Gero Chapter 25: Loss, Death, and Palliative Care

1. Which of the following characteristics are associated with acute grief? (Select all that apply.) a. Preoccupation with the loss of a loved one b. Waves of grief or distressing emotion c. Prolonged inability to sleep after a loss d. Exacerbations of grief on specific dates e. Change in attitude toward the future loss f. Inability to perform simple self-care tasks

a. Preoccupation with the loss of a loved one b. Waves of grief or distressing emotion f. Inability to perform simple self-care tasks

13. An older patient who has end-stage pulmonary disease decides to accept care from the palliative care nurse. This older adult will most likely benefit from the palliative care nurse in which patient needs of Weismans six needs for the dying? a. Closure b. Control c. Composure d. Cohesiveness

b. Control

12. While awaiting the imminent death of her sister, an older woman makes arrangements to bury her sister in the survivors home state because she cannot reach the other family members. Which step should the nurse implement? a. Ask questions, including questions about the location of her sisters family. b. Instruct this woman that this is not her decision to make. c. Try to contact the family to inform them of the decision. d. Question her about holding behaviors that she will want.

a. Ask questions, including questions about the location of her sisters family.

2. Which of the following indicate a person is effectively coping? (Select all that apply.) a. Avoids avoidance b. Confronts realities c. Focuses on solutions d. Redefines problems

b. Confronts realities c. Focuses on solutions d. Redefines problems

10. A patient loses her husband because of a sudden myocardial infarction, and she blames herself for not recognizing the warning signs. Which patient outcome associated with her loss should the nurse use to plan care? a. Meets her daily responsibilities b. Expresses feelings of guilt, fear, anger, or sadness c. Assesses the causes of the dysfunctional grieving processes d. Identifies problems connected to anticipatory grief

b. Expresses feelings of guilt, fear, anger, or sadness

2. The health care provider believes an older woman has approximately 6 weeks to live. After 2 months, the family remains at the bedside but, in the last few days, are becoming increasingly impatient and irritable. This pattern is least indicative of which of the following statements? a. Family is experiencing anticipatory grief for the older adult. b. Family desires that the patient be relieved of her misery. c. Anticipatory grieving can fail to attenuate acute grief upon death. d. Grievers deal more easily with known losses at known times.

b. Family desires that the patient be relieved of her misery.

6. After the loss and burial of a beloved pet, an older man loses weight because he eats very little. Three months later, he starts to paint pictures of the pet and his appetite slowly improves. Describe this individuals mourning for his pet. a. Weight loss from inadequate intake b. Pets burial and painting pictures of the pet c. Loss of his appetite resulting in weight loss d. Increased food intake after painting begins

b. Pets burial and painting pictures of the pet

7. The primary difference between the Loss Response Model (LRM) and the Worden model of grief is which of the following? a. In the Worden model, those grieving pass through stages in order. b. The LRM uses a systems approach that acts to uphold stability. c. In the Worden model, the system helps maintain equilibrium. d. In the LRM model, those who are grieving transition through several stages.

b. The LRM uses a systems approach that acts to uphold stability.

5. Which of the following statements is true about end-of-life care? a. The physician is the ultimate authority in the decision to use or not to use life-sustaining medical treatment. b. The proxy appointed in a living will cannot speak for the testator in health care matters other than terminal illness. c. A patient with dementia cannot be capable of making personal wishes known about life-sustaining treatment. d. The American Nurses Association encourages nurses to participate in assisted suicide.

b. The proxy appointed in a living will cannot speak for the testator in health care matters other than terminal illness.

3. After the older adult dies, the brother who has a history of alcohol abuse upsets the family by going on a drinking binge instead of attending the funeral. Which of the following is the best description of the brothers behavior? a. Personality disorder b. Disrespectful attitude c. Disenfranchised grief d. Chronic grief

c. Disenfranchised grief

9. The son of an older adult couple ends his life suddenly and violently. The husband proceeds with living as usual. After 1 year, the wife remains in seclusion and is hospitalized for dehydration. Which steps should the nurse implement to help improve the wifes mental health and wellness? a. Encourage additional fluids and social activity. b. Instruct the husband to display empathy for her. c. Establish a trusting, caring relationship with her. d. Ask social services for a survivors support group.

c. Establish a trusting, caring relationship with her.

3. Those who cope less effectively may exhibit which of the following? (Select all that apply.) a. Avoids avoidance b. Confronts reality c. Is demanding d. Is rigid

c. Is demanding d. Is rigid

8. When the older woman who is close to death asks the family to leave after short visits and acts withdrawn in their presence, the family becomes distraught. Which of the following does the nurse include in family teaching to explain the patients behavior? a. She is preoccupied with her own death. b. She must have unresolved family issues. c. She can be experiencing anticipatory grief. d. Her body prepares for death in this manner.

c. She can be experiencing anticipatory grief.

14. Which of the following is a true statement about loss, dying, and death for older adults? a. Men and women tend to respond similarly to the loss of a spouse. b. Visions on the part of a person who has lost a spouse are not normal grief reactions and should be regarded as signs of underlying defects. c. The grieving process is not rigidly structured. d. Bereaved persons regain their normal capability approximately 6 months after loss, and regressive behavior after that time should be discouraged.

c. The grieving process is not rigidly structured.

1. Which of the following statements is true about loss in older adulthood? a. A person experiences each stage of grief once, and then grieving is resolved. b. Antianxiety agents are frequently recommended for reducing the pain of grief. c. The loss response model is concerned with the effect of loss on an individual. d. Referring to the deceased in the past tense can acknowledge the deaths reality.

d. Referring to the deceased in the past tense can acknowledge the deaths reality.

11. The actions of the family members of an older adult who just died are chaotic, and they are unable to decide on a funeral home. Which recommendation should the nurse implement? a. Help them make a list of the problems. b. Provide a list of preferred funeral homes. c. Allow them privacy to work it out alone. d. Suggest they call someone who can help.

d. Suggest they call someone who can help.

4. Which of the following interventions is recommended for an older adult in the final stages of dying? a. Apply an electric blanket to keep the patient warm. b. Lower the head of the bed, and turn the head to the side. c. Decrease the number of visitors. d. Support the preservation of energy.

d. Support the preservation of energy.