Ch. 27 The Bereaved individual
Family members of a client who is dying begin to pull away from and provide less support to the client who is dying. As a result, the client who is dying expresses feelings of loneliness and isolation. Which is the most likely problematic grief response exhibited by the family? 1. Anticipatory grief response 2. Inhibited grief response 3. Chronic grief response 4. Exaggerated grief response
1
In which situation would the grief response be most difficult for the bereaved individual? 1. The individual has experienced a number of recent losses. 2. The individual knew beforehand that the loss was going to occur. 3. The individual lost an elderly person who was close to him or her. 4. The individual participated in the rituals associated with loss within his or her culture.
1
In which stage of grief outlined by Elizabeth Kübler-Ross does a client acknowledge the loss but hold out hope for additional alternatives? 1. Stage III 2. Stage V 3. Stage II 4. Stage I
1
Which behavior is exhibited by a bereaved individual in stage II of the grief process outlined by George Engel? 1. Regressing to a state of helplessness 2. Feeling numb 3. Participating in the funeral 4. Imitating admired qualities of the lost entity
1
Which is an example of delayed grief? 1. Overreaction to another person's loss 2. Detachment from a dying family member even before the death has occurred 3. Depressive mood disorder as a reaction to loss 4. Extreme feelings of powerlessness
1
Which is the major difference between normal grieving and a maladaptive grieving response? 1. Feeling worthless or having low self-esteem 2. Feeling considerable anger toward the environment 3. Feeling helpless and frustrated 4. Taking years to adapt to a new way of life
1
Which is the most commonly available type of hospice care in the United States? 1. Home-based care 2. Freestanding institutions that provide both inpatient and home care 3. Hospital-affiliated institutional care 4. Nursing home-affiliated institutional care
1
Which is the social worker's role in the hospice care setting? 1. Assisting the client's family with financial issues 2. Providing directions to the client regarding pain management 3. Providing companionship 4. Providing bereavement counseling to family members of the deceased
1
Which type of grief response acts as a defense for some individuals to ease the burden of loss when it actually occurs? 1. Anticipatory grief response 2. Delayed grief response 3. Exaggerated grief response 4. Normal grief response
1
Which type of grief response does a bereaved individual most likely experience if the individual is strongly influenced by his or her culture to maintain a "stiff upper lip" in response to the loss? 1. Delayed grief 2. Distorted grief 3. Prolonged grief 4. Anticipatory grief
1
Which are the most likely characteristics of the disorganization and despair stage in the grief process as hypothesized by John Bowlby? Select all that apply. 1. Perceptions of visualizing the lost person or object 2. Restless behavior 3. Resignation to the loss 4. Intense weeping 5. Anger toward the self
1, 2
According to the tasks proposed by J. William Worden, which strategies is a bereaved individual likely to employ to avoid or suppress the pain of grief? Select all that apply. 1. Refusing to allow oneself to think painful thoughts 2. Idealizing reminders of lost entity 3. Using alcohol or drugs 4. Regressing to a state of helplessness 5. Excessive crying
1, 2, 3
Which are the characteristic features of a distorted grief response? Select all that apply. 1. Anger toward the environment 2. Anger toward the self 3. Depressive mood 4. Overreaction to another person's loss 5. Keeping a "stiff upper lip"
1, 2, 3
Which behaviors are associated with the second stage of grief hypothesized by John Bowlby? Select all that apply. 1. Preoccupation with the loss 2. Intense weeping 3. Feelings of ambivalence 4. Restlessness and aimlessness 5. Somatic complaints
1, 2, 3
Which behaviors exhibited by bereaved individuals are examples of chronic grieving? Select all that apply. 1. Maintaining personal possessions aimed at keeping a lost loved one alive 2. Refusing to attend family gatherings after the loss of a spouse 3. Setting a place at the table for the deceased loved one 4. Overreacting to another person's loss 5. Refusing to grieve in the belief that one must be stoic in the face of adversity
1, 2, 3
Which symptoms indicate that the bereaved individual is going through clinical depression rather than normal grieving? Select all that apply. 1. Persistent state of dysphoria 2. Anhedonia 3. Not responding to social interaction and support from others 4. Expressing guilt over some aspect of the loss 5. Relating feelings of depression to specific loss experiences
1, 2, 3
Which strategies are effective to reduce stress among hospice support staff? Select all that apply. 1. Keeping the lines of communication open among all members of the hospice care 2. Keeping information readily accessible to all members 3. Providing extensive training to the members at the very beginning 4. Offering high financial rewards 5. Letting the members know that their efforts are appreciated
1, 2, 5
Which are the most common reasons for delayed grieving in a bereaved individual? Select all that apply. 1. The bereaved individual feels ambivalence toward the lost entity. 2. The bereaved individual feels extreme anger toward the lost entity. 3. The bereaved individual experiences social pressure to resume normal functions of daily life. 4. The bereaved individual feels a lack of internal and external resources to cope with loss. 5. The bereaved individual has had the opportunity to prepare for the loss.
1, 3, 4
In which situations does the grief response become more difficult? Select all that apply. 1. The bereaved individual was strongly dependent on the lost entity. 2. The lost entity is an elderly person. 3. The bereaved individual believes that he or she bears responsibility for the loss. 4. The bereaved individual has the opportunity to prepare for the loss. 5. The loss is sudden and unexpected.
1, 3, 5
A bereaved individual feels such intense sadness at the passing of the lost entity that the individual is unable to properly manage daily living activities. The individual also experiences chronic somatic symptoms. Which sort of grief response does this individual experience? 1. Normal grief 2. Distorted grief 3. Inhibited grief 4. Anticipatory grief
2
A client has recently gone through a mastectomy as a part of her treatment for breast cancer. She requires therapeutic intervention while she works through her feelings of grief regarding the mastectomy. Which stage of the grief response outlined by Elizabeth Kübler-Ross is the client most likely experiencing? 1. Acceptance 2. Depression 3. Bargaining 4. Anger
2
Children of which age group are most likely to believe that their thoughts or behaviors caused a person to become sick or to die? 1. 2 years of age 2. 3 to 5 years of age 3. 6 to 9 years of age 4. 10 to 12 years of age
2
How many components are there in an ideal hospice program? 1. 5 2. 7 3. 9 4. Eleven
2
In which stage of the grief response outlined by George Engel does an individual feel anger toward the people in the environment whom the individual holds accountable for the loss? 1. Shock and disbelief 2. Developing awareness 3. Restitution 4. Resolution of the loss
2
Which is a normal grief response? 1. Inhibited grieving 2. Anticipatory grieving 3. Exaggerated grieving 4. Prolonged grieving
2
Which is a sign of clinical depression in a bereaved individual? 1. Experiencing transient physical symptoms 2. Not expressing anger directly 3. Expressing feelings of guilt over some aspect of the loss 4. Experiencing a mixture of "good and bad days"
2
Which is the most likely characteristic of the disequilibrium stage in the grief process hypothesized by John Bowlby? 1. Feeling of shock 2. Preoccupation with the loss 3. Establishment of new patterns of organization 4. Somatic complaints
2
Which stage of the grief process outlined by Elizabeth Kübler-Ross is characterized by confusion and a decreased ability to function independently? 1. Denial 2. Anger 3. Bargaining 4. Acceptance
2
Which stage of the grief process outlined by Elizabeth Kübler-Ross is characterized by elevated anxiety levels and an idealized image of what has been lost? 1. Denial 2. Anger 3. Bargaining 4. Acceptance
2
Which statement is true regarding the concept of death held by most children between the ages of 6 and 9 years? 1. They believe death is reversible. 2. They may believe that death is contagious. 3. They are interested in the physical aspects of dying and the final disposition of the body. 4. They generally have an attitude of immortality.
2
Which actions are called for to complete the third task of the grief process outlined by J. William Worden? Select all that apply. 1. Allowing oneself to experience the intensity of the pain 2. Making adaptations to one's environment after the loss results in a change of lifestyle 3. Making adjustments to one's sense of self 4. Accepting the reality of the loss 5. Letting go of past attachments and forming new ones
2, 3
Which characteristic features are most likely to be observed in a client who is in Stage V of the grief response outlined by Elizabeth Kübler-Ross? Select all that apply. 1. Regression 2. Decreased anxiety 3. Resignation 4. Shame 5. Decreased ability to function independently
2, 3
A client who is a heavy smoker is informed by the health-care provider that his or her lung cancer has metastasized and he or she has only a few months to live. The individual says, "Please God, if I am spared this time, I will never touch a cigarette again." Which stage of the grief response is the client experiencing, based on the stages of grief outlined by Elizabeth Kübler-Ross? 1. Depression 2. Acceptance 3. Bargaining 4. Denial
3
How long does the acute phase of normal grieving last in a 40-year-old adult? 1. 2 to 3 weeks 2. 4 to 5 weeks 3. 6 to 8 weeks 4. 12 to 14 weeks
3
Which behavior is most likely to be observed in the restitution stage of the grief process as outlined by George Engel? 1. Refusal to acknowledge the loss 2. Regression to a state of helplessness 3. Participation in rituals associated with loss 4. Preoccupation with the loss
3
Which do most preschoolers and kindergartners believe regarding the concept of death? 1. They believe death is reversible. 2. They may believe that death is contagious. 3. They are interested in the physical aspects of dying and the final disposition of the body. 4. They generally have an attitude of immortality.
3
Which statements are true regarding the attitudes of children between 3 and 5 years toward death? Select all that apply. 1. They are able to understand that death is final and eventually affects everyone. 2. They are interested in the physical aspects of dying and the final disposition of the body. 3. They are concerned with safety issues and require a great deal of personal reassurance that they will be protected. 4. They believe death is reversible. 5. They believe that death is contagious
3, 4
Children of which age are most likely to personify death in their minds in the form of a monster? 1. 10-year-olds 2. 2-year-olds 3. 4-year-olds 4. 7-year-olds
4
How does it help a grieving client if the nurse encourages the client to reach out to familiar religious practices for support? 1. It increases the client's sense of self-worth. 2. It helps the client trust the nurse-client relationship. 3. It puts life back into a realistic perspective. 4. It helps the client find comfort in religious rituals with which he or she is familiar.
4
In which situation is the grief response facilitated? 1. The individual was strongly dependent on the lost entity. 2. The individual had a love-hate relationship with the lost entity. 3. The individual's physical health was unstable at the time of the loss. 4. The individual knew that the loss was imminent.
4
In which stage of the grief response outlined by George Engel does the bereaved individual idealize the concept of the loss? 1. Stage V 2. Stage II 3. Stage III 4. Stage IV
4
The nurse observes that a terminally ill client is becoming increasingly quiet and withdrawn. Therapeutic intervention concludes that the client is not depressed. Which stage of grief response is the client experiencing, as outlined by Elizabeth Kübler-Ross' stages of grief response? 1. Denial 2. Anger 3. Bargaining 4. Acceptance
4
Which condition is a predisposing factor in the development of depressive disorder in older adults? 1. Prolonged grieving 2. Inhibited grief 3. Distorted grieving 4. Cumulative grief
4
Which statements regarding hospice care in the United States are true? Select all that apply. 1. Hospice provides palliative and supportive care to meet the special needs of dying clients only. 2. Hospice care provides support for clients with terminal diseases who are undergoing aggressive treatments. 3. The hospice movement in the United States has evolved mainly as a system of institution-based care. 4. Hospice helps clients achieve physical and emotional comfort. 5. Clients in hospice care are encouraged to stay active for as long as they are able.
4, 5
A soldier who has been missing in action for more than 3 years finally returns home to his wife. She had believed him to be dead and had grieved over his loss. Now he is upset due to the realization that she had started to move on with her life. Which type of grief response has the wife exhibited in this situation? 1. Anticipatory grief 2. Inhibited grief 3. Distorted grief 4. Chronic grief
1