After the sudden death of his wife, a man says, "I can't live without her "¦ she was my whole life." Select the nurse's most therapeutic reply.

Correct Answer: B

Rationale: The correct answer is option B: "Her death is a terrible loss for you." This response demonstrates empathy and acknowledges the man's feelings of loss and grief, which is crucial in therapeutic communication. By validating his emotions, the nurse creates a safe space for the man to express his feelings and begin the healing process. Option A ("Each day will get a little better.") may minimize the man's current feelings of intense grief by implying a quick recovery, which can be invalidating and unhelpful. Grieving is a complex process that takes time, and the nurse should acknowledge the man's pain rather than rushing him through it. Option C ("It's important to recognize that she is no longer suffering.") may come across as dismissive of the man's emotional pain by focusing on the positive aspect of the wife no longer suffering. While this perspective can be comforting in some contexts, it may not address the man's immediate need for emotional support and validation of his grief. Option D ("Your friends will help you cope with this change in your life.") shifts the focus from the man's feelings to external sources of support. While social support is valuable, at this moment, the man needs validation and emotional support from the nurse to process his grief effectively. In an educational context, it is essential for nurses to understand the principles of therapeutic communication, which involve active listening, empathy, and validation of clients' feelings. By choosing the most appropriate responses in challenging situations like this, nurses can build trust, foster healing, and support clients effectively through their emotional struggles.

Correct Answer: A

Rationale: In response to trauma, the sympathetic arousal symptoms of rapid heart rate and rapid respiration prepare the person for flight or fight responses. Afterward, the dorsal vagal response damps down the sympathetic nervous system. This is a parasympathetic response with the heart rate and respiration slowing down and decreasing the blood pressure. Relaxation techniques promote activity of the parasympathetic nervous system.

Correct Answer: B

Rationale: The patient mentions that the symptoms make people more interested. This indicates that the patient feels uninteresting and unpopular without the symptoms, thus supporting the nursing diagnosis of chronic low self-esteem. Defining characteristics for the other nursing diagnoses are not present in the scenario.

Correct Answer: D

Rationale: The correct answer is D) Factitious disorders are under voluntary control, whereas somatic symptom disorders involve the expression of psychological stress through somatization. This is because factitious disorders are characterized by intentional production or feigning of physical or psychological symptoms in order to assume the sick role, whereas somatic symptom disorders involve genuine physical symptoms that are linked to psychological distress. In factitious disorders, the individual consciously fabricates symptoms for various reasons such as gaining attention or sympathy, whereas in somatic symptom disorders, the physical symptoms are not intentionally produced but are a manifestation of underlying psychological distress. Option A is incorrect because both somatic symptom disorders and factitious disorders involve unconscious elements, but the key difference lies in the intentionality of symptom production. Option B is incorrect as it does not capture the essential distinction between intentional symptom fabrication in factitious disorders versus genuine symptom expression in somatic symptom disorders. Option C is incorrect as neither disorder is exclusively determined by childhood sexual abuse or solely culturally bound; they can have diverse etiologies and manifestations beyond these factors. In an educational context, understanding the differences between somatic symptom disorders and factitious disorders is crucial for nurses to accurately assess and provide care for patients presenting with complex health behaviors. By recognizing the underlying motivations and mechanisms behind these disorders, nurses can offer appropriate interventions and support tailored to the individual's needs.

Correct Answer: D

Rationale: CDs are manifested by a persistent pattern of behavior in which the rights of others and age-appropriate societal norms are violated. Intermittent explosive disorder is a pattern of behavioral outbursts characterized by an inability to control aggressive impulses in adults 18 years and older. Criteria for ADHD and PTSD are not met in the scenario.