Loss and grief

Which patient is likely to experience anticipatory grief?

A middle-age adult diagnosed with amyotrophic lateral sclerosis (ALS)

Which stage of dying, according to the Kübler-Ross theory, is reflected in the patient's statement, "I miss my partner. I will never get my partner back?"

Acceptance

Which type of loss is illustrated when a young adult loses a limb from diabetes and is very upset about it?

Actual

Which loss occurs when the lost person is physically present but not psychologically available?

Ambiguous

Which type of grief is exemplified when the parents feel severe grief and loss after seeing their child suffering with cancer?

Anticipatory

Which action would the nurse take for a dying patient with chronic dull pain who does not have a support person to provide home care?

Arrange for inpatient hospice care

Which technique would the nurse use to communicate actively with a terminally ill patient?

Asking open-ended questions

Which stage of dying is being described when a terminally ill patient tells the nurse, "I would do whatever you say. Please relieve me of this illness?"

Bargaining

Which type of grief is exemplified when a father refuses to accept the death of a child and no longer has a job, avoids communication with others, and remains aloof?

Complicated

Which symptom is the nurse addressing when advising the patient's caregiver to increase fiber in the patient's diet?

Constipation

Which stage of the Kübler-Ross theory is reflected in the patient's statement, "I will seek a second opinion and have the tests done again at another hospital?"

Denial

Which type of grief is exemplified when a patient states, "I have been depressed since the death of my ex-husband?"

Disenfranchised

Which type of grief response describes a woman who experiences the loss of a very early term pregnancy and her friend suggests to her that she can "always try again?"

Disenfranchised

Which behavioral symptom observed by the nurse indicates normal grief?

Distancing from people

Which action would the nurse take for a dying patient who is breathing loudly?

Elevate the head of the bed

Which strategy would the nurse use to assist the patient newly diagnosed with colon cancer who is withdrawn?

Encourage the patient to identify fears and verbalize feelings

Which type of grief is exemplified when the survivor of a motor vehicle accident attempts suicide because of feeling responsible for the friend's death?

Exaggerated

Which statement about hospice care needs correction?

It accepts the patient into the program when the survival period is 10 months

Which critical thinking skill does the nurse use when considering how the patient's cultural perspectives affect the meaning of loss or death?

Knowledge

Which patient may experience intangible loss?

Lacks confidence

If the family of a dying patient is highly emotional and critical of the nursing care, which action by the nurse would be appropriate?

Listen to concerns

Which physical change in the patient suggests that death is near?

Noisy respirations Decreased muscle tone Decreased intake of food

Which action would the nurse take for a patient newly diagnosed with a serious, life-changing illness whose conversations are abrupt, superficial, and unrelated to the illness?

Remain alert for signals that the patient wants to talk

In which stage of mourning described by Bowlby's attachment theory does a person accept change, acquire new skills, and build new relationships?

Reorganization

Which type of loss is exemplified when a patient sustains severe injuries leading to loss of function from a motor vehicle accident?

Situational

Which theory includes denial and acceptance?

Stages of dying

Which right according to the Dying Person's Bill of Rights would the nurse be aware of when treating terminally ill patients?

To be free from pain To retain individuality To make decisions about care

Which stage of the attachment theory of grief and mourning is characterized by emotional outbursts of tearful sobbing?

Yearning and searching

In which stage of dying does a patient realize the full impact of the loss?

depression