A client is diagnosed with terminal cancer. Which situation should the nurse assess as reflecting Kubler-Ross's grief state of anger?

Correct Answer: A

Rationale: The correct answer is A because the client's statement of feeling that his faith has failed him and refusal to attend church indicate anger, which is a stage of grief according to Kubler-Ross. The client is expressing frustration and resentment towards his faith. Choice B reflects acceptance and preparation for death, not anger. Choice C shows a coping mechanism of setting a future goal, which is a form of denial or bargaining, not anger. Choice D reflects bargaining with God, which is another stage of grief, not anger. In summary, the other choices do not specifically demonstrate anger as a grief state according to Kubler-Ross, making choice A the correct answer.

Correct Answer: C

Rationale: The correct answer is C: The client snaps at the nurse and criticizes the nursing care provided. Displacement is a defense mechanism where emotions are redirected from the original source to a less threatening target. In this case, the client's frustration towards the healthcare provider's diet plan is displaced onto the nurse, leading to snapping and criticizing the nursing care. This behavior allows the client to express their anger indirectly. Incorrect choices: A: The client assertively confronts the health-care provider. This is not an example of displacement; it is direct confrontation. B: The client insists on being discharged and goes for a long, brisk walk. This choice does not demonstrate displacement but rather avoidance of the situation. D: The client hides his anger by explaining the logical reasoning for the diet to his spouse. This choice does not involve displacement but rather rationalizing the situation to cope with anger.

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.