CH 43: Loss, Grief, and Dying (questions)

A nurse caring for a client with a terminal illness understands which statement to be true? a. Recovery will be longer than 3 months. b. Recovery will be slow. c. Recovery is not expected. d. Recovery is dependent on selected treatment.

c. Recovery is not expected.

What is Kübler-Ross's third stage of grief? a. denial b. anger c. bargaining d. depression

c. bargaining

A client diagnosed with a terminal illness is displaying periods of depression and anger alternating with acceptance. The client's spouse is concerned about the client's labile mood. When talking with the client's spouse, which statement made by the nurse best addresses principles of loss and grieving? a. "Not everyone experiences grief in the same way and your loved one needs our support." b. "I think you are correct. Something is wrong with your loved one." c. "Most people go through all sorts of feelings and your loved one is no different." d. "Sometimes people become suicidal and we will place your loved one in restraints."

a. "Not everyone experiences grief in the same way and your loved one needs our support."

A nurse is assessing the spouse of a client who has just died. Which subjective findings of grief would the nurse expect to assess? Select all that apply. a. Bitterness b. Detachment c. Unkempt appearance d. Preoccupation with the loss e. Slowed motor function f. Excessive weight gain

a, b, d

The nurse is discussing end-of-life decisions with a patient who has terminal cancer. Which statements describe the patient's options? (Select all that apply.) a. The status of advance directives varies from state to state. b. The Patient Self-Determination Act of 1990 requires all hospitals to inform their patients about advance directives. c. In a living will, a patient appoints an agent that he or she trusts to make decisions if he or she becomes incapacitated. d. Nurses are legally responsible for arranging for a durable power of attorney for all terminal patients. e. Legally, all attempts must be made by the health care team to resuscitate a terminal patient. f. Living wills provide specific instructions about the kinds of health care that should be provided or foregone in particular situations.

a, b, f

The nurse is preparing a presentation on preparing children for death. What information should the nurse include? Select all that apply. a. Provide for stability and safety. b. Encourage forgetting of the deceased. c. Praise stoicism. d. Talk openly about death and the feelings associated with it. e. Encourage expression of feelings.

a, d, e

A client has been receiving dialysis for years and now states, "I have been thinking about this for a long time. I no longer wish to continue dialysis. I just want to die." What is the mostappropriate statement by the nurse? a. "Can you tell me about why you've made this decision?" b. "Have you discussed this with your health care provider?" c. "Does your family agree with this decision?" d. "Once you've started treatment, it's important to continue."

a. "Can you tell me about why you've made this decision?"

A nurse completing admission paperwork asks the client about having an advanced directive. The client states, "I do not know, what is an advanced directive?" What is the nurse's bestresponse? a. "It is a written document that identifies a person's preferences regarding which medical interventions to use in the event of a terminal condition." b. "It is a document created by you and your attorney naming a beneficiary to handle your estate if you become terminally ill." c. "I will contact the hospital social worker to come and discuss the development of an advance directive with you." d. "It is an agreement that authorizes the hospital to make decisions on your behalf, if you become incapacitated."

a. "It is a written document that identifies a person's preferences regarding which medical interventions to use in the event of a terminal condition."

The nurse is caring for a client who recently found out he has a terminal illness. The nurse notes that the client is hostile and yelling. Which statement by the nurse shows that she has understanding of the Kübler-Ross emotional responses to impending death? a. "Sometimes a person returns to a previous stage." b. "The duration of all stages is a few hours." c. "The process is the same from person to person." d. "Each stage of dying must be completed prior to moving to the next stage."

a. "Sometimes a person returns to a previous stage."

The nurse is providing care to a group of terminally ill clients. The client who is most likely experiencing the anger stage of grief is the one who states: a. "Why did this have to happen to me?" b. "I just want to see my son have a family of his own." c. "I don't care about anything. I have no energy." d. "I do not believe I have this disease."

a. "Why did this have to happen to me?"

Which assessment finding would best support a nursing diagnosis of Dysfunctional Grieving? a. A man is unable to return to work after his sister's death 18 months ago. b. A woman cries frequently and loudly in the weeks following her child's death in an accident. c. A woman has been experiencing chronic insomnia since her mother's death earlier this year. d. A man blames himself for not doing more to make his wife's recent death more comfortable.

a. A man is unable to return to work after his sister's death 18 months ago.

When planning care for a 55-year-old male client with newly diagnosed terminal pancreatic cancer, which nursing diagnosis would be most appropriate? a. Death Anxiety b. Impaired Comfort c. Failure to Thrive d. Ineffective Coping

a. Death Anxiety

A terminally ill client is being cared for at home and receiving hospice care. The hospice nurse is helping the family cope with the client's deteriorating condition, educating them on the signs of approaching death. Which sign would the nurse include in this education plan? a. difficulty swallowing b. increased sensory stimulation c. increased urinary output d. decreased pain

a. difficulty swallowing

The experience of parting with an object, person, belief, or relationship that one values is defined as: a. grief. b. loss. c. death. d. bereavement.

b. loss.

The condition of a client with a traumatic brain injury continues to deteriorate despite medical efforts. The decision is made to terminally wean the client from mechanical ventilation. Which statement by the nurse is most significant in educating the family regarding terminal weaning? a. "If you change your mind after we remove the breathing tube, just tell us and it will be reinserted." b. "All efforts will be taken to make sure your loved one is comfortable and out of pain." c. "Once the endotracheal tube is removed, your loved one will no longer be able to breathe." d. "Your loved one will not feel or be aware of anything that is happening once the breathing tube is removed."

b. "All efforts will be taken to make sure your loved one is comfortable and out of pain."

The condition of a client with a traumatic brain injury continues to deteriorate despite medical efforts. The decision is made to terminally wean the client from mechanical ventilation. Which statement by the nurse is most significant in educating the family regarding terminal weaning? a. "Your loved one will not feel or be aware of anything that is happening once the breathing tube is removed." b. "All efforts will be taken to make sure your loved one is comfortable and out of pain." c. "If you change your mind after we remove the breathing tube, just tell us and it will be reinserted." d. "Once the endotracheal tube is removed, your loved one will no longer be able to breathe."

b. "All efforts will be taken to make sure your loved one is comfortable and out of pain."

When preparing for palliative care with the dying client, the nurse should provide the family with which explanation? a. "Palliative care is the gradual withdrawal of mechanical ventilation from a client with terminal illness and poor prognosis." b. "The goal of palliative care is to give clients the best quality of life by the aggressive management of symptoms." c. "In palliative care, no attempts are to be made to resuscitate a client whose breathing or heart stops." d. "The client will have to go to an inpatient hospice unit in order to receive palliative care."

b. "The goal of palliative care is to give clients the best quality of life by the aggressive management of symptoms."

A client states, "My children still need me. Why did I get cancer? I am only 30." This client is exhibiting which stage, according to Kübler-Ross? a. Denial b. Anger c. Acceptance d. Bargaining

b. Anger

A client at a health care facility has died after a prolonged illness. A nurse is assigned to perform postmortem care for the client. Which intervention should the nurse perform when providing postmortem care? a. Place a rolled towel under the head. b. Cleanse drainage from the skin. c. Avoid replacing dentures in the mouth. d. Apply hairpins and clips.

b. Cleanse drainage from the skin.

The nurse is providing care for a confused client who no longer is able to make health care decisions. Which document will the nurse review on the client's medical record to determine the designated person to make decisions on the client's behalf? a. Health care provider's progress notes b. Durable power of attorney form c. Advance directive form d. Living will form

b. Durable power of attorney form

A client has recently lost a parent. The client spent about 6 months deeply mourning the loss and is just now able to function at the pre-loss level. During this process, a strong social support network was able to assist the client. What developmental stage of life does the nurse identify the client is in? a. infant b. adult c. school-aged child d. toddler

b. adult

Which manifestation of grief by the client who lost his wife 3 years earlier is considered abnormal? a. telling the nurse how his life has changed b. leaving the wife's room and belongings intact c. talking about his wife's absent-mindedness d. showing a photograph of the decedent

b. leaving the wife's room and belongings intact

A client with end-stage chronic obstructive pulmonary disease (COPD) has reached the end of the 6-month period for hospice services and the family caregiver states, "I don't know what we will do if they cut off our hospice services." What is the best response by the hospice nurse? a. "We can discontinue the service for a period of time and then when your family member gets worse, readmit them." b. "We can admit your family member to the hospital for treatment and they can reinstate the hospice benefits." c. "I will contact the health care provider to extend services since your family member meets the criteria." d. "Unfortunately, we are unable to continue services past the 6 month period of time."

c. "I will contact the health care provider to extend services since your family member meets the criteria."

The nurse is trying to help the client cope with the dying process. Which nursing statement is most appropriate? a. "You should try to make things right with your family." b. "There's no need for anger." c. "It must be very difficult for you." d. "I can't imagine how awful this is for you."

c. "It must be very difficult for you."

During an interview of the client at the community clinic, the nurse finds that the client is providing care for a parent, who is terminally ill. Which statement by the client indicates anticipatory grieving? a. "I do not think my parent really has cancer. I think my parent needs to get a third opinion." b. "There is no way I can stay in the hospital because my parent is sick." c. "My parent is suffering with cancer and death will be a relief of the pain." d. "It is fine if my parent dies. We have not been close for years."

c. "My parent is suffering with cancer and death will be a relief of the pain."

Which statement regarding perceptions of death by children is accurate? a. Adolescents tend to respond better than adults with death. b. Preschool-age children view death as a spiritual release. c. At about age 9, the child perceives death as irreversible. d. Toddlers perceive death as irreversible and unnatural.

c. At about age 9, the child perceives death as irreversible.

When reviewing a client's chart, the nurse notes that the client is in the disorganization stage of grief. Which assessment finding would support this diagnosis? a. "I haven't let my children out of my sight. I am afraid something will happen to them." b. "I had a good time at my class reunion. It was nice to be out with other people again." c. "A lot of the time I'm terrified that I'm going to die the same way." d. "I feel like I have absolutely no idea what to do next."

d. "I feel like I have absolutely no idea what to do next."

Which situation is most likely to warrant an autopsy? a. A palliative client dies unwitnessed during the night. b. A client's death is attributed to an infectious disease. c. A client dies after unsuccessful cardiopulmonary resuscitation. d. A client's death involves an allegation of a medical error.

d. A client's death involves an allegation of a medical error.

The wife of a client who has been diagnosed with a terminal illness asks the nurse about the differences between palliative care and hospice care. Which information would the nurse most likely include in the response? a. Hospice care focuses on quality of life while palliative care focuses on length of life. b. Hospice provides physical and psychological support; palliative care provides social and spiritual support. c. Hospice care differs from palliative care in its foundational philosophy. d. Hospice care is provided for clients who have 6 months or less to live; palliative care is provided at any time during illness.

d. Hospice care is provided for clients who have 6 months or less to live; palliative care is provided at any time during illness.

The children of a male client with late-stage Alzheimer disease have informed the nurse on the unit that their father possesses a living will. The nurse should recognize that this document is most likely to: a. make legal provisions for active euthanasia. b. dictate how the client wants his estate handled after his death, and by whom. c. give permission for organ donation. d. specify the treatment measures that the client wants and does not want.

d. specify the treatment measures that the client wants and does not want.