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Edward is a 20-year-old college student. The student’s roommates tell the school nurse that their friend has seemed more moody than usual since a grandparent died of a COVID-19 infection last month. They also report that the patient sleeps all day and sometimes doesn’t wake up until noon or later. They tell the nurse that they invite the patient to go with them to the dining hall most meals, but he declines most of the time and, when he does go, he will only eat a few bites. Edward admits to feeling “empty most days” and “doesn’t do much most days” and that “nothing is really fun anymore.”Edward states he “abandoned his grandfather who died alone in the ICU.” The nurse determines his depressive symptoms may be complicated due to “survivor’s guilt” and identifies his grief as (choose the best answer):

A.

Anger

B.

Bargaining

C.

Denial

D.

Complex or disenfranchised grief

Answer and Explanation

The Correct Answer is D

Choice A reason:

Anger is a common stage of grief where individuals may feel frustration and helplessness. While Edward may experience anger, his primary issue appears to be more complex, involving feelings of guilt and abandonment, which are indicative of a more complicated form of grief.

 

Choice B reason:

Bargaining is another stage of grief where individuals may try to make deals or promises in an attempt to reverse or lessen the loss. Edward’s feelings of guilt and abandonment do not align with the bargaining stage but rather suggest a deeper, more complicated grief process.

 

Choice C reason:

Denial is the initial stage of grief where individuals may refuse to accept the reality of the loss. Edward’s acknowledgment of his feelings and his depressive symptoms indicate that he is not in denial but rather struggling with more complex emotions related to his loss.

 

Choice D reason:

Complex or disenfranchised grief refers to a prolonged and intense form of grief that can occur when the loss is not openly acknowledged or socially supported. Edward’s feelings of guilt and abandonment, along with his depressive symptoms, suggest that he is experiencing a more complicated form of grief that requires specialized support and intervention.


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View Related questions

Correct Answer is ["B","C","D"]

Explanation

Choice A reason:

Advising the patient he will have permanent memory loss is incorrect. While temporary memory loss can occur with ECT, it is not typically permanent. It is important to provide accurate information about potential side effects without causing unnecessary fear.

Choice B reason:

Authorizing MD signs off medical clearance that may require pre-op checklist to include EKG or lab work is an important consideration. Medical clearance ensures that the patient is physically fit for the procedure and helps identify any potential risks.

Choice C reason:

Signed informed consent by MD and patient and nurse follows up using “Teach Back Method” answering any further post-op or pre-op questions is essential. Informed consent ensures that the patient understands the procedure, risks, and benefits. The “Teach Back Method” confirms that the patient comprehends the information provided.

Choice D reason:

NPO after midnight and hold all meds unless specified such as a sip of water and blood pressure pill ordered by MD is a standard pre-op instruction. Fasting reduces the risk of aspiration during anesthesia, and holding medications ensures that the patient does not take anything that could interfere with the procedure.

Correct Answer is C

Explanation

Choice A reason:

Tea-colored urine and constipation are not characteristic symptoms of serotonin syndrome. These symptoms may indicate other medical conditions but are not related to the excessive accumulation of serotonin in the body.

Choice B reason:

A productive cough and vomiting are not typical symptoms of serotonin syndrome. While vomiting can occur in severe cases, a productive cough is unrelated to serotonin syndrome and more indicative of respiratory conditions.

Choice C reason:

Muscle rigidity and high fever are hallmark symptoms of serotonin syndrome. This condition results from an excess of serotonin in the central nervous system and can lead to severe autonomic instability, hyperthermia, and neuromuscular abnormalities. Immediate medical intervention is required to manage these symptoms and prevent complications.

Choice D reason:

Hypotension and urinary retention are not primary symptoms of serotonin syndrome. While autonomic dysfunction can occur, the key features of serotonin syndrome include neuromuscular hyperactivity, autonomic instability, and altered mental status.

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