Missed PrepU Questions Basic Psychosocial Needs

The nurse is caring for a client who recently lost an infant to sudden infant death syndrome (SIDS). The client talks about how going back to work last week and that the couple want to become pregnant again soon to have another baby. The client reports feeling sad sometimes, but also feeling happy sometimes. What stage of grief does this client demonstrate? a. acceptance b. bargaining c. denial d. delusion

a

experiencing the emotions associated with grief before the expected loss actually happens.

anticipatory grief

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.

b, c, e; 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.

Disenfranchised grief is when your grieving doesn't fit in with your larger society's attitude about dealing with death and loss. The lack of support you get during your grieving process can prolong emotional pain.

disenfranchised grief

The family of a client receiving hospice care takes a dinner break only to learn that the client died while they were absent from the bedside. What should the nurse do to console the family at this time? a. Allow the family to feel guilty for leaving the client to die alone. b. Discuss how the client is no longer in pain and is now at rest. c. Explain that the time of death could not be predicted. d.Stay with the family while they view the body.

d. The family may go to great lengths to ensure that their loved one will not die alone. However, despite the best intentions and efforts of the family and clinicians, the client may die at a time when no one is present. If the client dies while family members are not present, the family may express feelings of guilt and will need emotional support. This would be provided by staying with the family while they view the body. Even though the time of death cannot be predicted, some clients appear to "wait" until family members are away from the bedside to die. The family does not need to hear how the client is no longer in pain and at rest. The family needs emotional support. The family should not be permitted to feel guilty for leaving the client. The family should take rest periods away from the bedside in order to provide the best support to the client.

painful experiences are intermingled with positive feelings, such as relief, joy, peace, and happiness that emerge after the loss of an important person. Frequently, these positive feelings elicit negative emotions of disloyalty and guilt in the bereaved.

uncomplicated grief

The nurse is teaching a group of high school students about risk-taking behaviors. Which topic would be considered an example of healthy behaviors? a. preventative vaccinations b. effects of cigarette smoking c. responsible drinking patterns d. motor vehicle accidents

a. Preventative vaccinations are not associated with a risk-taking behavior. Vaccinations are used as vehicles to prevent communicable diseases rather than living dangerously. The other choices are all associated with risk-taking behaviors: smoking, drinking, and motor vehicle accidents. These are especially important to discuss with young adults.

represents a failure to follow the predictable course of normal grieving to resolution

dysfunctional grief

The nurse notes that the client seems anxious. Which strategy should the nurse use to enhance communication? a. Ask about the source of the anxiety. b. Sit down to talk with the client. c. Maintain a distance of 6 to 12 inches. d. Maintain a neutral facial expression.

b. Sitting down to talk with the client enhances communication because it shows a willingness to take the time to listen. Asking direct questions limits the communication and decreases the client's ability to discuss his or her concerns. Maintaining a distance of only 6 to 12 inches with a client is likely to make him/her uncomfortable as the nurse is in the client's personal space; 18 inches to 4 feet (not 6 to 12 inches) while speaking allows most clients to feel comfortable, thereby enhancing communication. A concerned expression, not a neutral one, demonstrates interest and attention.

The nurse is meeting with a community group to discuss the changes that need to be made to meet their health needs after a community assessment has been done. One cultural group is insisting their views need to be implemented because they are in the majority in that community. What is the best action by the nurse? a. Seek to promote homogeneity and common views rather than focus on differences. b. Support the implementation of the ideas of the majority. c. Seek input from all groups and strive for consensus on what would benefit most or all of these people. d. Make decisions based on findings from the community assessment.

c. The responsibility is to conduct the community assessment and to identify the key needs. All members need to have representation in this process. It is best to strive for consensus on what the key issues are and to implement programs that would benefit most of the people, rather than responding to one interest group. Listening to the majority viewpoint or helping everyone to change their views and have homogeneity would not be effective. Decisions based on the community alone are also not an appropriate answer.

A client whose child has died is withdrawn, has flat affect, makes minimal eye contact, and states, "I can't live without my child." What is the most appropriate response by the nurse? a. "Would you like me to call your spouse?" b. "Could I call the health care provider for you?" c. "This is a normal response to the loss of a loved one." d. "I would like to sit with you and talk about your child."

d. This choice is the focused therapeutic response that would generate client-focused discussion. Calling someone else is not client focused and nursing intervention based. Stating that this is a normal response is nontherapeutic, and calling the health care provider is incorrect because the it is within the nurse's scope of practice to resolve this issue.

A child with a nut allergy presents with a severe reaction for the third time in 3 months. The parent says, "I'm having trouble with the food labels." What should the nurse do first? a. Refer the client to the dietician. b. Assess the parent's ability to read. c. Notify the health care provider (HCP). d. Obtain a social service consult.

b. Three severe reactions in 3 months indicate a serious problem with adhering to the prevention plan. The nurse should first determine if the parent can actually read the label. The underlying problem may be that the parent is visually impaired or unable to read. The parent's reading level determines what additional support is needed. Referrals to social services or a dietician may be indicated, but the nurse does not yet have enough information about the problem. The nurse would communicate with the HCP after assessing the situation to recommend referrals.

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? a. anticipatory b. dysfunctional c. uncomplicated d. disenfranchised

b. dysfunctional; 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.