Question 1

After the death of a spouse,an adult repeatedly says,"I should have made him go to the doctor when he said he didn't feel well." This individual is experiencing:

Accepted Answer

A)  preoccupation with the image of the deceased.
B)  sensations of somatic distress.
C)  anger.
D)  guilt. D

Question 2

A family asks the nurse,"What can we say when our terminally ill family member mentions death is coming soon?" Which response could the nurse suggest?

Accepted Answer

A)  "We think you will be around for a long time."
B)  "We don't want you to give up trying to get well."
C)  "We don't think we're ready to talk about this yet."
D)  "We feel so sad when we think of life without you." D

Question 3

An adult who was widowed 18 months ago says,"I can now remember good times we shared without getting upset.Sometimes I even think about the disappointments.I've become accustomed to sleeping in our bed alone." The work of mourning:

Accepted Answer

A)  is beginning.
B)  is progressing abnormally.
C)  is at or near completion.
D)  has not begun. C

Question 4

The spouse of a patient in hospice care angrily tells the nurse,"The care provided by the aide and other family members is inadequate,so I must do everything myself.Why can't anyone do things right?" The palliative care nurse should:

Accepted Answer

A)  provide teaching about anticipatory grieving.
B)  assign new personnel to the patient's care.
C)  arrange hospitalization for the patient.
D)  refer the spouse for crisis counseling.

Question 5

A nurse working with a person whose spouse recently died uses cheer and humor to lift the person's spirits.At one point,the widowed person smiles.What analysis of this scenario is correct?

Accepted Answer

A)  The nurse's technique was successful.
B)  Use of humor should be added to the plan of care.
C)  Approach may prove useful in other,similar situations.
D)  The nurse needs supervision;the communication technique was not appropriate.

Question 6

Which statements by a patient who is terminally ill give the nurse information relevant to spiritual assessment? Select all that apply.

Accepted Answer

A)  "I feel an inner peace with my decision to use hospice services."
B)  "I trust my health care provider to prescribe enough medication to keep me free of pain."
C)  "I have prepared advance directives to spare my children the need to make difficult decisions."
D)  "I plan to use these last weeks to experience the process of dying as fully as I experienced the richness of living."
E)  "Listening to hymns helps deepen my relaxation and the relief I get from my pain medication."

Question 7

A terminally ill patient says,"I know I'm not going to get well,but still..." and the patient's voice trails off.Which response by the nurse would be therapeutic?

Accepted Answer

A)  "What do you hope for?"
B)  "No,you're not going to get well."
C)  "Do you have questions about what is happening?"
D)  "I'm happy you are being realistic about your future."

Question 8

Shortly after a man's wife dies,the man approaches the nurse who cared for his wife during the final hours of life and says angrily,"If you had given her your undivided attention,she would still be alive." Which analysis applies?

Accepted Answer

A)  The comment summarizes the nurse's inadequacies.
B)  Anger is a phenomenon experienced during grieving.
C)  The patient had ambivalent feelings about his spouse.
D)  In some cultures,grief is expressed solely through anger.

Question 9

As death approaches,a patient with acquired immunodeficiency syndrome (AIDS)says,"I don't want to see a lot of visitors anymore.Just my parents and my sibling can come in for a while each day." What action should the nurse take?

Accepted Answer

A)  Ask the patient to reconsider the decision because many interested and caring friends can be sources of support.
B)  Discuss the request with the parents and sibling.Suggest that they explain the patient's decision to friends.
C)  Suggest that the patient discuss these wishes with the health care provider.
D)  Place a "no visitors" sign on the patient's door.

Question 10

A grieving patient tells a nurse,"It's been 8 months since my spouse died.I thought I would feel better by now,but lately I feel worse.I have no energy.I am lonely,but I don't want to be around people.What should I do?" What is the nurse's best counsel?

Accepted Answer

A)  Seek psychotherapy.
B)  Become active in a church.
C)  Attend a bereavement group.
D)  Understand this is a normal response.

Question 11

A patient with metastatic brain cancer says,"I'm dying,but I'm still living.I want to be in control as long as I can." Which reply shows the nurse was actively listening?

Accepted Answer

A)  "Our staff will do their best to help you feel comfortable."
B)  "Most people do not know how to help and are afraid of death."
C)  "Your mind and spirit are healthy,although your body is frail."
D)  "You want people to stop focusing on your weaknesses."

Question 12

A patient newly diagnosed with pancreatic cancer says,"My father also died of pancreatic cancer.I took care of him during his illness.I can't go through that." Select the highest priority nursing diagnosis.

Accepted Answer

A)  Anticipatory grieving
B)  Ineffective coping
C)  Ineffective denial
D)  Risk for suicide

Question 13

A nurse talks with a person whose spouse died while jogging.Which is the appropriate statement for the nurse?

Accepted Answer

A)  "At least your spouse did not suffer."
B)  "It's better to go quickly as your spouse did."
C)  "The loss of your spouse must be very painful for you."
D)  "You'll begin to feel better after you get over the shock."

Question 14

A person whose spouse died 2 years earlier tells friends,"I think I'll begin to go out socially,maybe even take someone to dinner." This comment best demonstrates that the individual is:

Accepted Answer

A)  denying the significance of the loss.
B)  in a period of resolution of grief.
C)  actively working through grief.
D)  experiencing intrusion.

Question 15

Children of a widowed parent confer with the nurse;their surviving parent repeatedly relates the details of finding the deceased parent not breathing,performing cardiopulmonary resuscitation (CPR),going to the hospital by ambulance,and seeing the pronouncement of death.The family asks,"What can we do?" The nurse should counsel the family:

Accepted Answer

A)  they should share their feelings with the surviving parent and ask for the retelling to stop.
B)  retelling the story should be limited to once daily to avoid unnecessary stimulation.
C)  retelling memories is to be expected as part of the aging process.
D)  repeating the story is a helpful and a necessary part of grieving.

Question 16

Which finding indicates the successful completion of an individual's grieving process?

Accepted Answer

A)  For 2 years,a person has kept the deceased spouse's belongings in their usual places.
B)  After 15 months,a widowed person realistically remembers both the pleasures and disappointments of the relationship with the spouse.
C)  Three years after the death,a person talks about the spouse as if the spouse were still alive and weeps when others mention the spouse's name.
D)  Eighteen months after the spouse's death,a person says,"I never cry or have feelings of loss even though we were always very close."

Question 17

Psychotherapy for individuals at risk for complicated grief focuses on which goals? Select all that apply.

Accepted Answer

A)  Identifying ways to break bonds with the deceased
B)  Exploring emotional responses to a loss
C)  Solving problems related to moving forward in life
D)  Learning about the stages and symptoms of grieving
E)  Using antipsychotic medications for dysfunctional grief

Question 18

An individual was killed during a store robbery 2 weeks earlier.The widowed spouse,who has schizoaffective disorder,cries spontaneously when talking about the death.Which is the nurse's most therapeutic comment?

Accepted Answer

A)  "I'm worried about how much you're crying.Your grief over your spouse's death has gone on too long."
B)  "The unexpected death of your spouse must be so painful.I'm glad you're able to talk to me about your feelings."
C)  "This loss is harder to accept because of your mental illness.Let's refer you to the partial hospitalization program."
D)  "Your crying shows me you aren't coping well.I made an appointment for you to see the psychiatrist for medication adjustment."

Question 19

The mourning process is more difficult when the bereaved:

Accepted Answer

A)  was relatively independent of the deceased.
B)  has experienced a number of previous losses.
C)  accepts that death is expected for older adults.
D)  had few unresolved conflicts with the deceased.

Question 20

A nurse manager notices that a staff member spends minimal time with a patient who is terminally ill with AIDS.The patient says,"I'm having intense emotional reactions to this illness.Sometimes I feel angry,but other times I feel afraid or abandoned." The nurse manager can correctly hypothesize that the most likely reason for the staff member's avoidance is:

Accepted Answer

A)  high risk for infection transmission.
B)  feelings of inadequacy in dealing with complex emotional needs.
C)  knowledge that the patient needs time alone with family and friends.
D)  belief that the patient's former lifestyle included high-risk behaviors.

Exam 25: Care for the Dying and Those Who Grieve