Chap 10- Grief and Loss

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

Which is a cognitive response to grief?

Attempting to keep the lost one present

A client is diagnosed with terminal kidney failure. The client's spouse demonstrates loss and grief behaviors. Which term accurately describes the spouse's experience?

Anticipatory grief

According to Mardi Horowitz (2001), life begins to feel "normal" again in which stage?

Completion

The spouse of a client who died of breast cancer is still grieving 2 years later. What type of grief is the spouse experiencing?

Complicated

A woman has had a breast removed to treat cancer. What type of loss will she most likely experience?

Physiologic loss

Which is the most frequent and persistent bereavement-associated symptom?

Sleep disturbances

Which likely takes place in the fourth stage of Kubler-Ross's stages of grieving?

Depression

A nurse has been present for the hospital death of a Muslim client who was surrounded by family members when the client passed. The nurse demonstrates appropriate cultural considerations when stating:

"Are there any rituals you will observe here for your loved one?"

What question should nurses ask themselves to determine if the care they provide to the grieving client has been both therapeutic and client focused?

"Do I have the strength to be present and to facilitate the client who is grieving?"

Which statement is typical of the first stage of grieving described by Engel?

"No, not me."

A community care nurse is visiting a client at home. The client was discharged from the hospital one week ago after having a mastectomy. After the nurse completes the physical examination, the nurse asks, "How are you feeling about your body changes?" The client tells the nurse she is not interested in talking right now and would prefer that the nurse leave. Which is the nurse's most effective use of communication skills?

"I just want you to know that I am available to talk when you are feeling up to it."

Kübler-Ross defines five stages of psychosocial responses to dying and death. Which statement is characteristic of the bargaining stage?

"Just let me live to see my grandson born."

A nurse is assessing a 7-year-old child in a school. The nurse suspects that the child has an insecure relationship with the parents. Which statement said by the child would have led the nurse to this conclusion?

"Please don't tell my mom anything we've talked about."

A Chinese client has just passed away. Which ritual would be performed in the funeral in order to assist the spirit of the deceased in the afterlife journey? Select all that apply.

-Burning incense -Reading scriptures

The nurse is speaking to the caregivers of a client who is experiencing complicated grief. The nurse is explaining some of the consequences of complicated grief. What are the health-related consequences associated with this type of grieving? Select all that apply.

-Panic disorder -Precipitation of a cardiac disease -Psychosomatic disorder

A community mental health nurse has come to know that the mother of a long-term client has passed away. What are ways for the nurse to determine if the client will be at risk for complicated grief? Select all that apply.

-The client is unable to trust others. -The client has attempted suicide in the past. -The client has low self-esteem.

The nurse is providing individual support to a female client who attends a group for people who have experienced loss of a family member to suicide. The client's son committed suicide one month ago. The client was not aware that her son experienced depression. Which risk factors for complicated grief are most likely for this client? Select all that apply.

-death by suicide -sudden, unexpected death -death of a child

After receiving word from the oncologist that the client's tumor is malignant, the client says to the nurse, "If you people had the faintest clue what you were doing, I wouldn't be like this." The nurse should recognize that the client may be experiencing which stage of grief?

Anger

A client has just been diagnosed with terminal brain cancer and given approximately 2 months to live. The client wishes to visit the client's mother soon to "say goodbye." The nurse acknowledges this reaction as what?

Anticipatory

A group of nursing students is reviewing information about grief and bereavement. The students demonstrate understanding of the information when they state

Bereavement is the process of mourning and grief is the emotional reaction.

The nurse is caring for a client whose spouse passed away several years ago. Upon assessment, the nurse finds that the client has a history of signs and symptoms of depression since the spouse's death. Which term correctly describes the client's response to the loss?

Complicated grief

Which type of grief occurs when a person is stuck in a state of chronic grieving?

Complicated grief

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.

Which factor is likely to have the greatest impact on how a client responds to grief?

Cultural influences

The client has been recently diagnosed with cancer. When the nurse tells the client about the diagnosis, the client says, "I have been eating healthy food and working out regularly." According to the Kubler-Ross's stages of grieving, which stage of grief is the client in?

Denial

After losing the client's father in a car accident, a client has started practicing effective coping strategies. According to Horowitz's stages of loss and adaptation, which stage is this indicative of?

Denial and intrusion

The nurse is assessing a client who is recently divorced. The client tells the nurse that the memories of the client's former spouse are interfering with an ability to concentrate at work. According to Horowitz's stages of loss and adaptation, this is indicative of which stage?

Denial and intrusion

Which is a term used to describe grief over a loss that is not or cannot be acknowledged openly, mourned publicly, or supported socially?

Disenfranchised grief

The client expresses grief about not being able to fulfill the wish to pursue doctoral studies. Which type of loss does this indicate?

Loss related to self-actualization

Which explanation would be the nurse's best response when asked about the denial stage of grief?

It provides the individual with a temporary escape from the reality of dying

Which culture believes that leaving the body alone after death is disrespectful?

Orthodox Jewish Americans

A client is assessed for recurring episodes of fainting and blurred vision. A diagnostic scan reveals the client has an ominous mass in the brain. When the client is told this news, the client appears stoic and does not cry. According to Horowitz's stages of loss and adaptation, this client is in which stage?

Outcry

During which phase of Bowlby's grief process does the bereaved person begin to reestablish a sense of personal identity, direction, and purpose for living?

Phase of recognition

The nurse is caring for a client who has been placed in palliative care. The nurse observes the client constantly looking at photographs from youth. According to the tasks of grieving by Rando, which task is being accomplished here?

Recollect

A hospice nurse is providing emotional care and support for a family who lost a son. The care will be provided based on what knowledge?

Stages of grief reactions may overlap and are individualized

A nurse is assessing a client who is depressed but unwilling to discuss the client's feelings. After speaking with the client's caregiver, the nurse learns that the client's pet died recently. Which is the most likely reason the client has hesitated to express the client's feelings?

The client feels that the nurse would not consider the grief as significant.

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.

The nurse is assessing a client who has been diagnosed with leukemia. Which behavior of the client would indicate that the client is experiencing the anger stage of Kubler-Ross's stages of grieving?

The client is verbally abusive.

A nurse is caring for a Jewish client with a terminal illness who is on a ventilator. The spouse of the client intends to stay near the client when the ventilator is removed. What is the reason for such a request, according to the Jewish culture? Choose the best answer.

The soul of the deceased should not be alone while leaving the body.

A female client who has recently been diagnosed with end-stage lymphoma tells the nurse, "I need to be able to go to my son's wedding. God, will you please just give me a little more time so I can see my first grandchild?" The nurse identifies that the client is experiencing which stage of Kubler-Ross' stages of grieving?

bargaining

A client who has been in recovery from alcohol abuse for over one year tells the nurse he is drinking 5 to 6 beers per night since the client's mother's death. Which is the nurse's most accurate explanation for the client's grief response?

behavioral

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 nurse is facilitating a support group for family members of people who have committed suicide. One client states,"My kids and I are just not the same. It was so selfish of my husband to do this." The nurse can accurately identify this as which type of response to grief?

emotional

A client with poorly controlled type 1 diabetes has just been informed that an amputation of the lower leg is required. The nurse can anticipate that the client will experience a reaction to the loss of which human need according to Maslow's hierarchy?

physiologic

The nurse is informing the client about being diagnosed with cancer. Which is most likely going to be the client's initial reaction?

shock

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