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 C
Explanation
Choice A Reason:
The four-point alternating gait is used when a client can bear weight on both legs. This gait provides maximum stability and is often used for clients with poor balance or coordination. It involves moving one crutch forward, followed by the opposite leg, then the other crutch, and finally the other leg. Since the client can only bear weight on one leg, this gait is not appropriate.
Choice B Reason:
The two-point alternating gait is also used when a client can bear weight on both legs. It is faster than the four-point gait and involves moving one crutch and the opposite leg simultaneously, followed by the other crutch and the opposite leg. This gait requires partial weight-bearing on both legs, making it unsuitable for a client who can only bear weight on one leg.
Choice C Reason:
The three-point gait is specifically designed for clients who can only bear weight on one leg. In this gait, both crutches are moved forward together, followed by the weight-bearing leg. The non-weight-bearing leg is then swung through. This gait provides the necessary support and stability for clients with one non-weight-bearing leg, making it the most appropriate choice in this scenario.
Choice D Reason:
The swing-through gait is used by clients who have good upper body strength and can bear weight on both legs, even if one leg is weaker. This gait involves moving both crutches forward together and then swinging both legs through to the crutches. It is not suitable for a client who can only bear weight on one leg, as it requires some degree of weight-bearing on both legs.
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.
