Chapter 28

While awaiting the imminent death of her sister, an older woman makes arrangements to bury her sister in the survivor's home state because she cannot reach the other family members. Which step should the nurse implement? a. Ask questions, including questions about the location of her sister's family. b. Instruct this woman that this is not her decision to make. c. Try to contact the family to inform them of the decision. d. Question her about holding behaviors that she will want.

A

Which of the following characteristics are associated with acute grief? (Select all that apply.) a. Preoccupation with the loss of a loved one b. Waves of grief or distressing emotion c. Prolonged inability to sleep after a loss d. Exacerbations of grief on specific dates e. Change in attitude toward the future loss f. Inability to perform simple self-care tasks

A, B, F

A 78-year-old patient who is dying of colon cancer with metastases to the liver is refusing to eat or drink. He is alert and oriented and states that he has no desire to eat, which is causing the family great distress. To best address the client and family, the nurse a. explains the family's concern to the client. b. educates the family that this is normal behavior in this situation. c. contacts the physician for an order for enteral feeding. d. contacts the dietitian for feeding supplements.

B

A patient loses her husband because of a sudden myocardial infarction, and she blames herself for not recognizing the warning signs. Which patient outcome associated with her loss should the nurse use to plan care? a. Meets her daily responsibilities b. Expresses feelings of guilt, fear, anger, or sadness c. Assesses the causes of the dysfunctional grieving processes d. Identifies problems connected to anticipatory grief

B

After the loss and burial of a beloved pet, an older man loses weight because he eats very little. Three months later, he starts to paint pictures of the pet, and his appetite slowly improves. Describe this individual's mourning for his pet. a. Weight loss from inadequate intake b. Pet's burial and painting pictures of the pet c. Loss of his appetite resulting in weight loss d. Increased food intake after painting begins

B

An older patient who has end-stage pulmonary disease decides to accept care from the palliative care nurse. This older adult will most likely benefit from the palliative care nurse in which patient needs of Weisman's six needs for the dying? a. Closure b. Control c. Composure d. Cohesiveness

B

The health care provider believes an older woman has approximately 6 weeks to live. After 2 months, the family remains at the bedside but, in the past few days, are becoming increasingly impatient and irritable. This pattern is least indicative of which of the following statements? a. Family is experiencing anticipatory grief for the older adult. b. Family desires that the patient be relieved of her misery. c. Anticipatory grieving can fail to attenuate acute grief upon death. d. Grievers deal more easily with known losses at known times.

B

When working with a bereaved individual, the goal of nursing interventions is to a. assist the individual to go through the stages of grief work in the optimal order. b. assist the individual to attain a healthy adjustment to the loss experience. c. encourage the individual to talk about his or her feelings about the deceased individual. d. offer support and advice about how to successfully achieve grief work.

B

Which of the following is a true statement about loss, dying, and death for older adults? a. Men and women tend to respond similarly to the loss of a spouse. b. Visions on the part of a person who has lost a spouse are not normal grief reactions and should be regarded as signs of underlying defects. c. The grieving process is not rigidly structured. d. Bereaved persons regain their normal capability approximately 6 months after loss, and regressive behavior after that time should be discouraged.

C

The actions of the family members of an older adult who just died are chaotic, and they are unable to decide on a funeral home. Which recommendation should the nurse implement? a. Help them make a list of the problems. b. Provide a list of preferred funeral homes. c. Allow them privacy to work it out alone. d. Suggest they call someone who can help.

D

Which of the following interventions is recommended for an older adult in the final stages of dying? a. Apply an electric blanket to keep the patient warm. b. Lower the head of the bed and turn the head to the side. c. Decrease the number of visitors. d. Support the preservation of energy.

D

Which of the following statements is true about loss in older adulthood? a. A person experiences each stage of grief once, and then grieving is resolved. b. Antianxiety agents are frequently recommended for reducing the pain of grief. c. The loss response model is concerned with the effect of loss on an individual. d. Referring to the deceased in the past tense can acknowledge the death's reality.

D

After an older adult dies, the brother who has a history of alcohol abuse upsets the family by going on a drinking binge instead of attending the funeral. Which of the following is the best description of the brother's behavior? a. Personality disorder b. Disrespectful attitude c. Disenfranchised grief d. Chronic grief

C

The son of an older adult couple ends his life suddenly and violently. The husband proceeds with living as usual. After 1 year, the wife remains in seclusion and is hospitalized for dehydration. Which steps should the nurse implement to help improve the wife's mental health and wellness? a. Encourage additional fluids and social activity. b. Instruct the husband to display empathy for her. c. Establish a trusting, caring relationship with her. d. Ask social services for a survivor's support group.

C

When an older woman who is close to death asks the family to leave after short visits and acts withdrawn in their presence, the family becomes distraught. Which of the following does the nurse include in family teaching to explain the patient's behavior? a. She is preoccupied with her own death. b. She must have unresolved family issues. c. She can be experiencing anticipatory grief. d. Her body prepares for death in this manner.

C