Mental Health- PrepU Chapter 21

A couple comes to the emergency department with their 5-month-old child that is not breathing or with a pulse. After resuscitation efforts, the child dies in the emergency department (ED) with the parents in attendance. Which action by the parents will help with the grieving process?

Plan funeral arrangements for the child.

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 the visitor and the client were having an affair. Which is the best action by the nurse after learning of this relationship?

Privately offer support to the visitor who was having the affair with the client.

A client is being seen in the clinic after a natural disaster. The client is crying but believes that their social support is adequate. What is the appropriate nursing action to support the client?

Provide counseling and support during the visit

What are characteristics of complicated grief? Select all that apply.

- trouble accepting the death - excessive bitterness - exacerbation of depression

Which phase of disaster focuses on implementing strategies for healing sick and injured people?

recuperative effort

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?"

A 75-year-old client recently experienced their partner passing away. The client is socially isolating and has not seen any friends or family in 3 weeks. Which priority question should the nurse ask the client?

"Are you having any thoughts of suicide or harming yourself?"

The nurse is performing an assessment for a client that is unkempt and withdrawn and reports fatigue and spending most of the days in bed after losing a job. Which is the most therapeutic response by the nurse?

"Have you considered harming yourself?"

The nurse is performing an initial psychological assessment on a client who has been rescued from a flood. Which question would be most important in helping determine the amount of support needed by the client?

"Have you thought about where you can stay right now?"

Which statement by a client would alert the nurse that the client is experiencing complicated grief?

"I am still so angry about my grandmother's death even after a year."

A nurse is assessing a young adult client who is seeking assistance at a local community counseling center. Which client statement(s) would indicate that the client is experiencing a crisis? Select all that apply.

"I don't understand; I can't seem to function like I usually do."

A client is being evaluated after acute grief. Which statement made by the client would indicate that the client has reached the adaptation phase?

"I have created a memory area of my partner that I visit when I am missing them."

A nurse is assessing a person who has suffered a loss and is grieving. When applying the dual process model, the nurse would most likely interpret which client statement as reflecting loss-oriented coping?

"I just can't believe that my spouse is gone."

An older adult client living alone after the death of a spouse is having difficulty maintaining the home. The client states to the nurse, "I don't need help. I've been managing for years." Which response helps the client shift from denial to consciously coping with the situation?

"If you were to need help with your house, who might you ask for help?"

A client is admitted with smoke inhalation after a fire has destroyed their home. The client states, "I wish I would have died in the fire." What is the nurse's best response?

"If you wish you would die, do you have a plan for this?"

A client who has been grieving the loss of the client's spouse 2 weeks ago says to the nurse, "The best part of my day is when I am back at work. Is that wrong?" Which is the most therapeutic response by the nurse?

"Working is letting you take an emotional break from grieving. There's nothing wrong with that."

After the death of a client's spouse, the client tells the nurse, "I can never live without my spouse. They were my whole life." Which is the most therapeutic response from the nurse?

"Your spouse's death is a terrible loss for you."

A nurse is describing uncomplicated grief during a presentation. Which statement(s) should the nurse include in the presentation? Select all that apply.

- "Most bereaved persons experience uncomplicated grief." - "Clinical intervention is not required for this type of bereavement."

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

A nurse notifies a client of the death of a parent after a motor vehicle crash. Which physical symptom(s) assessed by the nurse correlates with the immediate grieving process? Select all that apply.

- respiratory rate of 32 and difficulty breathing - states, "I feel a burning sensation in my upper chest area." - lack of strength and feels weak

A nurse is offering a support session to a client who is grieving the death of a partner. The nurse is correct in telling the client that the client is more likely to achive positive outcomes if which conditions are present? Select all that apply.

- the client is attending a support group - the client understands why the partner died - the client pays attention to self-care needs

Jake and Mary Patterson are sending their only daughter, Allie, off to college. Jake is worried about how he is going to pay for the increased costs of housing, tuition, fees, and living expenses. Mary is just as distressed about this event, but her worries surround her daughter's safety while being unsupervised in a college town. Which factor determines which parent will experience the worst crisis?

Each parent's perception of his or her ability to cope

The prime objective of the crisis intervener is to do which of the following?

Help the client find ways to solve the immediate problem.

Crisis theory holds that an imbalance exists between the client's problem and the immediate resources available to deal with it. Which of the following best describes the active crisis state?

It lasts about 4 to 6 weeks.

Which of the following would not be essential to assess when working with a person in crisis?

Past history of mental health care

A nurse is conducting a class for a group of colleagues about crisis. Which information would the nurse most likely include as being most influential on the outcome for a person experiencing a crisis?

Perception of the precipitating event

When establishing long-term treatment outcomes for a client experiencing a psychiatric crisis, the nurse references the fundamental goal of crisis interventions, which is to ...

Return the client to his pre-crisis level of function

A client diagnosed with depression following the death of her infant daughter consistently finds excuses to miss most of the unit's group sessions, especially those dealing with loss and grief. The nurse documents that the client is showing evidence of ...

Social withdrawal

The nurse is evaluating the effectiveness of the crisis intervention. Which of the following indicators suggests that the intervention has been effective?

The client has resumed his usual level of functioning.

An adult client is grieving the loss of a parent while being evaluated for another unrelated problem. The client has had a previous psychiatric diagnosis and displays mistrust toward others. Which outcome should be identified for the client?

The client will seek or accept professional assistance, if needed, to promote the grieving process.

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 ...

The meaning of the mastectomy to the client

The nurse is meeting with a client that is experiencing complicated grieving from the death of their child to suicide. In order to establish a therapeutic nurse-client relationship, which will the nurse do prior to the meeting?

The nurse should examine their personal attitudes related to loss and grieving.

Which is the most appropriate overall nursing goal for crisis intervention?

The overall goal of crisis intervention is to help the client return to the pre-crisis level of functioning.

A client is scheduled for a mastectomy for breast cancer. The client is quiet, shows little emotion, and states that they have no questions. Which priority assessment will the nurse perform for this client?

What the mastectomy means to the client

A nurse is caring for a group of clients experiencing loss and grief. Which client would have the highest anticipated grieving response?

a client whose partner of 14 years died in a motor vehicle crash

A nurse is counseling a client with depression on what to do in case the client has suicidal thoughts. Which option may provide the most immediate help for the client?

a telephone hotline

According to the stage theories of grief, during which stage of grief and bereavement does social withdrawal occur?

acute mourning

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

The nurse is counseling a client who lost a parent one year ago. The client states "I wish I could die too." The nurse is aware that the client is experiencing which type of grief?

complicated

A client is being counseled for depression and a decreased functional ability after the death of their parent 8 months ago. The client feels mistrustful and bitter about the death. What documentation would be provided by the nurse?

complicated bereavement

A client states to the nurse "I am feeling anxious about graduating from high school". The nurse recognizes this can involve which type of crisis?

developmental

Effective interventions while providing care during a crisis include ...

resolving immediate problems perceived as most threatening to the client.

The nurse is providing discharge instructions for a client who has received a prescription for lorazepam after the death of a loved one. Which phase of psychopharmacologic treatment does this describe?

stabilization

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?

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