ATI PN COPREHENSIVE 2020 PROCTORED

1.The nurse is discussing future treatments with a client who has a terminal illness. The nurse notes that the client has not been eating and responds to the nurses information by saying, What does it matter? The most ...

1.The nurse is discussing future treatments with a client who has a terminal illness. The nurse notes that the client has not been eating and responds to the nurses information by saying, What does it matter? The most appropriate nursing diagnosis for this client is: a. Social isolation b. Spiritual distress c. Denial d. Hopelessness d. A defining characteristic for the nursing diagnosis of hopelessness may include the client stating, 'What does it matter?' when offered choices or info concerning him. The clients behavior of not eating also is an indicator of hopelessness. a. This is not an example of social isolation. The client is not avoiding or restricted from seeing others. b. Spiritual distress is not the most appropriate nursing diagnosis for this client. The focus should be on the clients lack of hope. c. The clients behavior and verbalization does not indicate denial. 2.The nurse recognizes that anticipatory grieving can be most beneficial to a client or family because it can: a. Be done in private b. Be discussed with others c. Promote separation of the ill client from the family d. Help a person progress to a healthier emotional state d. The benefit of anticipatory grief: it allows time for the process of grief (i.e. to say good-bye & complete life affairs). it allows time to grieve in private, to discuss the anticipated loss w/ others, & to let go of the loved one. It can help a person progress to a healthier emotional state of acceptance & dealing w/ loss. a. Its not most beneficial for grieving to take place only in private. It is important for grief to be acknowledged by others, & to be able to receive the support of others in the grieving process. b. Anticipatory grieving can be discussed w/ others in most circumstances. However, at times, anticip. grief may be disenfranchised grief as well, meaning it cannot be openly acknowledged, socially sanctioned, or publicly shared, such as a partner dying of AIDS. The benefit of anticip. grieving is not so much that it can be discussed in most circumstances, as this discussion also can occur w/ normal grief when the actual loss has occurred. c. Anticip. grief is the process of disengaging or letting go that occurs before an actual loss or death has occurred. The benefit is not the separation of the ill client from the family as much as it is the process of being able to say good-bye, to put life affairs in order, and as a result, it can help a client or family to progress to a higher emotional state.3.A newly graduated nurse is assigned to his first dying patient. The nurse is best prepared to care for this client if he: a. Completed a course dealing with death and dying b. Is able to control his own emotions about death c. Experiences the death of a loved one d. Has developed a personal understanding of his own feelings about death d. When caring for clients experiencing grief, it’s important for the nurse to assess his own emotional well-being & to understand his own feelings about death. The nurse who is aware of his own feelings will be less likely to place personal situations & values before those of the client. a. Although course work on death & dying may add to the nurse’s knowledge base, it does not best prepare the nurse for caring for a dying client. The nurse needs to have an awareness of his own feelings about death first, as death can raise many emotions. b. Being able to control one’s own emotions is important; however, it is unlikely that the nurse would be able to do so if he has not first developed a personal understanding of his own feelings about death. c. Experiencing the death of a loved one is not prerequisite to caring for a dying client. Experiencing death may help an individual mature in dealing with loss, or it may bring up many negative emotions if complicated grief is present. The nurse is best prepared by first developing an understanding of his own feelings about death. 4.The family of a client with a terminal illness will be able to help provide some psychological support to their family member. To assist the family to meet this outcome, the nurse plans to include in the teaching plan: 1. Demonstration of bathing techniques 2. Application of oxygen delivery devices 3. Recognition of the clients needs and fears 4. Information on when to contact the hospice nurse c. A dying clients family is better prepared to provide psychological support if the nurse discusses with them ways to support the dying person and listen to needs and fears. a. Demonstration of bathing techniques may help the family meet the dying clients physical needs, not to providing psychological support. b. Application of oxygen devices may help the family provide physical needs for the client, not to provide psychological support for the client. d. Information on when to contact the hospice nurse is important knowledge for the family to have and may help them feel they are being supported in caring for the dying client. However, contact information does not help the family provide psychological support to the dying client.