Chapter 10: Grief and Loss

In which ways can anticipatory grief be helpful for the client and family?

Acceptance of impending death

The nurse is caring for a client who has just been diagnosed with cancer. The client states that the client will "never be able to cope with this situation." What is the nurse aware that coping is?

Coping is the physiologic and psychological processes that people use to adapt to change.

Which factor is likely to have the greatest impact on how a client responds to grief?

Cultural influences

The nurse is assessing a client who is recently divorced. The client tells the nurse that the memories of the client's former spouse are interfering with an ability to concentrate at work. According to Horowitz's stages of loss and adaptation, this is indicative of which stage?

Denial and intrusion

A community mental health nurse has come to know that the mother of a long-term client has passed away. What are ways for the nurse to determine if the client will be at risk for complicated grief? Select all that apply.

The client has low self-esteem. The client is unable to trust others. The client has attempted suicide in the past.

The nurse is caring for a hospitalized client who just received the news that a mass in the neck is malignant. As the nurse engages in an assessment of the client's needs, the nurse asks, "Who has been a helpful person to you in the past when you were having a difficult time?" Which component of the assessment is the nurse exploring?

support while grieving

A client is crying uncontrollably after having experienced an assault by a family member. The nurse is aware that the client is experiencing which type of crisis?

traumatic

The nurse is caring for a client who has recently lost a sibling due to suicide. Which type of grief does the nurse anticipate the client is experiencing?

traumatic grief

A nurse has been present for the hospital death of a Muslim client who was surrounded by family members when the client passed. The nurse demonstrates appropriate cultural considerations when stating:

"Are there any rituals you will observe here for your loved one?"

Which statement by a client would alert the nurse that the client is experiencing complicated grief?

"I am still so angry about my grandmother's death even after a year."

A community care nurse is visiting a client at home. The client was discharged from the hospital one week ago after having a mastectomy. After the nurse completes the physical examination, the nurse asks, "How are you feeling about your body changes?" The client tells the nurse she is not interested in talking right now and would prefer that the nurse leave. Which is the nurse's mosteffective use of communication skills?

"I just want you to know that I am available to talk when you are feeling up to it."

The nurse is assessing a client who is grieving the loss of a spouse. According to Kubler-Ross's stages of grieving, which statement indicates that the client is in the depression stage?

"My spouse is gone. I am having a really hard time finding a reason to keep going."

Which statement is typical of the first stage of grieving described by Engel?

"No, not me."

A nurse is assessing a 7-year-old child in a school. The nurse suspects that the child has an insecure relationship with the parents. Which statement said by the child would have led the nurse to this conclusion?

"Please don't tell my mom anything we've talked about."

Which assessment findings can most accurately be described as complicated grieving?

A person is unable to return to work after a sister's death 18 months ago

A client has just been diagnosed with terminal brain cancer and given approximately 2 months to live. The client wishes to visit the client's mother soon to "say goodbye." The nurse acknowledges this reaction as what?

Anticipatory

A client is diagnosed with terminal kidney failure. The client's spouse demonstrates loss and grief behaviors. Which term accurately describes the spouse's experience?

Anticipatory grief

The nurse is caring for a client whose spouse passed away several years ago. Upon assessment, the nurse finds that the client has a history of signs and symptoms of depression since the spouse's death. Which term correctly describes the client's response to the loss?

Complicated grief

A nurse is caring for a client with terminal cancer. The client states, "If I promise to change my bad habits, the cancer will go away." The nurse knows that this statement is an example of which of Kubler-Ross's stages of grief?

Bargaining

A group of nursing students is reviewing information about grief and bereavement. The students demonstrate understanding of the information when they state:

Bereavement is the process of mourning and grief is the emotional reaction.

A client with poorly controlled type 1 diabetes has just been informed that an amputation of the lower leg is required. The nurse can anticipate that the client will experience a reaction to the loss of which human need according to Maslow's hierarchy?

physiologic

The spouse of a client who died of breast cancer is still grieving 2 years later. What type of grief is the spouse experiencing?

Complicated

Which likely takes place in the fourth stage of Kubler-Ross's stages of grieving?

Depression

When working with a grieving client, which is the most effective intervention a nurse can use?

Encourages the client to express grief verbally

Which explanation would be the nurse's best response when asked about the denial stage of grief?

It provides the individual with a temporary escape from the reality of dying

The client expresses grief about not being able to fulfill the wish to pursue doctoral studies. Which type of loss does this indicate?

Loss related to self-actualization

Which culture believes that leaving the body alone after death is disrespectful?

Orthodox Jewish Americans

Which is the most frequent and persistent bereavement-associated symptom?

Sleep disturbances

A nurse is assessing a client who is depressed but unwilling to discuss the client's feelings. After speaking with the client's caregiver, the nurse learns that the client's pet died recently. Which is the most likely reason the client has hesitated to express the client's feelings?

The client feels that the nurse would not consider the grief as significant.

The nurse is caring for a client who is extremely depressed after receiving a diagnosis of cancer. Which body language should the nurse adopt while speaking to the client in order to demonstrate an attentive presence? Select all that apply.

The nurse should stand facing the client. The nurse should lean slightly toward the client. The nurse should maintain moderate eye contact while the client speaks.

A nurse is caring for a Jewish client with a terminal illness who is on a ventilator. The spouse of the client intends to stay near the client when the ventilator is removed. What is the reason for such a request, according to the Jewish culture? Choose the best answer.

The soul of the deceased should not be alone while leaving the body.

A client belonging to the Vietnamese culture has passed away. The caregivers of the client ask the nurse to allow them to put some rice grains in the mouth and place money with the deceased client. What is the belief associated with this ritual?

This ritual would help the spirit buy a drink as it moves to the afterlife.

A nurse is counseling a client with depression on what to do in case the client has suicidal thoughts. Which option may provide the most immediate help for the client?

a telephone hotline

A client who has been in recovery from alcohol abuse for over one year tells the nurse he is drinking 5 to 6 beers per night since the client's mother's death. Which is the nurse's mostaccurate explanation for the client's grief response?

behavioral

Which type of grief occurs when a person is stuck in a state of chronic grieving?

complicated grief

The nurse is providing individual support to a female client who attends a group for people who have experienced loss of a family member to suicide. The client's son committed suicide one month ago. The client was not aware that her son experienced depression. Which risk factors for complicated grief are most likely for this client? (Select all that apply.)

death of a child sudden, unexpected death death by suicide

A client who is in the process of divorce tells the nurse the client will require some time off from work due to the inability to concentrate. According to Bowlby's phases of grieving, which phase best reflects this client's current experience?

disorganization and despair

A client is experiencing a high level of stimulation after a terrorist attack. In providing psychological first aid to the client, which intervention would be best for the nurse to select?

explaining to the client that the client is safe

The nurse is meeting with a client who has two young children. The client and family have decided it is best for the client to quit the client's job to care for the children. The client reports often feeling unhappy. According to Maslow's hierarchy, the client's unhappiness is related to which human need?

loss of self-esteem