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.