Ch. 15 & 16

A common anxiety about suicide is reflected when the twin brother of a suicide victim asks

"Do you think I will be tempted to commit suicide like he did?"

As a Native American elder is dying, a young health-care worker complains to her supervisor that the eldest son is not at his father's bedside and is nowhere to be found. The culturally competent health-care worker responds:

He is observing his own private grieving away from his dying father."

The health-care worker assesses a normal response in a dying 8-year-old boy who says:

I will miss my mom and dad, but my grandmother in heaven will take care of me."

A young Cambodian man has just arrived at the hospital from the airport to find that his father has already died. His family members are all praying at the bedside. The culturally competent health-care worker would offer the young man a(n):

white hospital gown to wear

A terminally ill person has elected to stop receiving curative treatment and has requested no cardiopulmonary resuscitation. The family is very upset by this decision and wants to override the patient's decision. The best response to the family is:

"According to the dying person's bill of rights, your relative has the right to make this decision."

After the death of their child in the emergency room following a hit-and-run automobile accident, the mother says, "God is dead for me. God is as dead as my child. I will not worship a dead god!" The most helpful response would be:

"I can understand why you feel angry with God and everyone else right now."

The health-care worker enters the room of a patient who has just been diagnosed with a terminal illness. The son is highly agitated and tearfully screams, "I am taking my dad out of this place and take him somewhere where people actually care what happens to him!" The most helpful response would be:

"I can understand your angry feelings."

The family of a terminally ill Hindu patient requests that all life support equipment be removed, as per the wishes of the patient, and the loved one discharged to their care at home. The health-care worker points out that:

"I know that you and your loved one will be more comfortable at home; I will do what I can to expedite the process."

The process of bereavement includes the survivors': (Select all that apply.)

1 reaction to the loss. 2. adjustment to the loss. 3. reorganization of the fabric of life. except--refusal to integrate the loss. and portrayal of the deceased as perfect.

Persons experiencing bereavement should postpone making drastic changes in their lives for at least

1 year

The death rituals observed by the East Indian community include which aspect(s)? (Select all that apply.)

1, Family members wash and prepare the body. 2.Official mourning will last for 40 days.

The impending signs of death include: :

1. anorexia. 2. pulmonary congestion. 3. mottled extremities. except. thirst. andflushed face.

The health-care worker clarifies to the family of a dying patient that palliative care includes: (Select all that apply.)

1. patient-centered care 2. analgesics 3. oxygen therapy 4. laxatives except--curative therapy

The health-care worker recommends the services of _____________, a community health-care organization specializing in the care of dying patients and their families

Hospice

The statement that best depicts the preschooler's understanding of death is:

I know that my brother got taken because I had a fight with him

When a terminally ill patient says, "I feel that death is just around the corner," the most appropriate response would be:

Is this feeling something you would like to talk about

Saying goodbye to the pain of loss, the feeling of isolation, and the nearness of the loved one is known as _________ ____.

Letting Go

_________________ is the outward expression of grief

Mourning

The _________________ ___________________ Act of 1990 is a federal law stating that acute care or long-term care facilities must provide written information to patients concerning their rights to accept or refuse treatment and make advance directives

Omnibus Reconcilation

The grieving mother whose adolescent son died last week tells the home health-care worker that her 5-year-old has begun to wet the bed. The health-care worker's most helpful response would be:

Regression to less mature forms of behavior are not unusual after a death."

When the shocked father of a 17-year-old who committed suicide says, "We should have seen this coming. I feel so guilty." The most therapeutic response would be:

This must be awful for you. Tell me about your son

A health-care worker is preparing the body of an Arab American patient who just died for transfer to the morgue. Family members insist on washing and cleansing the body before it is taken away. The health-care worker's best response is:

Yes, of course you may. Do you need any special cloths or towels

At the time of a child's death, a "memory kit" is made for the parents. The most appropriate items in such a kit would be

a curl of the baby's hair

The parents of a 7-year-old are concerned because their child, upon being informed about the death of his grandmother, said, "Nana is mean. I don't love her anymore!" This behavior is:

a normal reaction

Seven months ago, a 30-year-old man lost his wife in an automobile accident. His coworkers have become concerned about his mood swings from rage to uncontrolled crying. The health-care worker recognizes that this is

abnormal grief that may require psychological counseling

A terminally ill man tells the health-care worker, "I have never believed in God or in an afterlife, but now it really doesn't seem so bad." The health-care worker assesses that this man has reached the dying state of:

acceptance

The most therapeutic communication to use with a bereaved family should reflect

acknowledgment of the loss

The best practice in promoting quality of life for a terminally ill 10-year-old child would be

allowing the child to return to his or her regular classroom

The health-care worker can support grieving families at the time of death by:

allowing the family time to stay with the loved one after the death.

Several health-care workers have requested to attend the funeral of a patient for whom they felt especially close. The supervisor recognizes that attending the funeral is:

appropriate, because it can assist in the resolution of personal grief.

The health-care worker can provide the best support to a family experiencing anticipatory grief related to the imminent death of a loved one by:

being available to the family

The primary goal of end-of-life care is:

comfort and care to promote death with dignity

The family of a young girl killed in an automobile accident arrives at the hospital shortly after her death and requests to see her body. Since she is disfigured from the accident, the most appropriate action is to:

contact a grief counselor to discuss this problem with them

The event most likely to make a grief reaction complicated and pathological would be:

death by suicide

The health-care worker can provide the best support to a family experiencing anticipatory grief related to the imminent death of a loved one by

discouraging premature expressions of grief

The document naming the person or persons who should make health-care decisions if a patient cannot make informed decisions for him- or herself is the:

durable power of attorney.

When the treatment for a 12-year-old child with terminal cancer needs to shift from cure to palliation, the health-care worker reminds the family it is important that they should:

explain this new approach in age-appropriate terms.

A dying patient becomes withdrawn and verbally uncommunicative. Relatives try to cheer him up, which is most indicative of:

failure to recognize the patient's need to openly express his grief.

Patients and families progress through various stages of reactions when a diagnosis of a terminal illness is made. After the helplessness phase, a period of adjustment usually follows. This phase is characterized by:

guilt.

A newborn in the neonatal intensive care unit is dying, and the neonatologist has shared with the parents their baby's prognosis. When the father sees his son, he says, "He looks just fine to me. I can't understand what all this is about." The health-care worker recognizes that the father is:

in denial or disbelief.

The best description of therapeutic communication related to terminally ill patients and their families would be that it is a(n):

interaction that involves accepting the patient's emotional responses.

The school-age siblings of a dying child should be:

involved in the plan of care for their sibling.

Denial is a common reaction to the diagnosis of a terminal illness, because the use of this defense mechanism:

is helpful to adaptation

hen a dying 90-year-old woman gives her rosary to her granddaughter, this gift should be viewed as a

legacy

A 90-year-old West Indian man is dying, and 20 family members fill the hall as they try to crowd into the room. The culturally competent health-care worker will:

move out unnecessary furniture to make room for the family

When caring for a terminally ill patient, health-care workers are permitted to provide interventions that:

offer pain relief to the dying person even if there is a risk death will occur

A bereaved person is in special need of condolence and support

on the anniversary date of the death.

A psychological death occurs begins when the

person is informed of a terminal illness

An 8-year-old child with a terminal illness is returning to school after having received treatment that has caused hair and weight loss. The most appropriate action by the school nurse would be to:

prepare the child's classmates and teachers for changes they can expect.

a dying 78-year-old Hispanic woman understands that in Hispanic families when death is near, the family will:

prohibit pregnant women and children from the bedside

When parents ask if their school-age child should attend the funeral of their grandmother, the health-care worker would base a response on the understanding that attendance will:

provide an closure for the child

The manner in which persons adjust to losses in their life will determine

quality of life

The sensitive health-care worker can demonstrate therapeutic presence by:

remaining near the patient and family

While doing final preparations for a Hindu woman to be picked up by the funeral home, the health-care worker observes a thread tied around the corpse's wrist and a basil leaf in her mouth. These items:

should be left in place

A terminally ill patient is unresponsive and having periods of apnea. The patient's family is arguing at the bedside about where the funeral should be held. The health-care worker should:

take the family members aside and explain that the patient may be able to hear them.

A widow of 10 months says that she has started sleeping better, is going out more with friends, and can talk about her husband without feeling so lost and angry. The health-care worker recognizes that this represents: a. the beginning of the "letting-go" process.

the beginning of the "letting-go" process.

A man whose wife died 6 months ago says that he sometimes still "hears" his wife's voice and has trouble sleeping and does not feel like socializing. The health-care worker recognizes that

these complaints are part of a normal grief response

A school-age child is diagnosed with a terminal illness. The parents want to protect their child from knowing the seriousness of the illness. The health-care worker should explain that:

truthfulness in understandable terms is the most supportive approach

A terminally ill patient in hospice care says that she plans to attend her grandson's college graduation 5 months from now. This patient:

will probably live to attend the graduation.