Question 1

The nurse educator is developing a seminar to help children who have experienced a loss.Which information should the nurse include to help these children adapt?

Accepted Answer

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.

Question 2

An older adult client has just learned of the death of an adult child as a result of an automobile accident.The adult child was in another city and died alone.Which action by the nurse is appropriate to address the client during the grieving process?

Accepted Answer

A)  Assisting the family through the complicated grief process 
B)  Planning care related to the guilt and grief the mother may feel 
C)  Obtaining a psychological consult for the mother 
D)  Helping the family to arrange the funeral and burial plans

Question 3

A terminally ill client is demonstrating cognitive signs that the end of life is near.Which assessment findings support the nurse's conclusion? Select all that apply.

Accepted Answer

A)  Inability to concentrate 
B)  Rambling incoherently 
C)  Nausea 
D)  Dry mouth 
E)  Shortness of breath

Question 4

A client with terminal lung cancer is experiencing shortness of breath.The nurse notes bilateral crackles and wheezes,despite oxygen at 4 liters per minute via nasal cannula and diuretic therapy.What nursing interventions are most appropriate for this client? Select all that apply.

Accepted Answer

A)  Elevate the head of the client's bed to a Fowler's position. 
B)  Change the client's oxygen therapy to a nonrebreathing mask. 
C)  Administer morphine sulfate per physician order. 
D)  Move the client to a room closer to the nurse's desk for closer observation. 
E)  Place a fan in the room to move air around the client.

Question 5

A client of Native American descent comes to the hospital in early labor at 23 weeks' gestation.The client's parents,sisters,and brothers are with her as well as her husband.The client's family insists on remaining with her during labor.Hospital policy,however,limits visitors to two.Which action is most appropriate for the nurse to take in this situation?

Accepted Answer

A)  Ask the parents of the baby what their needs are regarding the family 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.

Question 6

The nurse is caring for a client who just had amniocentesis and was told that the fetus has Down syndrome.What is an appropriate outcome goal for this client?

Accepted Answer

A)  To complete the work of grieving during the hospital stay 
B)  To begin the process of grieving the loss of a normal baby 
C)  To accept the upcoming birth of a baby with special needs 
D)  To consider the possibility of a therapeutic abortion

Question 7

An older adult client in the terminal phases of a debilitating muscular disease believes the healthcare team has "failed" and "given up" and "aren't trying as hard." On which belief should the nurse plan interventions for this client?

Accepted Answer

A)  When clients become terminal, physician care is no longer necessary. 
B)  This is a common fear in the terminally ill client. 
C)  Clients who feel this way are in denial of the facts of their care. 
D)  The client's idea of abandonment is unfounded.

Question 8

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?

Accepted Answer

A)  "Older school-age children begin to understand that death is inevitable." 
B)  "Adolescents tend to cope better with death than adults." 
C)  "Preschool children view death as a spiritual release." 
D)  "Toddlers perceive death as irreversible and unnatural."

Question 9

The nurse is concerned that a client whose spouse died 2 years ago is experiencing complicated grief.Which should the nurse consider when planning care for the client? Select all that apply.

Accepted Answer

A)  Monitoring for suicidal behavior 
B)  Psychotherapy 
C)  Substance abuse assessment 
D)  Alcohol abuse assessment 
E)  Referral for home care

Question 10

A nurse educator is teaching a group of nursing students about the feelings associated with losing a client.The educator suggests which activity as the most helpful when a nurse is coping with feelings of grief?

Accepted Answer

A)  Keeping a scrapbook of pictures of clients after they have died 
B)  Attending the wake or funeral of the client 
C)  Taking a week off from work in order to grieve 
D)  Leaving the unit to go home immediately after the client has died

Question 11

A nurse is caring for a child diagnosed with childhood traumatic grief after witnessing the death of a family member.Which clinical therapy or therapies will be most appropriate for the client? Select all that apply.

Accepted Answer

A)  Complicated grief treatment 
B)  Psychotherapy 
C)  Grief counseling 
D)  Bereavement groups 
E)  Provision of reassurance

Question 12

The novice nurse accepts a job working on a long-term care unit.Nursing care that is required includes caring for clients at the end of life.Which behavior by the nurse indicates a healthy response to the dying client and family?

Accepted Answer

A)  Paying close attention to details regarding the pain and comfort measures for the client 
B)  Delegating physical care of the client to the LPN and UAP 
C)  Remaining out of the room at the moment of death to allow the client and family privacy 
D)  Providing client care without explaining procedures

Question 13

The nurse identifies the nursing diagnosis of grieving as appropriate for the family of a terminally ill client.Which family behavior supports this diagnosis?

Accepted Answer

A)  The family members are crying out loud and wringing their hands during visits. 
B)  The family is tearful and sad during visits with the client. 
C)  The family members state that they cannot care for the client at home. 
D)  Some family members state they cannot go on with life.

Question 14

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 has just been told.How should the nurse expect the client to react to this information?

Accepted Answer

A)  The client will ask if mommy will cook her favorite meal when she wakes up. 
B)  The client will cry and be depressed. 
C)  The client will ask for her toys and ignore what has been said. 
D)  The client will react with anger and may be violent.

Question 15

During a home care visit,an older adult client states to the nurse,"my wife died 3 years ago." Which client action is a possible indicator that the client is experiencing complicated grief?

Accepted Answer

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 shows the nurse his wife's craft room and states that it remains just as she left it before she died. 
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 had never figured out how the washer works.

Question 16

The nurse is caring for a homosexual client who has just died due to complication associated with acquired immune deficiency syndrome (AIDS).The client's partner is still in the room and is dry-eyed and exhibiting somber behavior.The nurse offers condolences to the partner,realizing that the partner expects which to occur?

Accepted Answer

A)  The client's family will want to grieve with him. 
B)  The partner will want support from those around him on the unit. 
C)  The community will not allow the partner to grieve openly. 
D)  The boss at work will be supportive of bereavement leave.

Question 17

The client states to the nurse,"I have been having trouble sleeping since my boyfriend died unexpectedly 3 weeks ago." The client also confides that the boyfriend was married and they were seeing each other secretly.For which reason is the client most likely experiencing sleeping difficulty when grieving?

Accepted Answer

A)  External grief 
B)  Chronic grief 
C)  Abbreviated grieving 
D)  Disenfranchised grieving

Question 18

A nurse is caring for an older adult client with depression whose spouse died 2 months ago.When planning care for this client,what goals are most appropriate? Select all that apply.

Accepted Answer

A)  The client will use healthy coping mechanisms. 
B)  The client will attend psychotherapy as ordered. 
C)  The client will move on to acceptance of the loss. 
D)  The client will discuss any instances of suicidal thoughts with the nurse or another healthcare provider. 
E)  The client will attend complicated grief therapy as ordered.

Question 19

The hospice nurse reviews the care provided to a dying client.Which observations indicate that outcomes have been reached for this client? Select all that apply.

Accepted Answer

A)  The client discusses fears regarding death. 
B)  The client expresses the intention to recover from the illness. 
C)  The client is medicated for pain as needed. 
D)  The client is resting comfortably. 
E)  The family is informed of any changes in the client's condition.

Question 20

An older adult client with terminal liver disease is concerned about going home and living alone.The client is currently independent with care.The client is afraid of dying alone and does not want to lose control of body functions.Which should the nurse recognize about the client's concerns?

Accepted Answer

A)  Appropriate for the situation and will obtain an order for hospice care 
B)  Unrealistic fears because the client shows no symptoms at present 
C)  Common fears and concerns of the dying client 
D)  Signs of depression

Exam 27: Grief and Loss