Author Question: A client has received some bad news about a prognosis from the physician. When the nurse comes in ... (Read 36 times)

mwit1967 · **on:** Jul 19, 2018

A client has received some bad news about a prognosis from the physician. When the nurse comes in with medications, the client states in an angry tone, You're late; I was just about to call the hospital administrator to complain.

The nurse is aware that the client received a disappointing prognosis and understands the behavior as displacement. The nurse is silent for a few moments to let the client collect some thoughts and control any feelings. Which response should the nurse make next? 1. You are really angry at your physician; why don't you tell the physician how you feel.
2. You must be really angry at me.
3. I'm not late if I get this medication to you within thirty minutes of the scheduled time.
4. I know you heard some bad news today. I wonder if that could be bothering you.

Question 2

Which of the following client behaviors would indicate a need for further intervention in the anxious patient on a benzodiazepine?

1. The client asking to be taken off the medication gradually
2. The client relying more on coping skills and taking less medication
3. The client inquiring about behavior methods for anxiety control
4. The client requesting a higher dose of drug to achieve the intended effect

bimper21 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

4
Rationale: Acknowledging the client's prognosis will help the client examine thoughts and feelings more realistically and opens up the possibility for a discussion of anger. Stating that the client must be angry with the nurse, or defending the medication timetable, is self-focusing and does not recognize displacement. Suggesting that the client express anger to the physician shows a misunderstanding of the purpose of displacement and fails to focus on the client's thoughts and feelings.

Answer to Question 2

4
Rationale: Requesting higher doses of a benzodiazepine can be a sign of tolerance and addiction. The other responses are actually signs of relying less on the medication and more on coping strategies and are positive signs.