An outcome for a patient experiencing anticipatory grieving for a spouse diagnosed with terminal cancer would be that the patient will:

Correct Answer: A

Rationale: The correct answer is A because anticipatory grieving involves emotional involvement with the dying spouse. This allows the patient to process emotions, express love, and make meaningful connections before the actual loss. Choice B is incorrect as it suggests avoidance of pain through mental mechanisms, which is not conducive to healthy grieving. Choice C is incorrect as it focuses on a specific behavior (violence) rather than the emotional process of grieving. Choice D is incorrect as it assumes the patient's agreement to care for the spouse is the primary outcome, overlooking the emotional aspect of anticipatory grief.

Correct Answer: C

Rationale: The correct answer is C because it accurately reflects the known side effect of ECT, which is temporary short-term memory loss. This statement indicates the patient comprehends the potential cognitive impact of the treatment. A is incorrect because it does not address specific side effects of ECT. B is incorrect as it implies a misconception that only one session is needed. D is incorrect as ECT does not guarantee that depression will never return.

Correct Answer: A

Rationale: The correct answer is A: Tightness in the chest. This physical disturbance is commonly associated with acute grief due to the emotional pain experienced. It is a manifestation of the intense feelings of sadness and loss that accompany grief. Tightness in the chest can be a result of the stress response triggered by grief, leading to physical symptoms such as chest pain and difficulty breathing. Summary: B: Hypersomnia and C: Increased appetite are more commonly associated with conditions like depression, while D: Cardiovascular problems may be a long-term consequence of chronic stress but are not typically assessed as a primary physical disturbance in acute grief.

Correct Answer: A

Rationale: The correct answer is A because universality in Yalom's therapeutic factors refers to the recognition that one is not alone in their struggles. Patient A demonstrates this by acknowledging that others also face loneliness, fostering a sense of commonality and reducing feelings of isolation. In contrast, patient B's dysfunctional patterns do not relate to universality. Patient C's sense of belonging is related to group cohesion, not universality. Patient D's anger expression is not directly linked to recognizing shared experiences.

Correct Answer: B

Rationale: The correct answer is B: Medications the patient has recently taken. This is crucial because certain medications can cause delirium in elderly patients. Step 1: Evaluate recent medication history. Step 2: Identify medications known to cause delirium. Step 3: Determine if the patient has taken any of these medications. Other choices are incorrect because: A: Evidence of spasticity or flaccidity is more related to neuromuscular conditions. C: Level of preoccupation with somatic symptoms is not specific to delirium assessment. D: The patient’s level of motor activity is not a key factor in distinguishing delirium from other problems.

Correct Answer: C

Rationale: The correct answer is C because Lewy body disease can affect a patient's ability to communicate pain, making specialized pain assessment tools crucial. Special scales designed for patients with dementia can help in accurately assessing pain levels. These tools consider non-verbal cues and behavioral changes that may indicate pain. Asking the patient's family (A) may not always provide an accurate assessment of pain perception. Using a visual analog scale (B) may be challenging for a patient with cognitive impairment. Focusing solely on mental status (D) may overlook important indicators of pain in patients with Lewy body disease.

Correct Answer: A, C

Rationale: The correct answers are A and C. Statement A indicates a positive attitude towards aging, which is a good predictor of positive well-being. Feeling satisfied with growing older can lead to better emotional health and higher perceived mortality. Statement C suggests that retirement provides opportunities for personal fulfillment, which can contribute to positive well-being. Statements B and D do not directly address attitudes towards aging or well-being, making them less reliable predictors.

Correct Answer: B

Rationale: The correct answer is B: To prevent anoxia due to medication-induced paralysis of respiratory muscles. During electroconvulsive therapy, muscle relaxants are often used to prevent injury during the seizure. These medications can lead to paralysis of respiratory muscles, causing potential anoxia if oxygen is not administered. Providing pure oxygen ensures adequate oxygenation despite muscle paralysis. Incorrect Choices: A: Preventing increased intracranial pressure is not the primary rationale for administering oxygen during ECT. C: Hypotension, bradycardia, and bradypnea are potential side effects of ECT itself, but oxygen administration is not primarily to prevent these. D: Oxygen is not administered to prevent a blocked airway but rather to ensure adequate oxygenation during muscle paralysis.

Correct Answer: D

Rationale: Step-by-step rationale for why choice D is correct: 1. Maslow's hierarchy of needs places self-esteem as a fundamental psychological need. 2. Patient hygiene and dress contribute to self-esteem by promoting a sense of dignity and self-worth. 3. Attending to hygiene and dress before spousal visits shows respect for the patient's self-esteem. 4. This strategy directly addresses the self-esteem needs of elderly patients by enhancing their sense of self-worth and respect. Summary of why other choices are incorrect: A: Providing privacy for spouses does not directly address the patient's self-esteem needs. B: Arranging dining with spouses may enhance social needs but not directly address self-esteem. C: Including patients and spouses in educational sessions may promote social interaction but does not directly target self-esteem needs.