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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?

A.

Denial

B.

Anger

C.

Bargaining

D.

Acceptance

Answer and Explanation

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:

Attaching the restraints using a quick-release tie is essential for ensuring the safety of the client and the healthcare staff. A quick-release tie allows for the rapid removal of the restraints in case of an emergency, such as a fire or a sudden change in the client’s condition. This method is recommended by healthcare guidelines to ensure that restraints can be removed swiftly and safely.

Choice B reason:

Contacting the provider for a PRN (as needed) prescription for restraints is a necessary step to ensure that the use of restraints is authorized and documented. Restraints should only be used when absolutely necessary and with proper authorization to prevent misuse and to protect the client’s rights. This step ensures that the decision to use restraints is made with careful consideration and in accordance with legal and ethical standards.

Choice C reason:

Securing the restraints to a side rail on the client’s bed is not recommended. This practice can pose a significant risk to the client, as it can lead to injury if the client attempts to move or if the side rail is raised or lowered. Restraints should be secured to a part of the bed frame that does not move, such as the bed frame itself, to ensure the client’s safety.

Choice D reason:

Leaving enough room to fit three fingers between the restraints and the client’s wrist is incorrect. The correct practice is to leave enough room to fit two fingers between the restraints and the client’s wrist. This ensures that the restraints are not too tight, which could cause circulation problems or skin damage, and not too loose, which could allow the client to remove them.

Correct Answer is B

Explanation

Choice A: Physical therapist

Physical therapists primarily focus on improving a patient’s physical function, mobility, and strength. They work on activities such as walking, balance, and coordination1. While they play a crucial role in the rehabilitation of clients with traumatic brain injuries, their expertise is not specifically centered on activities of daily living (ADLs) like using eating utensils.

Choice B: Occupational therapist

Occupational therapists specialize in helping clients regain the ability to perform ADLs, which include tasks such as eating, dressing, and bathing. They use therapeutic techniques to improve fine motor skills, coordination, and cognitive function, which are essential for relearning how to use eating utensils. Their goal is to enhance the client’s independence and quality of life by enabling them to perform everyday activities.

Choice C: Speech-language pathologist

Speech-language pathologists focus on communication disorders and swallowing difficulties. They work with clients to improve speech, language, and cognitive-communication skills. While they are essential for addressing issues related to speech and swallowing, they do not typically focus on the motor skills required for using eating utensils.

Choice D: Social worker

Social workers provide support and resources to help clients and their families cope with the emotional, social, and financial aspects of a traumatic brain injury. They assist with discharge planning, accessing community resources, and providing counseling. However, they do not provide direct rehabilitation services related to the use of eating utensils.

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