Psych - Videbeck Ch 10

The nurse is assessing a client who reports feeling hopeless since a divorce. Which would be an appropriate question for the nurse to ask in order to determine mental health status for this client?

"Do you ever use drugs to help feel less emotional pain?"

A client is arranging a funeral ceremony for the client's child. According to the Worden's tasks of grieving, which task is being accomplished?

Acceptance of the reality of the loss

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

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.

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

A client continues to complain of chest pain and headaches after a disaster, even though all diagnostic tests are negative. In looking at risk factors for these symptoms, what would the nurse assess for?

post-traumatic stress disorder

Which factor does not influence the grieving person's return to homeostasis?

Adequate self-awareness on the part of the nurse

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

Which experience could be the possible cause of grief due the loss of security and belonging for the client?

Divorce

A client is exhibiting a behavioral response to grief. When obtaining a health history, the nurse would expect which assessment finding to be noted?

Hostility

Which is an example of a perceived loss?

An older client grieves for the loss of independence

After receiving word from the oncologist that the client's tumor is malignant, the client says to the nurse, "If you people had the faintest clue what you were doing, I wouldn't be like this." The nurse should recognize that the client may be experiencing which stage of grief?

Anger

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

Which term describes the process by which a person experiences grief?

Bereavement

A client's children have downplayed their grief following the death of their mother's partner, claiming that their mother and her partner were only together for a few months and that "he was no good for her anyways." The client is at risk of experiencing which type of grief?

Disenfranchised grief

Which occurs in the second phase of Bowlby's grieving process?

Emotional yearning for the loved one

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

Orthodox Jewish Americans

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

The nurse is speaking to the caregivers of a client who is experiencing complicated grief. The nurse is explaining some of the consequences of complicated grief. What are the health-related consequences associated with this type of grieving? Select all that apply.

Precipitation of a cardiac disease Panic disorder Psychosomatic disorder

Considering the spiritual response to grief, which nursing intervention has the potential of providing the most support to a grieving client?

asking, "Do you find comfort in your religion at times like this?"

A client has experienced a physcial assault and states "I keep having nightmares about it." Which intervention may be most helpful for the nurse to explore with the client at this time?

debriefing about the event

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

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

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."

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."

A client states to the nurse "I was just diagnosed with a terminal illness." What is the nurse's best response?

"What does that mean to you?"

According to Mardi Horowitz (2001), life begins to feel "normal" again in which stage?

Completion

Which is a term used to describe grief over a loss that is not or cannot be acknowledged openly, mourned publicly, or supported socially?

Disenfranchised grief

A woman has had a breast removed to treat cancer. What type of loss will she most likely experience?

Physiologic loss

A client tells the nurse the client been dating someone for three months after finalizing divorce one year ago. According to Rando (1984), the client is engaging in which grieving task?

re-investing

The nurse is providing discharge instructions for a client who has received a prescription for lorazepam after the death of a loved one. Which phase of psychopharmacologic treatment does this describe?

stabilization

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.)

sudden, unexpected death death by suicide death of a child

The nurse is performing an initial psychological assessment on a client who has been rescued from a flood. Which question would be most important in helping determine the amount of support needed by the client?

"Have you thought about where you can stay right now?"

A nurse is talking to a client who has been told the client has a terminal illness and is responding in an angry manner. What statement by the nurse would best facilitate the best possible client outcomes?

"How much do you know and what do you want to know?"

Kübler-Ross defines five stages of psychosocial responses to dying and death. Which statement is characteristic of the bargaining stage?

"Just let me live to see my grandson born."

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

"No, not me."

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

Sleep disturbances

The nurse is assessing a client who has been diagnosed with leukemia. Which behavior of the client would indicate that the client is experiencing the anger stage of Kubler-Ross's stages of grieving?

The client is verbally abusive.

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

complicated grief

A client who has recently lost his same-sex partner in a motor vehicle accident tells the nurse, "My family doesn't speak to me because of my lifestyle. I feel like I have no one to talk to about my loss." The client is experiencing:

disenfranchised grief.

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

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

In which of the phases of Bowlby's grief process does the bereaved person begin to understand the loss's permanence?

Phase of disorganization and despair

A client is crying continuously from having lost a friend in an accident. According to the tasks of grieving by Rando, which task of grief is expected to be accomplished next?

Recollect and reexperience

Which client is most at risk for experiencing anticipatory grief?

61-year-old spouse of a client experiencing symptomology of moderate-stage Alzheimer disease

A client diagnosed with terminal cancer is making plans to take flying lessons because that has always been the client's personal goal and it will allow the client to visit the client's elderly parents. What stage of death and dying according to Kübler-Ross is best illustrated in this description?

Acceptance

What question should nurses ask themselves to determine if the care they provide to the grieving client has been both therapeutic and client focused?

"Do I have the strength to be present and to facilitate the client who is grieving?"

The client is scheduled to undergo an amputation of the lower right limb. The client is experiencing grief over the pending procedure. Which question should the nurse ask while assessing the client's perception of loss?

"How do you feel about the news?"

The nurse is performing an assessment of a client who has experienced a traumatic event. In understanding the client's ability to cope with the event, what question would the nurse ask first?

"How have you managed a stressful event before?"

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 most effective use of communication skills?

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

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 client should the nurse anticipate will be at greatest risk for alteration in quality of life as a result of loss?

45-year-old with severe depression

The nurse most effectively explains to a terminally ill client's spouse that the frustration and anger the client is exhibiting is associated with what aspect of dying?

An expression of a universally held need of the dying

Which is a cognitive response to grief?

Attempting to keep the lost one present

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

Which can correctly be identified as a behavioral response to grief?

Crying uncontrollably

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

Cultural influences

The client has been recently diagnosed with cancer. When the nurse tells the client about the diagnosis, the client says, "I have been eating healthy food and working out regularly." According to the Kubler-Ross's stages of grieving, which stage of grief is the client in?

Denial

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 most accurate explanation for the client's grief response?

behavioral

During which phase of Bowlby's grief process does the bereaved person begin to reestablish a sense of personal identity, direction, and purpose for living?

Phase of recognition

The nurse is informing the client about being diagnosed with cancer. Which is most likely going to be the client's initial reaction?

Shock

The nurse is assessing a client who is deeply upset and is not expressing feelings. At the end of the assessment, the nurse concludes that the client is extremely depressed because of the death of a loved one. The client has disenfranchised grief. What is the most likely reason for the client not being willing to speak about it to the nurse?

The client feels uncomfortable speaking about the relationship with the deceased.

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.

Which outcome will the nurse evaluate to determine whether a client has successfully stabilized when engaged in the grieving process?

The client will verbalize acceptance of his or her terminal diagnosis.

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 Haitian American client has just passed away. The family members of the deceased are performing a vodun (voodoo) ritual for the client. Which belief is associated with the ritual?

To make peace with the spirits

After losing the client's father in a car accident, a client has started practicing effective coping strategies. According to Horowitz's stages of loss and adaptation, which stage is this indicative of?

Working through

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 nurse notifies a client of the death of a parent after a motor vehicle crash. Which physical symptoms would the nurse assess the client for based on the immediate grieving process? Select all that apply.

difficulty breathing lack of strength a hollow feeling in the abdomen

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 assessed for recurring episodes of fainting and blurred vision. A diagnostic scan reveals the client has an ominous mass in the brain. When the client is told this news, the client appears stoic and does not cry. According to Horowitz's stages of loss and adaptation, this client is in which stage?

outcry

Which client will the nurse identify as having the greatest risk for developing disenfranchised grief?

the wife of a man who was shot to death by police during a robbery

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 female client tells the nurse she has had low appetite and motivation since the recent breakup of a long-term relationship. The client states, "I just can't stand not having her around. I need her back." The client is experiencing which of Bowlby's phases of grieving?

yearning