Chapter 43: Loss, Grief, and Dying - FUNDAMENTALS

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What is Kübler-Ross's third stage of grief?

bargaining

Which statement by the client indicates acceptance of dying?

"I have finalized all my financial arrangements for my family."

The experience of parting with an object, person, belief, or relationship that one values is defined as:

loss

The nurse is trying to help the client cope with the dying process. Which nursing statement is mostappropriate?

"It must be very difficult for you."

A nurse is providing care to a terminally ill client. Which finding would alert the nurse to the fact that the client is dying? Select all that apply.

- Decreased urine output. - Irregular heart rate. - Pale, cool skin.

The nurse is preparing a presentation on preparing children for death. What information should the nurse include? Select all that apply.

- Encourage expression of feelings. - Provide for stability and safety. - Talk openly about death and the feelings associated with it.

Which situation is most likely to warrant an autopsy?

A client's death involves an allegation of a medical error.

Which assessment finding would best support a nursing diagnosis of Dysfunctional Grieving?

A man is unable to return to work after his sister's death 18 months ago.

A client states, "My children still need me. Why did I get cancer? I am only 30." This client is exhibiting which stage, according to Kübler-Ross?

Anger

A client's son is named to make decisions for his mother in the event she cannot speak for herself. This is an example of a(an):

Durable power of attorney

The hospice nurse is caring for a group of clients with terminal illness. Which is the highest care priority for a client in the process of dying?

Pain management

A client who was brought to the emergency room for gunshot wounds dies in intensive care 15 hours later. Which statement concerning the need for an autopsy would apply to this client?

The coroner must be notified to determine the need for an autopsy.

Which manifestation of grief by the client who lost his wife 3 years earlier is considered abnormal?

leaving the wife's room and belongings intact

The nurse has noted that a dying client is increasingly withdrawn and is often teary at various times during the day. The nurse recognizes that the client may be experiencing which of Kübler-Ross's stages of grief?

depression

A client with end-stage chronic obstructive pulmonary disease (COPD) has reached the end of the 6-month period for hospice services and the family caregiver states, "I don't know what we will do if they cut off our hospice services." What is the best response by the hospice nurse?

"I will contact the health care provider to extend services since your family member meets the criteria."

During an interview of the client at the community clinic, the nurse finds that the client is providing care for a parent, who is terminally ill. Which statement by the client indicates anticipatory grieving?

"My parent is suffering with cancer and death will be a relief of the pain."

The nurse is caring for a client who recently found out he has a terminal illness. The nurse notes that the client is hostile and yelling. Which statement by the nurse shows that she has understanding of the Kübler-Ross emotional responses to impending death?

"Sometimes a person returns to a previous stage."

When preparing for palliative care with the dying client, the nurse should provide the family with which explanation?

"The goal of palliative care is to give clients the best quality of life by the aggressive management of symptoms."

A client in a long-term care facility has signed a form stating that he does not want to be resuscitated. He develops an upper respiratory infection that progresses to pneumonia. His health rapidly deteriorates, and he is no longer competent. The client's family states that they want everything possible done for the client. What should happen in this case?

The client should be treated with antibiotics for pneumonia.

The children of a male client with late-stage Alzheimer disease have informed the nurse on the unit that their father possesses a living will. The nurse should recognize that this document is most likely to:

specify the treatment measures that the client wants and does not want.


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