herbal supplements I take.” This statement is incorrect. It is crucial to inform the doctor about all medications, including herbal supplements, as they can interact with prescription medications and cause adverse effects. Herbal supplements can strongly affect the body and may not work well with prescription medicines.
Choice B reason:
“I am less likely to experience an allergic reaction from medications I have taken before.” This statement is incorrect. Allergic reactions can occur even if the medication has been taken before without any issues. The immune system can develop sensitivities over time, and an allergic reaction can happen at any point.
Choice C reason:
“If a medication makes me feel nauseated, then I should stop taking it for 1 week.” This statement is incorrect. Stopping a medication without consulting a healthcare provider can be dangerous. It is important to discuss any side effects with a healthcare provider to determine the best course of action. Stopping a medication abruptly can lead to worsening of the condition or other complications.
Choice D reason:
“My medications could interact with foods that I eat.” This statement is correct. Certain foods can interact with medications and affect their absorption, effectiveness, or cause adverse effects. For example, grapefruit juice can interact with statins and increase the risk of side effects. It is important to be aware of potential food-drug interactions and follow the healthcare provider’s advice on medication administration.
Correct Answer is ["B","C","E"]
Explanation
Choice A Reason:
A negative Chvostek’s sign is not expected in a client with hypocalcemia. The Chvostek’s sign is a clinical indicator of hypocalcemia, where tapping the facial nerve triggers facial muscle twitching. A positive Chvostek’s sign indicates neuromuscular irritability due to low calcium levels. Therefore, a negative Chvostek’s sign would not be consistent with hypocalcemia.
Choice B Reason:
A positive Trousseau’s sign is a classic indicator of hypocalcemia. This sign is elicited by inflating a blood pressure cuff on the upper arm to a level above the systolic pressure for several minutes. The resultant carpopedal spasm (involuntary contraction of the hand and wrist muscles) is a positive Trousseau’s sign, indicating neuromuscular irritability due to low calcium levels.
Choice C Reason:
Muscle cramps are a common syptom of hypocalcemia. Low calcium levels increase neuromuscular excitability, leading to involuntary muscle contractions and cramps. These cramps can occur in various muscle groups, often causing significant discomfort.
Choice D Reason:
Abdominal distention is not typically associated with hypocalcemia. While abdominal distention can result from various gastrointestinal issues, it is not a direct symptom of low calcium levels. Hypocalcemia primarily affects neuromuscular function rather than causing abdominal distention.
Choice E Reason:
Tingling sensation around the lips, also known as perioral tingling, is a common symptom of hypocalcemia. This occurs due to increased neuromuscular irritability caused by low calcium levels, leading to sensations of tingling or numbness around the mouth.