Fundamentals of Nursing Q 88
A client has recently been told he has terminal cancer. As the nurse enters the room, he yells, “My eggs are cold, and I’m tired of having my sleep interrupted by noisy nurses!” The nurse may interpret the client’s behavior as:
A. An expression of the anger stage of dying.
B. An expression of disenfranchised grief.
C. The result of a maturational loss.
D. The result of previous losses.
Correct Answer: A. An expression of the anger stage of dying.
In the anger stage of Kubler-Ross’s stages of dying, the individual resists the loss and may strike out at everyone and everything, in this case, the nurse. Anger, as Kubler-Ross pointed out, is commonly experienced and expressed by patients as they concede the reality of a terminal illness. It may be directed, as with blame of medical providers for inadequately preventing the illness, of family members for contributing to risks of not being sufficiently supportive, or of spiritual providers or higher powers for the diagnosis’ injustice.
Option B: Grief can be caused by situations, relationships, or even substance abuse. Children may grieve a divorce, a wife may grieve the death of her husband, a teenager might grieve the ending of a relationship, or one might have received terminal medical news and are grieving pending death.
Option C: Maturational loss happens as a person develops and goes through the cycle of life, where developmental changes can create a loss specific to every stage of life. It’s a form of anticipatory loss — a type of loss that people anticipate happening at every stage.
Option D: Losses will occur in everyone’s life at different stages and under different circumstances. The pain of loss is universally acknowledged by all people. It’s the loss itself that can be categorized in a couple of different ways. Throughout lifetimes, people can be expected to experience two types of losses, called maturational losses and situational losses.