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):
Anger
Bargaining
Denial
Complex or disenfranchised grief
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 D
Explanation
Choice A reason:
Adolescents can experience social isolation and mental health challenges, but they are not the age group most likely to face chronic health problems that lead to suicidal risk. While adolescent suicide is a serious concern, older adults are more prone to chronic health issues and social isolation.
Choice B reason:
Young adults may also face social isolation and mental health issues, but they generally have fewer chronic health problems compared to older adults. The combination of social isolation and chronic health conditions is more prevalent in the geriatric population.
Choice C reason:
Middle-aged adults can experience significant stressors, such as career pressures and family responsibilities, which may contribute to mental health issues. However, they are not the age group most at risk for social isolation and chronic health problems leading to suicidal risk.
Choice D reason:
Geriatric or older adults are the age group most likely to be at risk for social isolation and have chronic health problems that lead to suicidal risk. Older adults often face multiple chronic health conditions, loss of loved ones, and reduced social networks, all of which can contribute to feelings of isolation and increased suicidal risk. Addressing these issues through social support and healthcare interventions is crucial for this population.
Correct Answer is C
Explanation
Choice A reason:
Being afraid of medical providers is not a determining factor for the suitability of rTMS. While patient comfort and willingness to undergo treatment are important, the primary considerations for rTMS eligibility are medical and safety-related.
Choice B reason:
His family’s agreement to take him to the hospital each week is supportive but not a primary criterion for rTMS eligibility. The focus should be on the patient’s medical suitability and safety for the procedure.
Choice C reason:
Signing an informed consent and having no presence of metal in the area of the magnetic stimulation, such as cochlear implants or medication pumps, are critical factors for rTMS eligibility. Metal implants in the head or neck can interfere with the magnetic fields used in rTMS, posing safety risks. Informed consent ensures that the patient understands the procedure, risks, and benefits.
Choice D reason:
Being angry about the death of his father is an emotional response and does not impact the medical suitability for rTMS. The decision to use rTMS should be based on medical criteria and safety considerations.