Chapter 10

A young couple just ended their relationship after a 9-month engagement. One of the individuals is seeking short-term counseling to assist in grieving this loss. Which type of loss best describes what this client is experiencing? A) Safety loss B) Loss of security and sense of belonging C) Loss of self-esteem D) Loss related to self-actualization

B

Friends of a teenage male recently killed in a car accident are discussing their sense of loss. Which of the following comments best indicates that the friends are trying to make sense of the loss cognitively? A) "Why did he have to die so young?" B) "He shouldn't have been driving so recklessly." C) "If we had only stayed longer, he would not have been on that road." D) "It took the ambulance too long to get there."

a

The nurse is establishing outcomes for a grieving client. Which of the following is an appropriate outcome? A) The client will develop a plan for coping with the loss. B) The client will demonstrate self-reliance during the grief process. C) The client will suppress emotions related to the loss. D) The client will verbalize that loss will not adversely affect the quality of life.

a

The nurse is working with a client who lost her youngest child two 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 her response to the client on the understanding of which of the following? A) Hostility is a common behavioral response to grief. B) It is too soon after the loss to empathize with the client. C) Personality traits such as aggressiveness are exaggerated during the grief process. D) The nurse may have nonverbally indicated a judgmental attitude toward the client.

a

The bereaved client has worked through many processes of grief with the nurse. Which of the following are eventual outcomes of the emotional dimension of grieving? Select all that apply. A) The survivor begins to reestablish a sense of personal identity, direction, and purpose for living. B) The survivor begins to gain independence and confidence. C) The survivor develops new ways of managing life and new relationships. D) The survivor's life returns to the same state as it was before the loss. E) The survivor forgets about the loss.

a b c

Which of the following persons are most likely experiencing complicated grieving? Select all that apply. A) The spouse of a person who died 7 years ago and visits the grave several times a day. B) The grandchild of a soldier killed in war who visits the grave once a year on Memorial Day. C) A driver whose spouse and children all died as a result of his driving drunk. D) An adult who insisted for many years that she hated her deceased parent. E) The parent of a child who died after the having left the child in a car on a hot day.

a c d e

The nurse is caring for a hospice client whose death is imminent. In preparing the family for the death of their loved one, then nurse prepares to assist the family in which of the following, regardless of the family's cultural preferences? Select all that apply. A) Dealing with the shock of losing a loved one B) Burial plans after death had occurred C) Efforts to stay connected to the client after death D) Use of support from family and friends E) Anger at the loss of a loved one

a c e

While the nurse is observing the grieving client, which of the following are critical components in assessment of a person's grief? Select all that apply. A) Adequate perception regarding the loss B) Adequate time to experience the loss C) Adequate support while grieving for the loss D) Adequate opportunities to say goodbye to the person E) Adequate coping behaviors during the process

a c e

A client is scheduled for a mastectomy for breast cancer. She is quiet, shows little emotion, and states that she has no questions. The nurse's assessment would need to focus on... A) the client's plans for reconstructive surgery. B) the meaning of the mastectomy to the client. C) whether the client truly understands the surgery. D) why the client seems depressed.

b

A client states to a nurse, "They found a lump in my neck, and now they tell me I have an incurable disease." The client is young and appears to find this information hard to believe. The client's statement shows the pattern of response called... A) restitution. B) shock and disbelief. C) physiologic grieving. D) recovery.

b

After the death of a client's wife, a man tells the nurse "I can never live without my wife. My wife was my whole life." Which is the most therapeutic response from the nurse? A) "Remember, your wife is no longer suffering." B) "Your wife's death is a terrible loss for you." C) "Each day will get a little better." D) "Your friends will help you cope with this."

b

The nurse is conducting a history and physical exam on a client who is grieving the unwanted loss of a marriage by divorce. Which of the following physical symptoms of grief would the nurse most likely expect to detect in the history? A) Hair loss B) Insomnia C) Compulsive behaviors D) Vomiting

b

The nurse is having an initial meeting with a client who has just spontaneously lost her unborn child. After establishing rapport, the priority nursing intervention should focus on which of the following? A) Assessing the client's support system B) Exploring what this loss means for the client C) Discussing helpful ways to cope with the loss D) Assessing what knowledge the client desires about the situation

b

The nurse is assessing the new grieving widow. Which of the following are critical components to assess in a grieving person? Select all that apply. A) Genetic risk B) Perception of the loss C) Support system D) Coping behaviors E) Religion

b c d e

Which of the following losses are likely to result in disenfranchised grief? Select all that apply. A) A young adult whose spouse has just died suddenly B) A family whose long-time pet snake has just died C) A nurse who has just witnessed the death of a patient D) A couple who has just experienced pregnancy loss E) The gay lover of a man who just died from AIDS F) The mother and sister of a soldier who was killed in war

b c d e

A client comes to the physician's office for an annual checkup. During the interview, the nurse learns that the client's husband died unexpectedly of a heart attack two months ago. The most appropriate response by the nurse would be... A) "At least you and your husband enjoyed life right until the end." B) "It's better to go quickly like your husband did instead of suffering." C) "The loss of your husband must be very painful for you." D) "You'll feel better after you get over the shock of your husband's death."

c

A client has just been informed of a diagnosis of terminal cancer. The client states, "God has to have mercy on me because my children need me. He knows I'll change if he gets me through this." The nurse documents that the wife is expressing signs of which of Kubler-Ross's stages of grief? A) Denial B) Anger C) Bargaining D) Depression

c

A nurse cared for a terminally ill client over a period of a month. The nurse found that spending time with the client was a pleasure. When the client died, the nurse experienced feelings of sadness, sleeping poorly, lacking energy, and feeling mildly depressed. Eventually the nurse explained the feelings to the nurse supervisor. The nurse supervisor is aware of which of the following? A) The nurse needs to use stress reduction strategies. B) The nurse needs to seek therapy for dysfunctional grief. C) The nurse is experiencing disenfranchised grief. D) The nurse needs to consider taking a leave of absence to pursue healing.

c

A young client tells the nurse that her husband died 3 months ago, and she is feeling alone and vulnerable. Which of the client would indicate that her coping skills are adequate? A) I can't understand why this happened to me. B) I'm mentally healthy. I can solve my own problems. C) I will find a support group. D) What can I do? My husband abandoned me.

c

An elderly woman who lives alone is beginning to have difficulty maintaining her household and performing daily tasks. The nurse asks her to identify someone who can help her. The woman replies, "I don't need help. I've been managing for years." Which of the following responses helps the client shift from denial to consciously coping with her situation? A) "You don't think you need any help? But your family is worried about you." B) "It must be hard to lose your independence. I'll ask a social worker to see what can be arranged." C) "If you were to need help with your house, who might you ask for help?" D) "If you don't ask for some help, then the only option is to move to an assisted living facility."

c

Kubler-Ross developed a model of five stages to explain what people experience as they grieve and mourn. Which is stage five of Kubler-Ross's stages of grieving? A) Denial B) Bargaining C) Acceptance D) Anger

c

The client says to the nurse, "I really want to see my first grandchild born before I die. Is that too much to ask?" The nurse would recognize that the client is in which stage of grieving, according to Kubler-Ross? A) Acceptance B) Anger C) Bargaining D) Depression

c

The most effective way for the nurse to provide culturally competent care to individuals who are grieving is which of the following? A) Understand the practices associated with a client's culture. B) Suggest developing a new ritual to make mourning meaningful. C) Ask the client which rituals are personally meaningful. D) Contact a spiritual leader from the client's culture to become involved.

c

The nurse approaches a client who looks very sad and is sitting alone crying. The best response by the nurse in this situation is... A) "I'm sorry you are sad. Is there anything I can do to help you feel better?" B) "Please don't cry. It will get better." C) "You look very sad. What is happening?" D) "What is bothering you?"

c

The nurse visits with a client who was recently in a motor vehicle accident. Which of the following is most likely to prevent the client from experiencing complicated grief? A) Tendency to suppress emotions B) History of depression C) Places trust in others who are familiar D) Social isolation

c

Which of the following terms is used to describe the process by which a person experiences the grief? A) Anticipatory grieving B) Disenfranchised grief C) Bereavement D) Mourning

c

. A nurse is caring for a client who is mourning the loss of a loved one. Which factor would the nurse expect to make the mourning process more difficult for the client? A) The client was relatively independent of the deceased. B) The client had few unresolved conflicts in the relationship with the deceased. C) The client has a good support system with meaningful relationships evident. D) The client has experienced a number of previous losses.

d

A child who has witnessed the murder of his classmate while at school would experience which kind of loss? A) Physiologic loss B) Loss of self-esteem C) Loss related to self-actualization D) Safety loss

d

A client grieving her husband's sudden death tells the bereavement nurse, "I am not feeling very well. Yesterday, I was sitting in my kitchen and a saw my husband walk through the door and stop and smile at me. Then he just faded away. I think I must be going crazy." The most appropriate action for the nurse to take is to... A) assess for recent substance use. B) suggest a referral to the mental health clinic. C) arrange for a prescription for risperidone. D) counsel that visualizations are a normal part of grieving.

d

A client who has been grieving the loss of his wife 2 weeks ago says to the nurse, "The best part of my day is when I am back at work. Is that wrong?" The nurse states to the client that work and other daily activities serve which purpose? A) "You cannot work effectively this soon. You should finish grieving first." B) "Working reminds you of your loss. It may be too early to go back." C) "Working is your way of avoiding grief, which will make it harder for you to move on." D) "Working is letting you take an emotional break from grieving. There's nothing wrong with that."

d

A client with terminal cancer has been told he has 3 or 4 months to live. Which of the following would indicate to the nurse that further interventions are needed? A) The client says he wants to live life to the fullest. B) The client hopes for a peaceful and dignified death. C) The client is reviewing his life and talking about death. D) The client says he is well and is making future plans.

d

A couple came to the emergency department with their 5-month-old son. He was pronounced dead of sudden infant death syndrome (SIDS). In the next day or two, it will be important for this couple to do which of the following? A) postpone notification of the extended family B) delay the grieving process until they are ready to cope C) minimize their discussion of the death with others D) plan funeral arrangements for their son

d

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 she and the client were having an illicit affair. Which of the following is the best action by the nurse after learning of this relationship? A) Give the name of a clergy to the visitor and suggest she contact him for support B) Encourage the visitor to ask for support from the friends who are present C) Ignore the information about the affair and tend to the family D) Privately offer support to the visitor who was having the affair with the client

d

A woman has just been served divorce papers from her husband. She has no financial resources and little social support. She states, "He's not really leaving. He'll be back." The most appropriate response by the nurse would be which of the following? A) "Has he done this before?" B) "I'll call social services and get you signed up for financial assistance." C) "You have to face reality. Here are the papers." D) "How is this affecting you right now?"

d

A woman has just delivered a stillborn baby boy. Which of the following would be the most appropriate nursing response? A) "Can I do anything for you?" B) "If something was wrong, it's better this way." C) "Your son is in heaven with God now." D) "Would you like to hold your son?"

d

A woman has just had a therapeutic abortion to end an unintended pregnancy. Afterward, the woman cries because although she wanted to have children in future years, this pregnancy was not well-timed. Which type of grief is this woman most likely to experience? A) Anticipatory grief B) Absence of grief C) Complicated grief D) Disenfranchised grief

d

After being laid off from work, a client becomes increasingly withdrawn and fatigued, spends entire days in bed, is unkempt, and is eating and sleeping poorly. The nurse would recognize that the client is in which stage of grieving, according to Kubler-Ross? A) Anger B) Bargaining C) Denial D) Depression

d

The nurse is working with a woman who lost her partner nearly 3 weeks ago. The woman has recently become less emotional and expressed an interest in possibly returning to work. Which response by the nurse is most appropriate at this time? A) "I am concerned. You are starting to show signs of ineffective grieving." B) "You must feel some anger. It is all right to let that out." C) "Let's look at the things in your life that you still enjoy." D) "You are just starting to accept that this loss is real."

d