PrepU Grief Quizzes

Caregivers of a 9-year-old client in the terminal phase of a fatal illness ask the nurse for guidance in discussing death with the client. Which response is appropriate?

"At this developmental stage, most children have an adult concept of death and should be encouraged to discuss it."

The parents of a 3-month-old infant have been told that their infant has died of sudden infant death syndrome. Which intervention is most important to include in the plan of care to assist the parents with their grieving process?

Provide an opportunity for them to see the infant.

After the nurse has taught the parents of a 5-year-old boy who has leukemia how to talk with their child about death and dying, which statement would indicate that the parents have age-appropriate expectations about their child's reaction to his impending death?

"He might think he's caused his death because he's misbehaved."

A client whose child has died is withdrawn, has flat affect, makes minimal eye contact, and states, "I can't live without my child." What is the most appropriate response by the nurse?

"I would like to sit with you and talk about your child."

The parents of an infant who just died from sudden infant death syndrome (SIDS) are angry at God and refuse to see any members of the clergy. How would the nurse respond?

"Is there anyone else I can call to support you at this time?"

The home health nurse attends to a terminally ill client whose older adult spouse is the primary caregiver. The spouse states, "I am so ashamed to admit that sometimes I wish it would all just end. I am so tired." How should the nurse respond?

"It sounds like you are overwhelmed. How can we better support you through this process?"

A client undergoing a mastectomy says, "I've been a basket case just thinking of what implications this has for my family." How should the nurse respond?

"This is a very difficult adjustment period for you and your family."

The nurse is caring for a pediatric client with leukemia who is very ill. When the nurse enters the room to give medication to the sleeping client, the nurse notices the parent of the client sobbing. What is the best response for the nurse to give in this situation?

"This must be very difficult for you. Would you like to talk about anything?"

The client states, "No one cares about me anymore. All the people I loved are dead." Which response by the nurse is most therapeutic?

"You must be feeling lonely at this time. Would you like to talk about your loss?"

A client has just expelled a hydatidiform mole. She's visibly upset over the loss and wants to know when she can try to become pregnant again. How should the nurse respond?

"You must wait at least 1 year before becoming pregnant again."

The client, who is dying from acquired immunodeficiency syndrome (AIDS), is admitted to the inpatient psychiatric unit because he attempted suicide. His close friend recently died from AIDS. The client states to the nurse, "What's the use of living? My time's running out." What is the nurse's best response?

"You're in a lot of pain. What are you feeling?"

The nurse is caring for a client who recently lost an infant to sudden infant death syndrome (SIDS). The client talks about how going back to work last week and that the couple want to become pregnant again soon to have another baby. The client reports feeling sad sometimes, but also feeling happy sometimes. What stage of grief does this client demonstrate?

Acceptance

A 16-year-old primiparous client has decided to place her baby for adoption. The adoptive parents are on their way to the hospital when the mother says, "I want to see the baby one last time." What should the nurse do?

Allow the client to see and hold the baby for as long as she desires.

Which nursing action is appropriate to include in the plan of care for a dying child to meet the child's emotional needs during the last days of life?

Answer the child's questions about illness and death honestly.

An older adult client has received a terminal lung cancer diagnosis. The client's adult children are tearful and afraid to leave their parent's bedside. What type of grieving is this family most likely experiencing?

Anticipatory

A multipara at 16 weeks' gestation is diagnosed as having a fetus with probable anencephaly. The client is from a conservative faith and has decided to continue the pregnancy and donate the neonatal organs after the death of the neonate. What should the nurse do?

Explore his or her own feelings about the issues of anencephaly and organ donation.

A nurse is working with a dying client and the client's family. Which communication technique is most important to use?

Use active listening and silence when communicating.

An older adult client is speaking to the nurse about the expected death of a spouse due to cancer 3 weeks ago. The client says, "My spouse is in a better place now, and I'm happy my spouse is not hurting anymore. But I just miss my spouse!" How should the nurse respond?

Validate the client's statement as evidence of a normal grieving process.

A terminally ill client's husband tells the nurse, "I wish we had taken that trip to Europe last year. We just kept putting it off, and now I'm furious that we didn't go." The nurse interprets the husband's statement as indicating which stage of adaptation to dying?

anger

A client with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is admitted to the labor and delivery unit. The client's condition rapidly deteriorates and despite efforts by the staff, the client dies. After the client's death, the nursing staff displays many emotions. With whom should the nurse-manager consult to help the staff cope with this unexpected death?

chaplain, because his educational background includes strategies for handling grief

At an emergency shelter, an earthquake victim tells the nurse that he is going to spend the night in his own bed at home. Which defense mechanism is the client exhibiting?

denial

A client with end-stage pancreatic cancer has decided to terminate medical intervention. What should a nurse anticipate when consulting with palliative care?

referral for bereavement counseling

After completing the nursing assessment for a client and family entering the palliative care program. Which are appropriate nursing goals at this time? Select all that apply.

Achieve a dignified and respectful death. Maximize the client's quality of life. Provide comfort during the dying process. Offer support for the client's family.

A school-age boy with a spinal cord injury is moved to the rehabilitation unit. The nurse notes that the child tends to refuse to cooperate in care and to be hostile. The nurse interprets this behavior as indicative of which response?

a stage of grief reaction

Which nursing activity supports the principles of palliative care for a dying infant and the infant's family?

creating a therapeutic, homelike environment for the infant and the infant's family

A client gives birth to a stillborn neonate at 36 weeks gestation. When caring for this client, which strategy by the nurse would be most helpful?

Encourage the client to see, touch, and hold the dead neonate.

A client with terminal cancer tells the nurse that she is not afraid to die and she is thinking about how to plan her funeral. The most appropriate referral the nurse could suggest would be to the:

pastoral care department.

While caring for a male neonate diagnosed with gastroschisis, the nurse observes that the parents seem hesitant to touch the neonate because of his appearance. The nurse determines that the parents are most likely experiencing which stage of grief?

shock

The nurse observes that a client is very sad and dejected after a myocardial infarction. What is the best response to the statement, "Life will never be the same"?

"You're very concerned when you think about how this will change your life."

A client has been diagnosed with colon cancer with metastasis to the lymph nodes. When the nurse enters the room, the client says life is "not worth living." What is the nurse's best therapeutic response?

Approach the client and ask if there are questions about the condition.

The client who is in end stages of cancer is requesting spiritual support. What should the nurse do next?

Ask the client what spiritual activities would be most helpful.

During the interview at a crisis center, a newly widowed client reveals the wish "to join my spouse in heaven." The nurse determines that the client does not plan self-harm. What is the best response by the nurse?

"What feelings have you been experiencing?"

A client with stage IV pancreatic cancer is admitted to hospice. The spouse breaks down crying, stating "I just don't know what I will do if my partner dies!" What is the best response by the nurse?

"What has helped you cope with the illness so far?"

The family of a client who dies lives an hour away from the facility. What should the nurse do to support the family at this time?

Keep the client in the bed until the family arrives.

A client complains of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. Suspecting gallbladder disease, the physician orders a diagnostic workup, which reveals gallbladder cancer. Which nursing diagnosis is appropriate for this client?

Anticipatory grieving

After doing well for a period of time, a child with leukemia develops an overwhelming infection. The child's death is imminent. Which statement offers the nurse the best guide in making plans to assist the parents in dealing with their child's imminent death?

Parents are especially grieved when a child does well at first but then declines rapidly.

A nurse is caring for a 5-year-old child with end-stage acquired immunodeficiency syndrome (AIDS). The child confides that the child is ready to go to heaven and see Grandpa. The nurse knows that the child's parents aren't comfortable with the idea of discontinuing treatment. What should the nurse do?

Talk with the parents about the dying process and make the parents aware of what the child has confided.

In terminating the relationship with the nurse, which client reaction should be considered the healthiest?

an expression of grief

A spouse brings the client to the emergency department. The spouse reports that since the death of their 7-month-old daughter 8 weeks earlier, the client has been neglecting the housework and family, has lost 20 lb (9.1 kg), and has not left the house. Which additional assessment findings would indicate to the nurse that the client may be experiencing extreme depression? Select all that apply.

obvious neglect of personal hygiene speaking in soft monotone voice inconsolable weeping

The nurse is counseling the family of an older adult who died today. Which factor facilitates attainment of a positive bereavement outcome?

possessing adequate financial resources

A nurse interviews the parent of a middle school student who is exhibiting behavioral problems, including substance abuse, following a sibling's suicide. The parent says, "I'm a single parent who has to work hard to support my family, and now I've lost my only son, and my daughter is acting out and making me crazy! I just can't take all this stress!" Which issue is the priority?

potential suicidal thoughts/plans of both family members

The family of a client who was receiving hospice care contacts the facility every week to talk with the nurse who was the client's primary caregiver. What action should be taken to support the family?

Contact the hospice agency to provide grief support for the family.

What is the most cost-effective suggestion for bereavement support for the hospice nurse to give a woman whose husband died 3 months ago and her three young children?

Continue her bereavement support through hospice.

A client states that her "life has gone down the tubes" since her divorce 6 months ago. Then, after she lost her job and apartment, she took an overdose of barbiturates so she "could go to sleep and never wake up." Which statement by the nurse should be made first?

"I know you took an overdose of barbiturates. Are you thinking of suicide now?"

An obstetric ultrasound reveals that the client's fetus has spina bifida. The mother is concerned about raising a child with a congenital abnormality and starts to cry. Which response by the nurse is best?

"I know this must be overwhelming. I'm here to sit with you and support you."

A client who has experienced the loss of her husband through divorce, the loss of her job and apartment, and the development of drug dependency is suffering situational low self-esteem. Which outcome is most appropriate initially?

The client will discuss her feelings related to her losses.

On entering the room of a client who has undergone a dilatation and curettage (D&C) for a spontaneous abortion, the nurse finds the client crying. Which comment by the nurse would be most appropriate?

"I am truly sorry you lost your baby."

A nurse has been caring for an adolescent client in a residential facility. The child has been through a series of foster placements since infancy with no success in any placement until the age of 7 when placed with a middle-aged single woman. The client thrived there until the woman was killed in a car accident. The client attempted suicide after her foster mother died in response to the loss and the child was placed in the residential facility. The nurse has become close to this client and wants to help her address her issues and move on with her life. Which comment to the manager demonstrates that the nurse understands the client's issues and is able to respond appropriately to the client's needs?

"It's difficult for her to love and trust again after her losses. In this facility, she can learn to deal with her loss in a less emotionally charged environment than a foster home."

A client with a spinal cord injury who has been active in sports and outdoor activities talks almost obsessively about his past activities. In tears, one day he asks the nurse, "Why can't I stop talking about these things? I know those days are gone forever." Which response by the nurse conveys the best understanding of the client's behavior?

"Reviewing your losses is a way to help you work through your grief and loss."

The healthcare provider has indicated that a client has a poor prognosis for recovery, and the family is very concerned. How would the nurse best support the family?

Accommodate their grieving, explain what is happening, and encourage involvement in the care.

The roommate of a recently deceased client is observed sitting in the client lounge crying. What should the nurse do to support this person?

Console the roommate as grieving begins.

The hospice nurse is caring for a client who has been diagnosed with terminal cancer. The client breaks down in tears and shares with the nurse "I should just end it now so my kids can start moving on with their lives. They will be better off without me. When they come to visit tomorrow, just tell them I'm not up for visitors." The nurse understands the client is in which stage of the grief process?

Depression

The family of a client who died unexpectedly arrives to the care area. In which way should the nurse support the family at this time? Select all that apply.

Provide emotional support. Serve as an attentive listener. Expect the family to express grief. Arrange for the family to view the body.

The widow of a client who successfully completed suicide tearfully says, "I feel guilty because I'm so angry at him for killing himself. It must have been what he wanted." After assisting the widow with dealing with her feelings, which intervention is most helpful?

Refer her to a group for survivors of suicide.

A child with leukemia fails to respond to therapy. Which statement offers the nurse the best guide in making plans to assist the parents in dealing with their child's imminent death?

Relatives are especially grieved when a child does well at first but then declines rapidly.

A client experienced the loss of home and beloved family dog in flood waters 4 months ago. The client states that since the loss, the client finds it hard to "feel anything." The client says they can't concentrate on simple tasks, thinks about the flood incessantly, and fears losing control. The client reports becoming extremely anxious whenever the flood is mentioned and must leave the room if people talk about it. The admitting nurse suspects the client has post-traumatic stress disorder (PTSD). Which nursing goal would be most appropriate for this client?

The client will demonstrate progress in dealing with the grief of losing their home and dog.

A nurse is talking with a client who is terminal. The client tells the nurse, "I have a document that says that my child is the one to make decisions about my health care if I cannot. This form should be on my chart." When reviewing the client's medical record related to this discussion, the nurse would most likely find a:

durable power of attorney for health care.

The nurse is encouraging an unlicensed assistive personnel (UAP) to interact with a dying client and family. The nurse should help the UAP understand that:

when health care personnel do not understand their own feelings about death and dying, they often avoid the client.