PNU 128 Videbeck PrepU Chapter 10: Grief and Loss

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."

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

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."

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

Divorce

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

A nurse has been present for the hospital death of a Muslim client who was surrounded by family members when the client passed. The nurse demonstrates appropriate cultural considerations when stating:

"Are there any rituals you will observe here for your loved one?"

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?"

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."

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."

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."

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

"No, not me."

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

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

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.

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

Completion

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 can correctly be identified as a behavioral response to grief?

Crying uncontrollably

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

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

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

Physiologic loss

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

Orthodox Jewish Americans

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 caring for a client who has been placed in palliative care. The nurse observes the client constantly looking at photographs from youth. According to the tasks of grieving by Rando, which task is being accomplished here?

Recollect

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

Shock

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

Sleep disturbances

A nurse is assessing a client who is depressed but unwilling to discuss the client's feelings. After speaking with the client's caregiver, the nurse learns that the client's pet died recently. Which is the most likely reason the client has hesitated to express the client's feelings?

The client feels that the nurse would not consider the grief as significant.

A 74-year-old is being seen in the mental health clinic. The client has never fully regained the level of activity the client had prior to the death of the client's spouse. The client continues to have symptoms of depression and has not been able to work or volunteer. In addition, the client complains of "anxiety attacks" that occur nearly every night. What type of grief reaction is this client exhibiting?

The client is experiencing complicated grieving reaction. The client needs to have a comprehensive mental health assessment.

The nurse is assessing a client who has lost the client's family in an accident. According to George Engel's stages of grieving, which behavior indicates that the client is in the stage of resolution of the loss?

The client repeatedly views family photos.

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 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 is conducting a visit to a client who is receiving palliative care at home for dying. The client's husband tells the nurse, "I know she needs to be with God. This is not a good place for her now." The client is experiencing which stage of Kubler-Ross' stages of grieving?

acceptance

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 mostaccurate explanation for the client's grief response?

behavioral

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

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.)

death of a child sudden, unexpected death death by suicide

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 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

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

A nurse in charge on a unit with a client who is receiving postoperative care for a below the knee amputation is deciding which nurse to assign to this client. Which nurse would be mostbeneficial for the client?

the nurse who has worked with the client before and after the amputation

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