Mental Chapter 10

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? Maturational loss Anticipatory grief Dysfunctional grieving Bereavement

Anticipatory grief

A nurse is conducting a visit to a client who is receiving palliative care at home for dying. The client's husband tells the nurse, "I know she needs to be with God. This is not a good place for her now." The client is experiencing which stage of Kubler-Ross' stages of grieving? acceptance depression bargaining anger

acceptance

Which is an example of a perceived loss? A client mourns the loss of an amputated leg A client grieves for the loss of a spouse to cancer An older client grieves for the loss of independence A client grieves for the loss of a job

An older client grieves for the loss of independence

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? Denial Anger Bargaining Depression

Anger

Which stages of grieving, according to Kubler-Ross (1969), occurs when the person asks God or fate for more time to delay the inevitable loss? Bargaining Denial Anger Depression

Bargaining

Which term describes the process by which a person experiences grief? Bereavement Homeostasis Mourning Attentive presence

Bereavement

Which factor is likely to have the greatest impact on how a client responds to grief? Socioeconomic factors Cultural influences Religious influences Cause of death

Cultural influences

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

Depression

Which occurs in the second phase of Bowlby's grieving process? Emotional yearning for the loved one Numbness and denial Cognitive disorganization Reintegrating sense of self

Emotional yearning for the loved one

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? All members of the family will react to loss in the same way Grief is an abnormal physical reaction to a loss Stages of grief reactions may overlap and are individualized Bereavement is a normal process, requiring little intervention

Stages of grief reactions may overlap and are individualized

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

Physiologic loss

Which outcome will the nurse evaluate to determine whether a client has successfully stabilized when engaged in the grieving process? The client will express his or her feelings both verbally and nonverbally. The client will verbally identify his or her terminal diagnosis within 48 hours. The client will verbalize decreased suicidal thoughts within 48 hours. The client will verbalize acceptance of his or her terminal diagnosis.

The client will verbalize acceptance of his or her terminal diagnosis

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 disturbed by the other spirits. The soul of the deceased should not be alone while leaving the body. The soul of the deceased should comfortably be able to travel into the afterlife. The soul of the deceased should pass through the body of a close family member.

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

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 denial and intrusion working through completion

outcry

A client tells the nurse the client been dating someone for three months after finalizing divorce one year ago. According to Rando (1984), the client is engaging in which grieving task? re-investing re-adjusting re-collecting Resolving

re-investing

Which statement is typical of the first stage of grieving described by Engel? "No, not me." "Why me?" "My husband was the best man in the world." "The funeral service helped me survive."

"No, not me."

The nurse most effectively explains to a terminally ill client's spouse that the frustration and anger the client is exhibiting is associated with what aspect of dying? An expression of a universally held need of the dying A sign of the anger stage of grieving An unconscious means of facilitating separation with loved ones A symptom of poor acceptance of the client's inevitable death

An expression of a universally held need of the dying

Which is a cognitive response to grief? Attempting to keep the lost one present Indigestion Guilt Anguish of abandonment

Attempting to keep the lost one present

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? emotional behavioral spiritual physiologic

behavioral

Which client will the nurse identify as having the greatest risk for developing disenfranchised grief? a teenager who has lost his grandfather to cancer the wife of a man who was shot to death by police during a robbery a man who is grieving the loss of a business he founded 25 years ago a single adult whose 14 year old pet dog has died

the wife of a man who was shot to death by police during a robbery

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

Shock

A client belonging to the Vietnamese culture has passed away. The caregivers of the client ask the nurse to allow them to put some rice grains in the mouth and place money with the deceased client. What is the belief associated with this ritual? This ritual would bless the deceased. This ritual would help in making peace with the spirits. This ritual would assist the spirit in the journey of afterlife. This ritual would help the spirit buy a drink as it moves to the afterlife.

This ritual would help the spirit buy a drink as it moves to the afterlife.

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? denial depression bargaining acceptance

bargaining

Which type of grief occurs when a person is stuck in a state of chronic grieving? complicated grief traumatic grief uncomplicated grief bereavement

complicated grief

A client who has recently lost his same-sex partner in a motor vehicle accident tells the nurse, "My family doesn't speak to me because of my lifestyle. I feel like I have no one to talk to about my loss." The client is experiencing: disenfranchised grief. complicated grieving. ambivalent attachment. insecure attachment.

disenfranchised grief.

The nurse meets with a client who reports meeting with siblings yesterday to chose a coffin for the deceased mother. How can the nurse most accurately describe this process to the client? mourning anticipatory grieving grieving bereavement

mourning

A nursing instructor lecturing about death and grief realizes a need for further instruction when a student states what? "The grieving process is the same for children and adults." "Children are at risk for mental health problems after experiencing a loss." "Children face many challenges while growing up." "Children's responses to loss reflect their developmental level."

"The grieving process is the same for children and adults."

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 Phase of disorganization and despair Phase of yearning and searching Phase of numbing

Phase of recognition

uring which phase of Bowlby's grief process does reality begin to set in? Phase of yearning and searching Phase of disorganization and despair Phase of numbing Phase of recognition

Phase of yearning and searching

A client is exhibiting a behavioral response to grief. When obtaining a health history, the nurse would expect which assessment finding to be noted? Stupor Hostility Sadness Calmness

Hostility

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: "You probably won't cremate the body, will you?" "How would you like to complete the five steps of the burial process?" "Shall I ask the pastor to attend for support?" "Are there any rituals you will observe here for your loved one?"

"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? "How do I personally react when I am working through the grieving process?" "How long can I continue working with grieving clients?" "Do I have the strength to be present and to facilitate the client who is grieving?" "Do I still get personal satisfaction from my work with the grieving client?"

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

A client has responded to the recent diagnosis of lung cancer by making extensive plans for overseas travel with the client's children, despite the fact that the oncologist has informed the client of the extremely poor prognosis. The nurse consequently recognizes that the client is likely in the denial stage of grief. How can the nurse best facilitate adaptive grieving for this client? Address the client's diagnosis and prognosis at a later time or date Enlist the assistance of another nurse to help the client face the reality of the situation Supplement conversations with the client by using written material about the diagnosis Restate the client's situation in more specific and detailed terms

Address the client's diagnosis and prognosis at a later time or date

Which factor does not influence the grieving person's return to homeostasis? Adequate self-awareness on the part of the nurse Adequate perception of the situation Adequate coping Adequate support systems

Adequate self-awareness on the part of the nurse

According to Mardi Horowitz (2001), life begins to feel "normal" again in which stage? Completion Working through Denial and intrusion Outcry

Completion

hen working with a grieving client, which is the most effective intervention a nurse can use? Encourages the client to express grief verbally Provides both written and oral information explaining the grieving process Encourages the client to participate in a grief support group Affords the client sufficient private time during the day to grieve

Encourages the client to express grief verbally

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 Neurofibromatosis Psychosomatic disorder Development of cancer Precipitation of a cardiac disease

Panic disorder Psychosomatic disorder Precipitation of a cardiac disease

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 Phase of disorganization and despair Phase of yearning and searching Phase of numbing

Phase of recognition

Which is the most frequent and persistent bereavement-associated symptom? Sleep disturbances Headaches Impaired appetite Indigestion

Sleep disturbances

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 feelings related to the pet's death are insignificant. The client does not want to remember the memories of the pet. The client feels that the nurse would not consider the grief as significant. The client feels that the nurse would not be able to make the client feel better.

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

he nurse is preparing a care plan for a client experiencing grief. What are the expected outcomes of a successful intervention? Select all that apply. The client will actively participate in social activities. The client will identify the meaning of the loss. The client will develop healthy strategies for coping with loss. The client will try to solve problems without any assistance. The client will recognize the negative effects of the loss on the client's life.

The client will identify the meaning of the loss. The client will develop healthy strategies for coping with loss. The client will recognize the negative effects of the loss on the client's life.

A Haitian American client has just passed away. The family members of the deceased are performing a vodun (voodoo) ritual for the client. Which belief is associated with the ritual? To make peace with the spirits To ward off depression of the bereaved To assist the spirit of the deceased in the afterlife journey To help the spirit buy a drink as it moves to the afterlife

To make peace with the spirits

A female client tells the nurse she has had low appetite and motivation since the recent breakup of a long-term relationship. The client states, "I just can't stand not having her around. I need her back." The client is experiencing which of Bowlby's phases of grieving? shock, numbness and protest yearning disorganization and despair reorganization

yearning

Which phrase can do much to instill hope in the dying client? "This is a hopeless situation." "Nothing more can be done." "Everything will be fine, so don't worry." "Let me tell you about your illness."

"Let me tell you about your illness."

The nurse is assessing a client who reports feeling hopeless since a divorce. Which would be an appropriate question for the nurse to ask in order to determine mental health status for this client? "Do you ever use drugs to help feel less emotional pain?" "Is there a history of mental illness in your immediate family?" "Would you consider marrying again?" "Do you feel that someone else could ever love you?"

"Do you ever use drugs to help feel less emotional pain?"

The client is scheduled to undergo an amputation of the lower right limb. The client is experiencing grief over the pending procedure. Which question should the nurse ask while assessing the client's perception of loss? "How do you feel about the news?" "Do you feel like talking to anybody right now?" "How can we relieve your anxiety?" "What do you usually do when you are excessively stressed?"

"How do you feel about the news?"

A nurse is talking to a client who has been told the client has a terminal illness and is responding in an angry manner. What statement by the nurse would best facilitate the best possible client outcomes? "Why are you so angry? The doctor told you why you will not live." "I'm sorry you are in pain right now, but we have to talk about this." "When you feel like talking about how you feel, let me know." "How much do you know and what do you want to know?"

"How much do you know and what do you want to know?"

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." "Have I said something to offend you?" "I can sit with you here so that you don't feel alone." "It would be beneficial for you to connect with other people who have had this surgery."

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

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? "I love playing with friends." "I love my dad and mom very much." "My mom and dad do not play with me." "Please don't tell my mom anything we've talked about."

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

Which statement, made by the nurse, focuses on the purposeful assessment of a client coping with a terminal diagnosis? "How can I help you right now?" "Social services will help make the arrangements for your hospice care." "Who do you want to share information about your prognosis with?" "Getting such news has to be upsetting; can we talk about your feelings?"

"Who do you want to share information about your prognosis with?"

After the loss of the client's mother, the client tells the nurse the client has been refusing social invites from friends to spend evenings going through old family pictures and videos. This information is consistent with which stage of grieving, according to Engel? relinquishing restitution resolution recovery

resolution

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? Outcry Completion Denial and intrusion Working through

Denial and intrusion

Which client should the nurse anticipate will be at greatest risk for alteration in quality of life as a result of loss? 45-year-old with severe depression 50-year-old with psychosis in the context of schizophrenia 72-year-old in the late stages of dementia 24-year-old diagnosed with borderline personality disorder

45-year-old with severe depression

Which client is most at risk for experiencing anticipatory grief? 61-year-old spouse of a client experiencing symptomology of moderate-stage Alzheimer disease 18-year-old person who failed to earn a sports scholarship to college. 45-year-old person whose company is scheduled for major layoffs 24-year-old woman whose fiancé has suddenly broken off their wedding engagement

61-year-old spouse of a client experiencing symptomology of moderate-stage Alzheimer disease

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 person cries frequently and loudly in the weeks following a child's death in an accident A person blames oneself for not doing more to make a spouse's recent death more comfortable A person has been experiencing chronic insomnia since the person's mother's death earlier this year

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

A client diagnosed with terminal cancer is making plans to take flying lessons because that has always been the client's personal goal and it will allow the client to visit the client's elderly parents. What stage of death and dying according to Kübler-Ross is best illustrated in this description? Bargaining Anger Depression Acceptance

Acceptance

In which ways can anticipatory grief be helpful for the client and family? Clear examination of treatment options Admission to hospice care An earlier and less painful death Acceptance of impending death

Acceptance of impending death

A client is arranging a funeral ceremony for the client's child. According to the Worden's tasks of grieving, which task is being accomplished? Acceptance of the reality of the loss Working through the pain of grief Adjustment to the environment that has changed due to the loss Emotional relocation of that which has been lost and moving on with life

Acceptance of the reality of the loss

A group of nursing students is reviewing information about grief and bereavement. The students demonstrate understanding of the information when they state: Grief and bereavement are used interchangeably as responses to loss. Bereavement is the process of mourning and grief is the emotional reaction. Grief involves confronting the stressor, but bereavement helps to avoid the stressor. Bereavement is influenced by culture, but grief is not.

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? Anger Outcry Complicated grief Disenfranchised grief

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 a physiologic measure used to deal with change, and the client will physically adapt. Coping is the physiologic and psychological processes that people use to adapt to change. Coping is the human need for faith and hope, which create change. Coping is a social measure used to deal with change and loss.

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

Which can correctly be identified as a behavioral response to grief? Crying uncontrollably Weight loss Lack of energy Palpitations

Crying uncontrollably

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? Anger Denial Bargaining Depression

Denial

The client's mother passed away and the client is crying incessantly. According to George Engel's stages of grieving, which stage of grief is the client in? Restitution Shock and disbelief Developing awareness Resolution of the loss

Developing awareness

A client's children have downplayed their grief following the death of their mother's partner, claiming that their mother and her partner were only together for a few months and that "he was no good for her anyways." The client is at risk of experiencing which type of grief? Unresolved grief Atypical grief Disenfranchised grief Dysfunctional grief

Disenfranchised grief

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 Anticipatory grieving Bereavement Mourning

Disenfranchised grief

Which experience could be the possible cause of grief due the loss of security and belonging for the client? Divorce Amputation Failure to achieve promotion at work Violence at workplace

Divorce

The client expresses grief about not being able to fulfill the wish to pursue doctoral studies. Which type of loss does this indicate? Loss of safety Loss of self-esteem Loss related to self-actualization Loss of security and a sense of belonging

Loss related to self-actualization

Which are considered physiological signs the nurse expects to observe in a grieving individual? Select all that apply. Hypersomnia Weight gain Indigestion Palpitations Lack of energy

Indigestion Palpitations Lack of energy

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 It gives all involved a chance to hope that there has been a mistake made It provides an opportunity to adjust to the realization that death will occur It affords the individual a chance to prepare for the death experience

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

A client has experienced the death of a spouse. They were married for 50 years; the client depended on the spouse for simple activities of daily living. While assessing the client for depression, of what should the nurse be most aware? The client's risk for physical illness is relatively high. The client's risk of morbidity remains the same as before the spouse's death. The client's should be advised to relocate after the death of the spouse. The client's pessimism will not have an effect on health.

The client's risk for physical illness is relatively high.

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. Reading scriptures Burning incense Performing Voodoo ritual Dressing the body in a white kimono Performing the five-step burial procedure

Reading scriptures Burning incense

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? React Recognize Relinquish Recollect

Recollect

A client is crying continuously from having lost a friend in an accident. According to the tasks of grieving by Rando, which task of grief is expected to be accomplished next? React Readjust Reinvest Recollect and reexperience

Recollect and reexperience

The nurse is assessing a client who is deeply upset and is not expressing feelings. At the end of the assessment, the nurse concludes that the client is extremely depressed because of the death of a loved one. The client has disenfranchised grief. What is the most likely reason for the client not being willing to speak about it to the nurse? The client wants to forget about the person who is dead. The client does not yet feel ready to talk about the feelings. The client feels that the nurse would not be able to make the client feel better. The client feels uncomfortable speaking about the relationship with the deceased.

The client feels uncomfortable speaking about the relationship with the deceased.

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 has a large family. The client has low self-esteem. The client is unable to trust others. The client has a history of cardiac diseases. The client has attempted suicide in the past.

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

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 a normal grief reaction and does not need any intervention at this time. The client is experiencing a prolonged reaction but within normal limits of the grieving process. The client is having a prolonged reaction to the spouse's death, but since the client is surrounded by family members who provide support, the client does not need any interventions at this time. The client is experiencing complicated grieving reaction. The client needs to have a comprehensive mental health assessment.

The client is experiencing complicated grieving reaction. The client needs to have a comprehensive mental health assessment.

The nurse is caring for a client who is extremely depressed after receiving a diagnosis of cancer. Which body language should the nurse adopt while speaking to the client in order to demonstrate an attentive presence? Select all that apply. The nurse should keep her arms folded. The nurse should stand facing the client. The nurse should lean slightly toward the client. The nurse should sit on one side of the client. The nurse should maintain moderate eye contact while the client speaks.

The nurse should stand facing the client. The nurse should lean slightly toward the client. The nurse should maintain moderate eye contact while the client speaks.

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 safety security and belonging self-actualization

physiologic

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? Outcry Completion Working through Denial and intrusion

Working through

Considering the spiritual response to grief, which nursing intervention has the potential of providing the most support to a grieving client? arranging for the hospital chaplain to visit the client asking, "Do you find comfort in your religion at times like this?" sitting silently with the client as he or she cries explaining the stages of grief to the client

asking, "Do you find comfort in your religion at times like this?"

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 of a child sudden, unexpected death death by suicide low self-esteem low trust in others

death of a child sudden, unexpected death death by suicide

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? shock, numbness, and protest yearning disorganization and despair reorganization

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 spiritual behavioral physiologic

emotional

The nurse is meeting with a client who has two young children. The client and family have decided it is best for the client to quit the client's job to care for the children. The client reports often feeling unhappy. According to Maslow's hierarchy, the client's unhappiness is related to which human need? loss of self-esteem loss of self-actualization safety loss physiologic loss

loss of self-esteem

A client is attending a support session with a nurse after hearing about the sudden death of the client's best friend due to heart attack. The client asks, "I just don't understand how this could have happened? He exercised every day." This client is attempting to: make sense of the loss . keep the friend present. emotionally relocate the loss. adjust to a changed environment.

make sense of the loss

The nurse is caring for a hospitalized client who just received the news that a mass in the neck is malignant. As the nurse engages in an assessment of the client's needs, the nurse asks, "Who has been a helpful person to you in the past when you were having a difficult time?" Which component of the assessment is the nurse exploring? perception of loss support while grieving coping behaviors anticipatory grieving

support while grieving

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 a nurse who is just returning to work from a one-week vacation a nurse who often has been assigned to the client 3 previous night shifts a nurse with previous experience working with clients who have amputations

the nurse who has worked with the client before and after