Module 27 - Grief and Loss

The nurse is planning care for a group of clients who are experiencing grief. Which principle from accepted grief models should the nurse use to guide care? A) No clear timetables for grief exist, nor are there clear-cut stages of grief. B) There is strong research evidence indicating that these models are not useful for many dying clients. C) These models serve as clear and definitive predictors of grief behaviors. D) The Kübler-Ross model is primarily used to describe anticipatory grief.

A) No clear timetables for grief exist, nor are there clear-cut stages of grief.

The nurse is providing counseling to the family of a terminally ill client. The family has children of varying ages. Which statement regarding the reactions of children to death is appropriate for the nurse to include in the counseling session? A) "Older school-age children begin to understand that death is irreversible." B) "Adolescents tend to cope better with death than adults." C) "Preschool children view death as a spiritual release." D) "Toddlers are able to fully comprehend the ideas related to death."

A) "Older school-age children begin to understand that death is irreversible."

A client is hospitalized for suicidal ideations as a response to complicated grief. Which collaborative interventions can the nurse anticipate including in this client's care? Select all that apply. A) Social service consult B) Bereavement group C) Antidepressant medication D) Sleep medication E) Psychotherapy

A) Social service consult B) Bereavement group C) Antidepressant medication E) Psychotherapy

The nurse is caring for an adolescent client who has just learned she is pregnant. Which assessment questions is most appropriate to determine the client's risk for perinatal loss? A) "At what age did you begin menstruating?" B) "When was your last menstrual period?" C) "Is this your first pregnancy?" D) "Do you use any substances such as drugs, alcohol, or tobacco products?"

D) "Do you use any substances such as drugs, alcohol, or tobacco products?"

A client tells the nurse that her boyfriend died 3 weeks ago. The client states that she has been unable to grieve openly because her boyfriend was married and no one knew of their relationship. The nurse recognizes that the client is experiencing which type of grief? A) External grief B) Chronic grief C) Abbreviated grieving D) Disenfranchised grieving

D) Disenfranchised grieving

The nurse recognizes that the spouse of a terminally ill client has completed the grieving process, but the ill client is still alive. Because of this, the nurse may need to provide what interventions for the ill client? A) Interventions to prevent physical and spiritual distress of the spouse B) Interventions to prevent despair in other family members C) Interventions to prevent guilt in the client D) Interventions to prevent isolation and loneliness for the client

D) Interventions to prevent isolation and loneliness for the client

A client experienced the loss of a spouse due to chronic illness, the loss of a grandchild due to stillbirth, and the loss of a long-time family pet, all within a 6-week period. This individual is experiencing what type of loss? A) Caregiver loss B) Cumulative loss C) Compound loss D) Complicated loss

B) Cumulative loss

The nurse is caring for a client who lost his job and is having a difficult time finding another job. The nurse recognizes that the client is grieving. Which pattern of behavior would be the nurse's priority concern? A) Alcohol or drug use B) Excessive sleeping C) Overeating D) Failing to exercise

A) Alcohol or drug use

The nurse is caring for a client who is diagnosed with complicated grieving after the loss of a child. Which treatment approaches does the nurse anticipate being included in the collaborative plan of care for this client? Select all that apply. A) Antidepressants B) Electroconvulsive therapy C) Talk therapies D) Cognitive therapy E) Anger management

A) Antidepressants C) Talk therapies D) Cognitive therapy

The nurse is caring for a client who has experienced fetal demise at 23 weeks' gestation and will have labor induced to deliver the fetus. The client's extended family insists on being present for the delivery. Which action is most appropriate for the nurse to take in this situation? A) Ask the client about her preferences regarding the family's request. B) Call security to escort the family out of the hospital. C) Speak with the nurse manager about supporting the family's wishes. D) Show the family to the waiting room.

A) Ask the client about her preferences regarding the family's request.

The nurse is concerned that a client whose spouse died 2 years ago is experiencing complicated grief. Which interventions should the nurse consider when planning care for this client? Select all that apply. A) Monitoring for suicidal behavior B) Psychotherapy C) Substance abuse assessment D) Alcohol abuse assessment E) Hypnosis

A) Monitoring for suicidal behavior B) Psychotherapy C) Substance abuse assessment D) Alcohol abuse assessment

The staff nurse is planning for a client who is grieving the loss of a spouse. Which should the nurse identify as an appropriate independent nursing intervention? A) Teach the client about the grieving process B) Select an appropriate antidepressant C) Conduct complicated grief therapy (CGT) D) Provide chaplain services

A) Teach the client about the grieving process

The nurse is preparing to assess a client whose spouse died several weeks ago. Which of the following symptoms is the nurse most likely to observe in the client as part of the classic grief response? Select all that apply. A) Weight loss B) Frequent headaches C) Difficulty sleeping D) Excessive energy E) Increased appetite

A) Weight loss B) Frequent headaches C) Difficulty sleeping

The nurse is caring for a 3-year-old client on the pediatric unit who was in an automobile accident. The client's mother was killed in the accident, and the client recently learned of her mother's death. Which nursing intervention would be most appropriate to support the developmental needs of this client? A) Work with the surviving family members to ensure that the client's routine remains as normal as possible after release from the hospital. B) Do not correct the client when she expresses the belief that her mother will "wake up and come home." C) Provide the client with the same level of reassurance and attention as any other client on the unit. D) Avoid answering the client when she asks questions about her mother's death.

A) Work with the surviving family members to ensure that the client's routine remains as normal as possible after release from the hospital.

The nurse is caring for a client on the unit who has just died. The client's adolescent daughter is very quiet, and the nurse attempts to talk with her. The adolescent remains silent, not wishing to talk about the loss. Which action by the nurse is appropriate to assist the adolescent? A) Ask the doctor to prescribe a sedative for the adolescent. B) Ask the adolescent if any friends are available to talk. C) Provide the adolescent with paper, pens, and pencils. D) Notifying the hospital chaplain to come talk with the adolescent.

B) Ask the adolescent if any friends are available to talk.

The nurse is caring for a family whose 8-year-old son recently died. The remaining family members include the mother, father, and two young children. Which of the following questions would best help the nurse assess this family's level of functioning? A) "Have you returned to your normal schedule yet?" B) "How have you expressed your feelings about the loss?" C) "When do you think your grieving process will be complete?" D) "Have any of you experienced prior loss?"

B) "How have you expressed your feelings about the loss?"

A nurse is caring for an older adult client who is experiencing grief after the recent loss of a spouse. What should the nurse anticipate with regard to the older adult's response to grief? A) Grief in an older adult initially presents differently than in a younger adult. B) Older adults may seem to experience the emotional aspects of grief more acutely than younger adults. C) Manifestations of grief in older adults are usually less severe than those observed in younger clients. D) Manifestations of grief in older adults are usually trust issues, suspecting once-close friends and family members of judging their pain or not understanding their emotions.

B) Older adults may seem to experience the emotional aspects of grief more acutely than younger adults.

A nurse is planning care for a couple who has experienced a miscarriage. Which aspect of the grief response is essential for the nurse to anticipate? A) The grief experienced by fathers after perinatal loss appears similarly to the grief experienced by mothers after perinatal loss. B) Postpartum depression may occur in women who have experienced perinatal loss. C) Grief is typically less severe when the perinatal loss occurs before 20 weeks' gestation. D) Perinatal loss refers only to emotional changes that occur after perinatal loss.

B) Postpartum depression may occur in women who have experienced perinatal loss.

The nurse is caring for a client who found a loved one who committed suicide. In addition to the normal grief process, the nurse recognizes the client may be at risk for what other complication? A) Seasonal affective disorder (SAD) B) Posttraumatic stress disorder (PTSD) C) Obsessive-compulsive disorder (OCD) D) Major depressive disorder (MDD)

B) Posttraumatic stress disorder (PTSD)

An older adult client whose spouse died 6 months ago tells the nurse stories about the deceased spouse. When care has been completed, the client thanks the nurse for listening and states, "My children will not listen to these stories." From which type of intervention would this client most likely benefit? A) Antidepressant medication B) Referral to a support group C) Occupational therapy D) Referral to a social worker

B) Referral to a support group

During a home care visit, an older adult client states to the nurse, "My wife died 3 years ago." Which action is a possible indicator that the client is experiencing complicated grief? A) The client tells the nurse that his wife was an awful cook and that he has eaten better meals since she died. B) The client says he hasn't seen the doctor since his wife died because the doctor's office reminds him of his wife. C) The client has an album of photographs of his wife open on the living room table. D) The client indicates that he sends his laundry out to be done because he doesn't know how the washer works.

B) The client says he hasn't seen the doctor since his wife died because the doctor's office reminds him of his wife.

The home health nurse is visiting an older client with a terminal illness for a routine medication check. The nurse determines that the client has declined since the last home visit. The nurse suggests that the client should be transported to the hospital; however, the family members state that they want the client to stay in the home. Which action by the nurse is most appropriate? A) Follow the decision of the family. B) Call for an ambulance to transport the client to a hospital. C) Ask the client's preference regarding transport to the hospital. D) Encourage the family to take the client to the hospital.

C) Ask the client's preference regarding transport to the hospital.

The nurse is caring for a grieving family who is from another culture and has different religious beliefs. The nurse is not familiar with the family's culture or religion. What should the nurse do to provide emotional support for this family? A) Encourage the family to go eat a meal and come back to the hospital later. B) Ask the physician to assess the family for ineffective coping. C) Ask the family how the nurse can meet the family's cultural needs. D) Refer the family to a group counseling session.

C) Ask the family how the nurse can meet the family's cultural needs.

The nurse is interviewing an older adult client whose spouse died 4 years ago. The client states, "I keep our home exactly the way it was the day my husband died. I still buy and prepare all his favorite foods, and I launder his dress shirts each week." The client begins to cry, explaining that caring for her husband was her sole purpose in life, so she sees no need to go on living if she can't carry out these activities. The client's comments are suggestive of which of the following conditions? A) Anticipatory grieving B) Self-care deficit in the area of feeding C) Complicated grieving D) Death anxiety

C) Complicated grieving

Which intervention should the nurse perform to help the family grieve following the loss of an unborn child at 36 weeks' gestation? A) Remove all baby supplies from the mother's room. B) Refrain from talking about the baby. C) Facilitate and support the family viewing and holding the infant. D) Ask to have the mother moved off the postpartum floor.

C) Facilitate and support the family viewing and holding the infant.

The community nurse is developing a seminar to help children who have experienced a loss. Which information should the nurse include to help these children adapt? A) Explain that magical thinking helps with the pain. B) Remind the child that big children don't cry. C) Help create new memories. D) Pretend that the individual has not really gone

C) Help create new memories.

The nurse is caring for a client who has just died due to an intentional drug overdose. The client's partner is still in the room but is dry-eyed and exhibiting somber behavior. The nurse should recognize that the partner's behavior is most likely related to which of the following factors? A) The partner is waiting to grieve until the client's family can join him. B) The partner is seeking support from staff members on the unit. C) The partner anticipates that others will find the client's actions socially unacceptable. D) The partner is concerned that others may view him as weak if he shows too much emotion.

C) The partner anticipates that others will find the client's actions socially unacceptable.

Which clients should the nurse identify as being at risk for prenatal loss? Select all that apply. A) The woman who drinks one cup of coffee every morning B) The woman recovering from a gastrointestinal virus C) The unmarried 14-year-old girl living in the city D) The woman who lacks access to health and prenatal care E) The woman who had a healthy baby 6 months ago resulting from a healthy pregnancy

C) The unmarried 14-year-old girl living in the city D) The woman who lacks access to health and prenatal care E) The woman who had a healthy baby 6 months ago resulting from a healthy pregnancy

A nurse working in labor and delivery is planning care for a client who is arriving to the unit with a suspected perinatal loss. Which nursing intervention is most appropriate in this situation? A) Place the client in a room closest to the nurse's station to closely observe the client. B) Call the hospital chaplain to ensure the chaplain can be in the client's room when the client arrives. C) Call the local funeral home and notify them of the client's situation. D) Place the client in the room farthest from the other clients.

D) Place the client in the room farthest from the other clients.