Basic Psychosocial Needs
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Baptist
Birth and death rituals: At birth, none (baptism of believers only); before death, counseling by a clergy member and prayer Dietary restrictions: Alcohol, coffee, and tea (in some groups) prohibited Practices in health crisis: Healing by laying on of hands (in some groups) as well as resistance to medical therapy (occasionally approved)
The client who has a history of angry outbursts when frustrated begins to curse at the nurse during an appointment after being informed that she will have to wait to have her medication refilled. Which response by the nurse is most appropriate? "You're being very childish." "I'm sorry if you can't wait." "I won't continue to talk with you if you curse." "Come back tomorrow, and your medication will be ready."
Correct response: "I won't continue to talk with you if you curse." Explanation: Stating "I won't continue to talk with you if you curse" sets limits on the client's behavior and points out the negative effects of her behavior. Therefore, this response is most appropriate and therapeutic. The statement "You're being very childish" reprimands the client, possibly causing the anger to escalate. The statement "I'm sorry if you can't wait" fails to provide feedback to the client about her behavior. The statement "Come back tomorrow, and your medication will be ready" ignores the client's behavior, failing to provide feedback to the client about the behavior. It also shows poor nursing judgment because the client may need her medication before tomorrow or may not return to the clinic the following day.
Which activity would be most appropriate to include in a playroom that will be used by children aged 13 months to 6 years? A. free play with adult supervision B. a group sing-along C. drawing and painting projects D. viewing cartoon videos
Correct response: free play with adult supervision Explanation: Planning any single activity that will appeal to children from ages 13 months to 6 years is next to impossible because of the developmental differences found in such a wide age group. It would be best to allow these children to participate in free play with adult supervision. A group sing-along would be appropriate for preschoolers and school-aged children. However, toddlers have short attention spans and would most likely find it difficult to participate in a group activity, such as a sing-along. Although drawing and painting projects would be appropriate for preschoolers and school-aged children, toddlers have a tendency to put objects into their mouths. Therefore, drawing and painting projects would be inappropriate for this age group. Viewing cartoon videos would be inappropriate for young toddlers, who typically have short attention spans. Additionally, young toddlers may not understand the videos.
Libel versus slander
Libel is a defamatory statement that is written. Slander is a defamatory statement that is oral.
What religion is "anointing of the sick" seen in?
Roman Catholic
Uncomplicated grief
is a grief reaction that normally follows a significant loss and proceeds normally.
What are the 5 stages of grief? (Mnemonic device)
1. Denial -feeling of shock and numbness, disbelief that this is real. 2. Anger 3. Bargaining 4. Depression -characterized by withdrawal from life and loved ones, feelings of intense sadness, and feeling like there is no reason to go on. 5. Acceptance -is accepting the new reality, focusing on what time is left and trying to make the most of it. D: DEATH (Denial) A:ALWAYS (anger) B:BRINGS (bargaining) G:GREAT (grieving/depression) A:ACCEPTANCE
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Eastern Orthodox
Birth and death rituals: At birth, baptism and confirmation; before death, last rites and, for members of the Russian Orthodox Church, arms crossed after death, fingers set in a cross, and unembalmed body clothed in natural fiber Dietary restrictions: For members of the Russian Orthodox Church and usually the Greek Orthodox Church, no meat or dairy products on Wednesdays and Fridays and during Lent Practices in health crisis: Anointing of the sick; for members of the Russian Orthodox Church, replacement of cross necklace immediately after surgery and prohibition of shaving of male patients, except in preparation for surgery; for members of the Greek Orthodox Church, communion and Sacrament of Holy Unction
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Episcopalian
Birth and death rituals: At birth, baptism; before death, occasional last rites Dietary restrictions: For some members, abstention from meat on Fridays and fasting before communion (which may be daily) Practices in health crisis: Communion, prayer, and counseling (all performed by a minister)
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Hindu
Birth and death rituals: At birth, importance of noting the exact time of birth; Jatakarma (ceremony that involves putting honey into the child's mouth and whispering the name of God in the child's ear to welcome the baby into the family); possibly, postponement of naming until 10 days after birth; if the patient is dying, possible aromatherapy to assist the dying patient's soul to rest in peace; at death, proper performance of funeral rites to ensure the cycle of life and reincarnation Dietary restrictions: Beef intake prohibited; possibly, vegetarian diet; possibly fasting on special occasions, such as holy days (dietary restrictions may vary during different stages of life) Practices in health crisis: Preference by women for female health care providers; possible desire to wear personal clothing under hospital gown; possible unwillingness to discuss problems involving the genitourinary system; desire to keep small statue or picture of the family god at the bedside and to start each day with prayer
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Mormon
Birth and death rituals: At birth, none (baptism at age 8 years or older); before death, baptism and gospel preaching Dietary restrictions: Alcohol, tobacco, tea, and coffee prohibited; meat intake limited Practices in health crisis: Belief in divine healing through the laying on of hands; communion on Sundays; refusal of medical treatment by some members; special undergarment worn by many
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Christian Scientist
Birth and death rituals: At birth, none; before death, counseling by a Christian Science practitioner Dietary restrictions: Alcohol, coffee, and tobacco prohibited Practices in health crisis: Refusal of all treatment (most groups), including drugs, biopsies, physical examination, and blood transfusions; vaccinations permitted only when required by law; alteration of thoughts to cure illness; hypnotism and psychotherapy prohibited (beliefs honored by Christian Scientist nurses and nursing homes)
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Buddhist
Birth and death rituals: At birth, none; when possible, continuation of life and therefore pursuit of Enlightenment to observe Buddhist respect for all life; if prolonging life won't permit continued pursuit of Enlightenment, possible acceptance of euthanasia, withdrawal of care, and organ donation Dietary restrictions: Vegetarian diet, dietary moderation Practices in health crisis: No specific restrictions, but moderation possibly encouraged to support pursuit of Enlightenment
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Lutheran
Birth and death rituals: Baptism usually performed 6 to 8 weeks after birth Dietary restrictions: None Practices in health crisis: Communion, prayer, and counseling (all performed by a minister)
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Muslim
Birth and death rituals: Fetus aborted spontaneously before 130 days treated as discarded tissue and after 130 days treated as a human being; before death, confession of sins with family present; after death, only relatives or friends may touch the body Dietary restrictions: Pork prohibited; daylight fasting during the ninth month of the Islamic calendar Practices in health crisis: Faith healing administered for the patient's morale only; rejection of medical therapy by conservative members; possible preference for same-gender health care provider; possibly many visitors for a hospitalized patient to fulfill the religious obligation of charity; possible request for the bed be turned toward Mecca for prayer (if bedridden); possible use of a prayer rug, if physically able; obtain permission before entering the patient's room, if possible.
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Roman Catholic
Birth and death rituals: Infant baptism, including baptism of aborted fetus without signs of clinical death (tissue necrosis); before death, last rites, which includes confession, anointing of the sick, and final communion. Dietary restrictions: Fasting or abstention from meat on Ash Wednesday and on Fridays during Lent (practice usually waived during hospitalization) Practices in health crisis: Burial of major amputated limb (sometimes) in consecrated ground; organ donation or transplantation allowed if the benefit to the recipient outweighs the donor's potential harm; Anointing of the Sick sacrament performed just before death as well as when patients are ill and sometimes shortly after admission9
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Orthodox Presbyterian
Birth and death rituals: Infant baptism; scripture reading and prayer before death Dietary restrictions: None Practices in health crisis: Communion, prayer, and counseling (all performed by a minister)
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Jehovah's Witness
Birth and death rituals: None Dietary restrictions: Abstention from foods to which blood has been added Practices in health crisis: Typically, no blood transfusions permitted; possible court order required for emergency transfusion
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Church of Christ
Birth and death rituals: None (baptism at age 8 years or older) Dietary restrictions: Alcohol discouraged Practices in health crisis: Communion, anointing with oil, laying on of hands, and counseling (all performed by a minister)
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Adventist
Birth and death rituals: None (baptism of adults only) Dietary restrictions: Alcohol, coffee, tea, opioids, stimulants, and meat or animal products (in some groups) prohibited Practices in health crisis: Communion and baptism, divine healing, anointing with oil, prayer, and Saturday Sabbath (in some groups)
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: United Methodist
Birth and death rituals: None (baptism of children and adults only) Dietary restrictions: None Practices in health crisis: Communion administered before surgery or similar crisis; donation of body parts encouraged
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Pentecostal Assembly of God, Foursquare Church
Birth and death rituals: None (baptism only after age of accountability) Dietary restrictions: Abstention from alcohol, tobacco, meat slaughtered by strangling, any food to which blood has been added, and sometimes pork Practices in health crisis: Divine healing through prayer, anointing with oil, and laying on of hands
BELIEFS AND PRACTICES OF SELECTED RELIGIONS: Judaism
Birth and death rituals: Ritual male circumcision on the eighth day after birth; burial of a dead fetus; ritual washing of the dead; burial (including organs and other body tissues) as soon as possible; no autopsy or embalming Dietary restrictions: For Orthodox and Conservative Jews, kosher dietary laws (for example, pork and shellfish prohibited); for Reform Jews, usually no restrictions Practices in health crisis: Rabbinical consultation required for organ donation or transplantation; for Orthodox and Conservative Jews, medical procedures possibly prohibited on the Sabbath (from sundown Friday to sundown Saturday) and on special holidays except where withholding the procedure would be detrimental to the person's health.5
Six months after undergoing a radical modified mastectomy to treat breast cancer, a client is admitted for chemotherapy. When the nurse enters the client's room, the client is sobbing and states, "I thought the chemotherapy would help, but now I feel worse." Which response by the nurse is most appropriate? A. "You sound discouraged. Chemotherapy commonly makes people feel worse." B. "Can you tell me more about how you are feeling right now about your treatment?" C. "Can you tell me what side effects of the chemotherapy are most troubling for you?" D. "It can be discouraging to feel worse after treatment. How can I help you feel better?"
Correct response: "Can you tell me more about how you are feeling right now about your treatment?" Explanation: In asking the client how they are feeling about treatment, the nurse is engaging in active listening by focusing on the actual information offered by the client. This promotes interactions focused on the client's feelings and concerns. Addressing the client's feelings validates the client as a person and helps establish trust. Focusing only on side effects of chemotherapy is an assumption by the nurse and narrows the client's ability to respond. Simply making statements about how the feelings are common will not facilitate exploration of the client's feelings. Asking the client to say how the nurse can help does not encourage more discussion about how the client feels.
A nurse is caring for a spiritually distressed client. Which are the factors affecting spiritual distress? Select all that apply. self-alienation chronic illness seeing a religious leader ability to introspect sociocultural deprivation
Correct response: self-alienation chronic illness sociocultural deprivation Explanation: Factors affecting spiritual distress include self-alienation, loneliness, or social isolation; anxiety; sociocultural deprivation; thought of death of self or dying of others; pain; life changes; and chronic illness of self or others. Disconnectedness to self can be expressed through an inability to introspect or an inability to see a religious leader.
A home health nurse is working with the family of a client who has Alzheimer's disease. The nurse notes that the client's spouse is too exhausted to continue providing care alone. The adult children live too far away to provide relief on a weekly basis. Which nursing interventions would be most helpful? Select all that apply. A. mediating a family meeting to confirm that additional family support is needed B. suggesting the spouse seek psychological counseling to help cope with exhaustion C. recommending community resources for adult day care and respite care for the client D. encouraging the spouse to talk about the difficulties involved in caring for a loved one with Alzheimer's disease E. asking whether friends or church members can help with errands or provide short periods of relief F. recommending that the client be placed in a long-term care facility
Correct response: C. recommending community resources for adult day care and respite care for the client D. encouraging the spouse to talk about the difficulties involved in caring for a loved one with Alzheimer's disease E. asking whether friends or church members can help with errands or provide short periods of relief Explanation: Many community services exist for Alzheimer's clients and their families. Encouraging use of these resources may make it possible to keep the client at home and to alleviate the spouse's exhaustion. The nurse can also support the caregiver by urging them to talk about the difficulties faced in caring for a spouse. Friends and church members may be able to help provide care to the client, allowing the caregiver time for rest, exercise, or an enjoyable activity. Mediating a family meeting to confirm family needs to the adult children would probably be ineffective and might evoke anger or guilt. Counseling might be helpful, but it would not alleviate the caregiver's physical exhaustion or address the client's immediate needs. A long-term care facility is not an option until the family is ready to make that decision.
A client with bleeding esophageal varices and cirrhosis of the liver due to alcoholism asks the nurse, "Will I survive and make it out of the hospital? One of my friends died from the same problem." What is the best nursing response? -"You'll be okay after the physician gets the bleeding under control." -"That's a difficult question to answer, and this must be very frightening for you." -"What makes you think you're not going to make it?" -"Chronic alcoholism has serious consequences, and you may have the same outcome as your friend."
Correct response: "That's a difficult question to answer, and this must be very frightening for you." Explanation: This answer is an honest response that acknowledges the client's fears and concerns, yet does not give false reassurance.
A client is scheduled for cardiac catheterization. The client reports being nervous because there have been incidents of people dying during this procedure. How would the nurse respond? A. "Do you have any history of an anxiety disorder we should be aware of?" B. "All procedures carry some degree of risk and the risk with this one is very low." C. "What makes you think you will die during the cardiac catheterization procedure?" D."Would you like to go over the details of the procedure with me now?"
Correct response: "Would you like to go over the details of the procedure with me now?" Explanation: The client's statements reflect anxiety about the upcoming procedure, which is normal and should not prompt the nurse to suspect the client has a history of any anxiety disorders, which is a medical diagnosis. Often fear related to procedures is related to uncertainty, so the nurse should offer to clarify the procedure with the client as a first step. The client did not state believing they would die during the procedure, only that the client is aware that others have so the nurse would be inaccurate in summarizing the client's concern in this way. Stating all procedures carry risk and this is a safe one is dismissive of the client's concerns.
A nurse is working in the emergency department when a woman comes in reporting that she was notified that her husband was just admitted following an accident. The woman is pacing, tearful, and her attention span seems poor. The nurse recognizes that the woman is having moderate anxiety. What should be the nurse's first response? A. "Hi! I'm really glad you are here. I work on this unit and was here when your husband came in. He was in really bad shape." B. "Your husband is awake and stable right now. I'll take you to his room." C. "Your husband had an X-ray, and he might have a fractured femur. His hemoglobin and hematocrit are stable. He is diaphoretic. He has had an analgesic while awaiting an orthopedic consultation." D. "You seem really nervous about all of this. Maybe you should complete the admission paperwork before seeing your husband."
Correct response: "Your husband is awake and stable right now. I'll take you to his room." Explanation: When people are experiencing moderate anxiety, their attention span is limited and they are only able to focus on immediate concerns, so being brief and concise with communication initially is best. Giving the client too many details, or using medical terms prior to her knowing the immediate condition of her husband, will just increase her anxiety. At this point she is also unable to focus on details such as paperwork as her immediate concern is her husband.
A nurse is caring for multiple grieving clients. Which client is most likely to experience disenfranchised grief? A. A 50-year-old client whose ex-spouse died suddenly in a motor vehicle accident B. A 60-year-old client whose child has been diagnosed with terminal cancer C. A 70-year-old client whose best friend died from a heart attack D. An 80-year-old client whose spouse died from Alzheimer disease
Correct response: A 50-year-old client whose ex-spouse died suddenly in a motor vehicle accident Explanation: The 50-year-old client whose ex-spouse died suddenly in a motor vehicle accident is most likely to experience disenfranchised grief, as this is not a loss that is typically recognized by others, because they are divorced. The 60-year-old client whose child has been diagnosed with terminal cancer is probably currently experiencing anticipatory grief, as the client is anticipating the death of a child. The 70-year-old client whose best friend died from a heart attack and the 80-year-old client whose spouse died from Alzheimer disease do not have any indications that they will experience disenfranchised grief, as the loss of a close friend or spouse is well-recognized by others.
Which description best matches the role of a parish nurse? A. A nurse who works to reintegrate the healing tradition into the life of a faith community. B. A trained layperson who provides for the spiritual needs of a congregation or parish. C. A nurse who provides home health services similar to a visiting nurse. D. A spiritual leader, such as a minister, who is also a registered nurse.
Correct response: A nurse who works to reintegrate the healing tradition into the life of a faith community. Explanation: Parish nurses and health ministry teams work to reintegrate the healing tradition into the life of faith communities. The key roles of the parish nurse are health educator, personal health counselor, referral agent, trainer of volunteers, developer of support groups, integrator of faith and health, and health advocate. Parish nurses are not visiting nurses or home health nurses.
The nurse is caring for an older adult client with end stage heart disease who has repeatedly stated in the past that they want no lifesaving care if their heart stops. Now the client is confused and the children have informed the nurse that they want CPR provided if the client's heart stops. What would the nurse do next? Select all that apply. A. Call the health care provider and make the family's current wishes known so that the DNR is changed. B. Verify that the code status order that is on the chart now is a DNR as the client desired. C. Explain to the family that even confused, the client's past wishes will be followed. D. Ignore the family request for full code status and hope the client's heart doesn't stop. E. Discuss the complexity of the illness and what would happen if CPR was initiated.
Correct response: B. Verify that the code status order that is on the chart now is a DNR as the client desired. C. Explain to the family that even confused, the client's past wishes will be followed. E. Discuss the complexity of the illness and what would happen if CPR was initiated. Explanation: The nurse's primary commitment is always to the client, whether as an individual, family, group, or community. The nurse serves as the advocate or spokesperson for the client, who frequently does not understand the complexity of his or her illness or disease and is unaware of treatment modalities and outcomes of care. The other activities would not advocate for the client.
A mother reports she cannot afford the antibiotic azithromycin, which was prescribed by the health care provider (HCP) for her toddler's otitis media. What is the nurse's best response? A. Instruct the mother on the importance of the medication. B. Ask the mother if she has considered using any medical assistance programs in her community. C. Confer with the HCP about whether a less expensive drug could be prescribed. D. Consult with the social worker.
Correct response: Confer with the HCP about whether a less expensive drug could be prescribed. Explanation: The nurse must act as an advocate for the client when the client cannot afford treatment. It may be possible to substitute a less expensive antibiotic. Correct procedure includes contacting the HCP to explain the mother's economic situation and request a substitution. For example, amoxicillin is more economical than azithromycin. If it is not possible to use another antibiotic, then the nurse can explore other avenues with the mother and/or social worker.
The adult child of a dying client is surprised at a parent's adamant request to meet with the hospital chaplain and has taken the nurse aside and said, "I don't think that's what my parent really wants. My parent has never been a religious person in the least." What is the nurse's best action in this situation? -Contact the chaplain to arrange a visit with the client. -Perform a detailed spiritual assessment of the client. -Organize a meeting between the chaplain, the adult child, and the client to achieve a resolution. -Document the client's request and wait to see if the parent reiterates the request.
Correct response: Contact the chaplain to arrange a visit with the client. Explanation: The nurse's primary duty is to honor the client's request for a meeting with a spiritual adviser.
The nurse is caring for a client whose spouse has just passed away. The nurse knows that according to the Kubler-Ross Model of Grief, there are five stages of grief that most grieving people progress through in order, although not everyone experiences all stages or in this order. Place the stages of grief in the order that is most commonly observed, and that the nurse would expect to see in this grieving client. List the 5 stages of grief...
Correct response: Denial Anger Bargaining Depression Acceptance Explanation: Elisabeth Kubler-Ross described the five stages of grief as a model that many grieving clients progress through. Although not all clients will experience all five stages or in this chronological order, and some may go back and forth between the stages, the nurse should understand the five stages of grief and be able to put them in the chronological order that the majority of clients will experience which is denial, anger, bargaining, depression and acceptance.
An older adult client shares with the nurse having never gotten over the grief of losing a parent 22 years ago. The client states that the parent completed suicide and the client found the parent and called for emergency assistance. The nurse assesses that the client is experiencing which type of grief? Anticipatory Uncomplicated Disenfranchised Dysfunctional
Correct response: Dysfunctional Explanation: Dysfunctional grief is intense grief that does not result in reconciliation of feelings, such as this client is experiencing. Anticipatory grieving is grief before the actual loss occurs. Uncomplicated grief is a grief reaction that normally follows a significant loss and proceeds normally. Disenfranchised grief is grief that is not openly acknowledged, socially sanctioned, or publicly shared.
The family of a client who dies lives an hour away from the facility. What should the nurse do to support the family at this time? A. Move the client to a private room. B. Transport the client to the facility morgue. C. Keep the client in the bed until the family arrives. D. Notify the family to visit the client at the mortuary.
Correct response: Keep the client in the bed until the family arrives. Explanation: In a hospital or long-term care facility, the nurse should follow the facility's procedure for preparation of the body and transportation to the facility's morgue. However, the needs of families to remain with the deceased, to wait until other family members arrive before the body is moved, and to perform after-death rituals should be honored. The client should not be moved to a private room, transported to the facility morgue, or transported to the mortuary without the family first having an opportunity to view the body in the facility.
Family members of a dying client have asked for the hospital chaplain's help in having a member of the clergy come to the patient's bedside to perform Anointing of the Sick. The nurse who is providing care for the client should recognize that the family is likely... Roman Catholic. Christian Scientist. Jehovah's Witness. Jewish.
Correct response: Roman Catholic. Explanation: Among the sacraments of the Roman Catholic Church is the Anointing of the Sick. This specific rite is not a component of Jehovah's Witness, Christian Scientist, or Jewish religious belief.
An appropriate nursing diagnosis for a bedridden and hospitalized client who tells the nurse that they are upset because they haven't missed a Methodist church service in 50 years is... A. Spiritual distress related to inability to attend church services evidenced by verbal states of guilt. B. Spiritual need as evidenced by verbalization and distress at missing Methodist church services. C. Dysfunctional grieving related to inability to attend church services as a result of the client's medical condition. D. Potential for Enhanced spiritual well-being related to distress at missing Methodist church services.
Correct response: Spiritual distress related to inability to attend church services evidenced by verbal states of guilt. Explanation: People with Spiritual dysfunction or Spiritual distress may verbalize such distress or express a need for help.
An 80-year-old client with severe kidney damage is placed on life support and dialysis. Care decisions are being made by his wife, who is showing signs of early Alzheimer's disease. The client's daughter arrives from out of town with a copy of the client's living will, which states that the client did not want to be on life support. What action should the nurse take next? -Immediately inform the health care provider (HCP) about the living will. -Suggest to the daughter that she discuss her father's wishes with her mother. -Prepare to remove the client from life support. -Make a copy of the living will and give it to the client's wife.
Correct response: Suggest to the daughter that she discuss her father's wishes with her mother. Explanation: The most appropriate action is to encourage the daughter to talk to her mother about the end-of-life issues first to reach a consensus or agreement. This is a family decision. Immediately informing the HCP or preparing to remove the client from life support would be premature if the family is not in agreement. Although a copy of the living will should be on the client's medical record, it is up to the daughter to show it to her mother.
A client from Pakistan informs the nurse of cultural dietary requests. The nurse responds to the special dietary needs by stating, "You are now living in the United States and you should try to start eating those foods common to an American diet." This inappropriate response is an example of cultural imposition. cultural blindness. cultural diversity. cultural assimilation.
Correct response: cultural imposition. Explanation: The nurse's response is an example of cultural imposition, which is defined as the belief that everyone should conform to the majority belief system. Cultural blindness is the result of ignoring differences and proceeding as though they do not exist. In this situation, the nurse did not ignore the request but inappropriately responded to it. Cultural diversity is defined as a diverse group in society, with varying racial classifications and national origins, religious affiliations, languages, physical sizes, genders, sexual orientations, ages, disabilities, socioeconomic statuses, occupational statuses, and geographic locations. Cultural assimilation occurs when members of a minority group live within a dominant group and lose the cultural characteristics that make them different.
A client who comes to the crisis center in a very distressed state tells the nurse, "I just can't get over being fired last week. I've asked for help. I've talked to friends. I've tried everything to get through this, but nothing is working. Help me!" Which initial crisis intervention strategy should the nurse use? referral for counseling support system assessment emotion management unemployment assistance
Correct response: emotion management Explanation: Letting the client express feelings (emotion management) is essential before trying to solve the problem or deciding what kind of referral is appropriate. A referral for counseling, assessment of the client's support system, and unemployment assistance may be appropriate after the client's anxiety is reduced.
A client suspects the end of life is near. However, others talk about only pleasant matters and maintain a persistently cheerful facade. The nurse plans care for this client by recognizing that these behaviors will most likely cause the client to experience which feeling? relieved isolation hope independence
Correct response: isolation Explanation: Clients tend to experience isolation and loneliness when those around them are trying to hide or mask the truth. They are then left to face the realities of death alone. Clients do not experience relief or hopefulness when others are falsely cheerful. Independence is promoted by offering realistic choices about care at the end of life.
Which philosophy should the nurse integrate into the plan of care for a client and family to help them best cope during the final stages of the client's illness? A. living each day as it comes as fully as possible B. reliving the pleasant memories of days gone by C. expecting the worst and being grateful when it does not happen D. planning ahead for the remaining good times that will be spent together
Correct response: living each day as it comes as fully as possible Explanation: When supporting the friends or family of a terminally ill client, it is best to focus on the present. This can be accomplished by living each day to its fullest. Friends and families also want to know what to expect and want someone to listen to them as they express grief over the approaching death. Focusing on the past can interfere with enjoying the present. Expecting the worst interferes with focusing on day-to-day positive experiences. Planning ahead is inappropriate because of uncertainty when the length of life is unknown.
A nurse is administering a prescribed dose of an injection to a middle-aged client with Bell's palsy. What are the sources of fulfillment in the middle-years of an adult client's life? productive activity advanced study sense of faith personal experiences
Correct response: productive activity Explanation: The middle years are fulfilled through productive activity—in Erikson's term, generativity. This time is of growth and renewed questioning, in some ways very similar to adolescence. For young adults, their beliefs and attitudes change due to some situations such as advanced study or education or new religious affiliations possibly intertwined with achieving intimate relationships, choosing careers, and starting families. The challenge during this stage is to establish one's own sense of faith and commitment based on personal experience and reflection on meaning in life.
x Nurses are aware that culture links a wide variety of behaviors and events uniquely. For Westerners, which is a culturally linked behavior to autopsy? A. the cause of death can be discovered B. rebirth is made impossible C. body ultimately decomposes into dust D. the continuation of society is prevented
Correct response: the cause of death can be discovered Explanation: Westerners believe that autopsy is used to discover the causes of death. Hmong who have not converted to Christianity believe that autopsy prevents continuation of society and rebirth. Judeo-Christians believe that the body ultimately decomposes into dust.
Which factors should be the primary factor in a nurse's decision whether to pray with a client? A. the client's openness to being prayed for B. the nurse's familiarity with the prayer traditions of different faiths C. the nature and course of the client's current diagnosis D. the availability of a hospital chaplain or other spiritual counselor
Correct response: the client's openness to being prayed for Explanation: Many factors influence the nurse's decision to pray with a client. Central among these, however, is the question of whether the client is open to this possibility. This factor is more important than the nurse's familiarity with specific prayer traditions, the patient's medical condition, or the presence or absence of a chaplain.
fetal demise
Infant who died in mother's womb before labor Labor will proceed as normal Infection will present foul odor Stage of Decomposition:Skin blisters, skin slogging, dark discoloration, head soft
Anticipatory grieving
is grief before the actual loss occurs.
Disenfranchised grief
is grief that is not openly acknowledged, socially sanctioned, or publicly shared.
Dysfunctional grief
is intense grief that does not result in reconciliation of feelings