A client has been given a diagnosis of human immunodeficiency virus (HIV). Which statement made by the client does the nurse recognize as the bargaining stage of grief?

Correct Answer: B

Rationale: The correct answer is B: "If I don't do intravenous (IV) drugs anymore, God won't let me die." This statement reflects the bargaining stage of grief, where the individual tries to negotiate with a higher power to avoid the negative outcome. It shows a sense of trying to control the situation through a specific action. In contrast, choices A, C, and D do not demonstrate bargaining behavior. Choice A expresses anger and blame, not bargaining. Choice C shows acceptance and proactive behavior, not bargaining. Choice D reflects denial or disbelief in the diagnosis, not bargaining.

Correct Answer: C

Rationale: The correct answer is C because the statement indicates that the wife has gained insight and reflection on the experience, showing acceptance. Choice A reflects regret and longing for reconciliation, not acceptance. Choice B demonstrates anger and resentment, not acceptance. Choice D suggests ongoing distress and difficulty coping, not acceptance. Acceptance involves acknowledging the reality of the situation, learning from it, and moving forward positively.

Correct Answer: A

Rationale: In interpersonal psychotherapy (IPT), the commonly used psychotherapeutic technique is communication analysis. This technique focuses on improving communication patterns and understanding how interpersonal interactions contribute to the individual's emotional distress. A) Communication analysis is the correct answer because it is central to IPT. By analyzing and improving communication patterns, individuals can enhance their relationships and address underlying emotional issues effectively. B) Exploring transference is a technique commonly associated with psychodynamic therapy, not specifically IPT. Transference involves projecting feelings onto the therapist based on past relationships, which is not the primary focus of IPT. C) Strengthening defense mechanisms is more aligned with psychodynamic or cognitive-behavioral approaches rather than IPT. IPT focuses on improving interpersonal relationships rather than solely focusing on individual defense mechanisms. D) Testing the validity of thoughts against reality is a cognitive-behavioral therapy technique aimed at challenging and changing negative thought patterns. This approach is not a primary technique used in IPT, which focuses on interpersonal dynamics. Educationally, understanding the specific techniques associated with different therapeutic approaches is crucial for mental health professionals to provide effective treatment tailored to the individual's needs. Knowing the core techniques of IPT helps clinicians apply the appropriate interventions to address interpersonal issues and improve overall mental well-being.

Correct Answer: D

Rationale: In the context of psychiatric emergencies, the correct answer is option D: Helping school children learn to manage stress and be resilient. This option is a form of primary prevention for suicide because it focuses on promoting mental health and well-being in a population before any suicidal ideation or behavior occurs. By teaching children coping strategies, stress management skills, and resilience-building techniques, we can potentially reduce the risk of suicide in the future. Option A, psychiatric hospitalization of a suicidal patient, is a form of tertiary prevention aimed at managing and treating individuals who are already at high risk for suicide. This is not considered primary prevention as it is addressing the issue after it has already arisen. Option B, referral of a formerly suicidal patient to a support group, falls under secondary prevention as it aims to prevent recurrence or worsening of suicidal behavior in individuals who have already exhibited such tendencies. While support groups can be beneficial for individuals at risk, they do not target the broader population for prevention purposes. Option C, suicide precautions for 24 hours for newly admitted patients, is a form of secondary prevention that focuses on closely monitoring and ensuring the safety of individuals who are currently at risk for suicide. This measure does not address preventing suicide in the general population or before suicidal behavior emerges. In an educational context, it is crucial to understand the different levels of prevention in addressing psychiatric emergencies like suicide. By emphasizing primary prevention strategies such as teaching children resilience and stress management skills, we can work towards creating a mentally healthy environment that reduces the likelihood of suicide in the future. This approach underscores the importance of early intervention and promotion of mental well-being in our communities.

Correct Answer: C

Rationale: In the context of a person intentionally overdosing on antidepressants, the nursing diagnosis with the highest priority is "C) Risk for suicide." This is because the individual's immediate safety is the primary concern when dealing with a suicide attempt. Assessing and managing the risk for suicide takes precedence over other nursing diagnoses in this critical situation. Option A) Powerlessness may be a valid nursing diagnosis for this scenario, as the individual may indeed feel powerless, but addressing the immediate risk of suicide is of higher priority. Option B) Social isolation is also important to address, as social support plays a role in mental health, but it is secondary to ensuring the person's safety in a psychiatric emergency. Option D) Compromised family coping is relevant, considering the impact on the individual's family, but in an acute psychiatric emergency, the immediate risk of suicide takes precedence over addressing family coping mechanisms. Educationally, this question highlights the critical thinking skills required in psychiatric emergencies. It emphasizes the importance of prioritizing nursing interventions based on the urgency of the situation and the potential for harm. Understanding the hierarchy of nursing diagnoses in psychiatric emergencies is crucial for providing effective and timely care to individuals in crisis.