The concept of grief and loss

19) The extended family of a client having labor induced because of fetal demise wants to be present for the delivery. Which action is most appropriate for the nurse to take in this situation? A) Ask the client about her preferences regarding the family's request. B) Call security to escort the family out of the hospital. C) Speak with the nurse manager about supporting the family's wishes. D) Show the family to the waiting room.

A) Ask the client about her preferences regarding the family's request.

17) The nurse is caring for an adolescent client who has just learned of being pregnant. Which assessment question is most appropriate to determine the client's risk for perinatal loss? A) "At what age did you begin menstruating?" B) "When was your last menstrual period?" C) "Is this your first pregnancy?" D) "Do you use any substances such as drugs, alcohol, or tobacco products?"

D) "Do you use any substances such as drugs, alcohol, or tobacco products?"

6) A client whose partner died a few weeks ago is unable to openly grieve because the partner was married and no one was aware of the relationship. For which type of grief should the nurse plan care for this client? A) External grief B) Chronic grief C) Abbreviated grieving D) Disenfranchised grieving

D) Disenfranchised grieving

12) The nurse is providing counseling to the family of a terminally ill client who has siblings of varying ages. Which statement regarding the reactions of children to death is appropriate for the nurse to include in the counseling session? A) "Older school-age children begin to understand that death is irreversible." B) "Adolescents tend to cope better with death than adults." C) "Preschool children view death as a spiritual release." D) "Toddlers are able to fully comprehend the ideas related to death."

A) "Older school-age children begin to understand that death is irreversible."

24) A client is grieving after the loss of a job. Which pattern of behavior would be the nurse's priority concern? A) Alcohol or substance use B) Excessive sleeping C) Overeating

A) Alcohol or substance use

5) The nurse is caring for a client with complicated grieving after the loss of a child. Which treatment approaches does the nurse anticipate being included in the collaborative plan of care for this client? Select all that apply. A) Antidepressants B) Electroconvulsive therapy C) Talk therapies D) Complicated grief treatment E) Anger management

A) Antidepressants C) Talk therapies D) Complicated grief treatment

9) The adolescent child of a recently deceased patient is quiet and does not talk about the loss. Which action by the nurse is appropriate to assist the adolescent? A) Ask the doctor to prescribe a sedative for the adolescent. B) Ask the adolescent if any friends are available to talk. C) Provide the adolescent with paper, pens, and pencils. D) Notifying the hospital chaplain to come talk with the adolescent.

A) Ask the doctor to prescribe a sedative for the adolescent. B) Ask the adolescent if any friends are available to talk. C) Provide the adolescent with paper, pens, and pencils. D) Notifying the hospital chaplain to come talk with the adolescent.

7) The nurse is concerned that a client whose spouse died 2 years ago is experiencing complicated grief. Which interventions should the nurse consider when planning care for this client? Select all that apply. A) Monitoring for suicidal behavior B) Psychotherapy C) Substance abuse assessment D) Alcohol abuse assessment E) Hypnosis

A) Monitoring for suicidal behavior B) Psychotherapy C) Substance abuse assessment D) Alcohol abuse assessment

3) The nurse is planning care for a group of clients who are experiencing grief. Which principle from accepted grief models should the nurse use to guide care? A) No clear timetables for grief exist, nor are there clear-cut stages of grief. B) There is strong research evidence indicating that these models are not useful for many dying clients. C) These models serve as clear and definitive predictors of grief behaviors. D) The Kübler-Ross model is primarily used to describe anticipatory grief.

A) No clear timetables for grief exist, nor are there clear-cut stages of grief.

8) A client is hospitalized for suicidal ideations as a response to complicated grief. Which collaborative interventions can the nurse anticipate including in this client's care? Select all that apply. A) Social service consult B) Bereavement group C) Antidepressant medication D) Sleep medication E) Psychotherapy

A) Social service consult B) Bereavement group C) Antidepressant medication E) Psychotherapy

28) The staff nurse is planning for a client who is grieving the loss of a spouse. Which action should the nurse identify as an appropriate independent nursing intervention? A) Teach the client about the grieving process B) Select an appropriate antidepressant C) Conduct complicated grief therapy (CGT) D) Provide chaplain services

A) Teach the client about the grieving process

1) The nurse is preparing to assess a client whose spouse died several weeks ago. Which symptoms is the nurse most likely to observe in the client as part of the classic grief response? Select all that apply. A) Weight loss B) Frequent headaches C) Difficulty sleeping D) Excessive energy E) Increased appetite

A) Weight loss B) Frequent headaches C) Difficulty sleeping

11) The mother of a 3-year-old client was killed in an accident, and the client recently learned of the parent's death. Which nursing intervention would be most appropriate to support the developmental needs of this client? A) Work with the surviving family members to ensure that the client's routine remains as normal as possible after release from the hospital. B) Do not correct the client when she expresses the belief that the parent will "wake up and come home." C) Provide the client with the same level of reassurance and attention as any other client on the unit. D) Avoid answering the client when she asks questions about her mother's death.

A) Work with the surviving family members to ensure that the client's routine remains as normal as possible after release from the hospital.

27) The nurse is caring for a family whose 8-year-old son recently died. Which question would best help the nurse assess this family's level of functioning? A) "Have you returned to your normal schedule yet?" B) "How have you expressed your feelings about the loss?" C) "When do you think your grieving process will be complete?" D) "Have any of you experienced prior loss?"

B) "How have you expressed your feelings about the loss?

23) A client experienced the loss of a spouse due to chronic illness, the loss of a grandchild due to stillbirth, and the loss of a long-time family pet, all within a 6-week period. Which type of loss is this client experiencing? A) Caregiver loss B) Cumulative loss C) Compound loss D) Complicated loss

B) Cumulative loss

16) The nurse is caring for an older adult client who is experiencing grief after the recent loss of a spouse. Which behavior should the nurse anticipate with regard to the older adult's response to grief? A) Grief in an older adult initially presents differently than in a younger adult. ' B) Older adults may seem to experience the emotional aspects of grief more acutely than younger adults. C) Manifestations of grief in older adults are usually less severe than those observed in younger clients. D) Manifestations of grief in older adults are usually trust issues, suspecting once-close friends and family members of judging their pain or not understanding their emotion

B) Older adults may seem to experience the emotional aspects of grief more acutely than younger adults.

22) The nurse is planning care for a couple who has experienced a miscarriage. Which aspect of the grief response is essential for the nurse to anticipate? A) The grief experienced by fathers after perinatal loss appears similar to the grief experienced by mothers after perinatal loss. B) Postpartum depression may occur in women who have experienced perinatal loss. C) Grief is typically less severe when the perinatal loss occurs before 20 weeks' gestation. D) Perinatal loss refers only to emotional changes that occur after perinatal loss.

B) Postpartum depression may occur in women who have experienced perinatal loss.

25) The nurse is caring for a client who found a loved one who committed suicide. In addition to the normal grief process, the nurse recognizes the client may be at risk for which other complication? A) Seasonal affective disorder (SAD) B) Posttraumatic stress disorder (PTSD) C) Obsessive-compulsive disorder (OCD) D) Major depressive disorder (MDD)

B) Posttraumatic stress disorder (PTSD)

15) An older adult client whose spouse died 6 months ago tells the nurse stories about the deceased spouse because the client's children do not want to hear the stories. From which type of intervention would this client most likely benefit? A) Antidepressant medication B) Referral to a support group C) Occupational therapy D) Referral to a social worker

B) Referral to a support group

4) During a home care visit, an older adult client states to the nurse, "My spouse died 3 years ago." Which action is a possible indicator that the client is experiencing complicated grief? A) The client says the spouse was an awful cook and meals have been better since the death. B) The client hasn't seen the doctor since the spouse died because the doctor's office provides sad memories. C) The client has an album of photographs of the spouse open on the living room table. D) The client indicates that the laundry is sent out to be done because of not knowing how to work the washing machine.

B) The client hasn't seen the doctor since the spouse died because the doctor's office provides sad memories.

13) During a home visit, the nurse is concerned that an older adult with a terminal illness should be hospitalized; however, the family wants the client to stay home. Which action by the nurse is most appropriate? A) Follow the decision of the family. B) Call for an ambulance to transport the client to a hospital. C) Ask the client's preference regarding transport to the hospital. D) Encourage the family to take the client to the hospital.

C) Ask the client's preference regarding transport to the hospital.

26) The nurse is caring for a grieving family who is from another culture and has different religious beliefs. Which action should the nurse take to provide emotional support for this family? A) Encourage the family to go eat a meal and come back to the hospital later. B) Ask the physician to assess the family for ineffective coping. C) Ask the family how the nurse can meet the family's cultural needs. D) Refer the family to a group counseling session.

C) Ask the family how the nurse can meet the family's cultural needs.

20) A client delivers a still born child at 36 weeks' gestation. Which intervention should the nurse perform to help the family grieve? A) Remove all baby supplies from the mother's room. B) Refrain from talking about the baby. C) Facilitate and support the family viewing and holding the infant. D) Ask to have the mother moved off the postpartum floor.

C) Facilitate and support the family viewing and holding the infant.

10) The community nurse is developing a seminar to help children who have experienced a loss. Which information should the nurse include to help these children adapt? A) Explain that magical thinking helps with the pain. B) Remind the child that big children don't cry. C) Help create new memories. D) Pretend that the individual has not really gone.

C) Help create new memories.

14) An older adult whose spouse died 4 years ago has not made changes in the home and states that caring for the spouse was the client's sole purpose in life. For which condition should the nurse plan care for this client? A) Anticipatory grieving B) Self-care deficit in the area of feeding C) Prolonged grief disorder D) Death anxiety

C) Prolonged grief disorder

2) The partner of a client who just died due to an intentional drug overdose is somber and dry eyed. Which factor should the nurse suspect is causing the partner's behavior? A) The partner is waiting to grieve until the client's family can join him. B) The partner is seeking support from staff members on the unit. C) The partner anticipates that others will find the client's actions socially unacceptable. D) The partner is concerned that others may view showing emotion as weakness.

C) The partner anticipates that others will find the client's actions socially unacceptable. D) The partner is concerned that others may view showing emotion as weakness.

The nurse is preparing to assess clients in the prenatal clinic. Which clients should the nurse identify as being at risk for prenatal loss? Select all that apply. A) The woman who drinks one cup of coffee every morning B) The woman recovering from a gastrointestinal virus C) The unmarried 14-year-old girl living in the city D) The woman who lacks access to health and prenatal care E) The woman who had a healthy baby 6 months ago resulting from a healthy pregnancy

C) The unmarried 14-year-old girl living in the city D) The woman who lacks access to health and prenatal care E) The woman who had a healthy baby 6 months ago resulting from a healthy pregnancy

21) The nurse is planning care for a client who is arriving on the unit with a suspected perinatal loss. Which nursing intervention is most appropriate in this situation? A) Place the client in a room closest to the nurse's station to closely observe the client. B) Call the hospital chaplain to ensure the chaplain can be in the client's room when the client arrives. C) Call the local funeral home and notify them of the client's situation. D) Place the client in the room farthest from the other clients.

D) Place the client in the room farthest from the other clients.

29) The nurse recognizes that the spouse of a terminally ill client has completed the grieving process, but the ill client is still alive. Which goal should the nurse identify for the ill client? A) Prevent physical and spiritual distress of the spouse B) Prevent despair in other family members C) Prevent guilt in the client D) Prevent isolation and loneliness for the client

D) Prevent isolation and loneliness for the client