Chapter 21 PREP U

Which assessment findings can most accurately be described as complicated grieving?

A person is unable to return to work after a sister's death 18 months ago

A couple came to the emergency department with their 5-month-old child. The child was pronounced dead of sudden infant death syndrome (SIDS). In the next day or two, it will be important for this couple to do what?

Plan funeral arrangements for the child.

A nurse has been caring for a gunshot victim who has just died. Various family and friends are present. One of the visitors privately discloses to the nurse that the visitor and the client were having an illicit affair. Which is the best action by the nurse after learning of this relationship?

Privately offer support to the visitor who was having the affair with the client

The nurse is assessing a client in crisis. The client states, "I don't feel like I can go on anymore." Which of the following is the nurse's best response?

"Are you having thoughts of hurting yourself?"

Which statement by a client rescued after a tornado would alert the nurse to consult a mental health specialist?

"I am not sure who I can call to come help me right now."

A nurse is assessing a person who has suffered a loss and is grieving. When applying the dual process model, the nurse would most likely interpret which client statement as reflecting loss-oriented coping?

"I just can't believe that my spouse is gone."

An older adult who lives alone is beginning to have difficulty maintaining the household and performing daily tasks. The nurse asks this client to identify someone who can help. The client replies, "I don't need help. I've been managing for years." Which response helps the client shift from denial to consciously coping with the situation?

"If you were to need help with your house, who might you ask for help?"

The nurse approaches a client who looks very sad and is sitting alone crying. Which is the best response by the nurse in this situation?

"You look very sad. What is happening?"

A nurse is assessing a client who is grieving. The nurse suspects that the client is experiencing complicated bereavement based on which statement? Select all that apply.

-"If only I could go back to the way it was before my husband died." -"My life has no meaning since my husband died last year."

The bereaved client has worked through many processes of grief with the nurse. Which are eventual outcomes of the emotional dimension of grieving? Select all that apply.

-The survivor begins to reestablish a sense of personal identity, direction, and purpose for living. -The survivor begins to gain independence and confidence. -The survivor develops new ways of managing life and new relationships.

In traumatic grieving, external factors influence reactions and potential long-term outcomes. Which characteristic would a nurse identify as an external factor? Select all that apply.

-extent of violence -suddenness -degree of preventability

A nurse is offering a support session to a client who is grieving the death of a partner. The nurse is correct in telling the client that the client is more likely to achive positive outcomes if which conditions are present? Select all that apply.

-the client is attending a support group -the client understands why the partner died -the client pays attention to self-care needs

A possible outcome of surveying a disaster is that the surveyor often experiences ...

An exaggerated fear for his or her safety

A nurse is describing the process of learning how to cope with a loss. Which term would the nurse use to describe this process?

Bereavement

The nurse is caring for a client who has just been diagnosed with cancer. The client states that the client will "never be able to cope with this situation." What is the nurse aware that coping is?

Coping is the physiologic and psychological processes that people use to adapt to change.

The prime objective of the crisis intervener is to do which of the following?

Help the client find ways to solve the immediate problem.

The nurse is working with a client who lost the client's youngest child 2 months ago. When the nurse approaches, the client yells, "I don't want to talk to you. You have no idea what it's like to lose a child!" The nurse bases a response to the client on the understanding of what?

Hostility is a common behavioral response to grief.

The nurse is conducting a history and physical exam on a client who is grieving the unwanted loss of a marriage by divorce. Which physical symptom of grief would the nurse most likely expect to detect in the history?

Insomnia

What is accurate regarding a crisis?

Occurs when an individual is at a breaking point

Which of the following would not be essential to assess when working with a person in crisis?

Past history of mental health care

A nurse is conducting a class for a group of colleagues about crisis. Which information would the nurse most likely include as being most influential on the outcome for a person experiencing a crisis?

Perception of the precipitating event

A 15-year-old client comes to the clinic in a state of crisis because her boyfriend has ended their relationship. Which type of crisis would the nurse describe this as?

Situational

Losing one's job is an example of which type of crisis?

Situational

A nurse is caring for a client who is grieving the loss of a loved one. Which factor would the nurse identify as contributing to the possibility of complicated bereavement?

The client has experienced a number of previous losses.

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.

A client with terminal cancer has been told the client has 3 or 4 months to live. Which would indicate to the nurse that further interventions are needed?

The client says the client is well and is making future plans.

The nurse is establishing outcomes for a grieving client. Which is an appropriate outcome?

The client will develop a plan for coping with the loss.

A client who is a lawyer is meeting with a nurse therapist for the first time. The client has been highly anxious and increasingly consumed with thoughts about how he may have mismanaged a case and possibly committed malpractice. He relates that he has been pacing in his office and at home and cannot think clearly about what to do next. Which of the following interventions is appropriate at this time?

The nurse asks the client to relate the events that immediately preceded his feelings of anxiety.

The nurse understands that crises are self-limiting. This implies that upon evaluation of crisis intervention, the nurse should assess for which outcome?

The patient will resume the precrisis level of functioning.

A situational crisis refers to ...

The result of an external source of severe stress the individual is not prepared to cope with

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

The nurse is counseling a client who lost a parent one year ago. The client states "I wish I could die too." The nurse is aware that the client is experiencing which type of grief?

complicated

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 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

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 most beneficial for the client?

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