Question 1

The mother of a preschool child dies suddenly of a ruptured cerebral aneurysm.What recommendation should the nurse make to the family regarding how to most therapeutically care for the child?

Accepted Answer

A)   Take the child to the funeral even if he is frightened.
B)   Notify the physician immediately if the child shows signs of regression.
C)   Spend as much time as possible with the child.
D)   Provide distraction whenever the child begins to express feelings of sadness. C

Question 2

Which dysrhythmia confirms death?

Accepted Answer

A)   Asystole (absence of heart activity) 
B)   Pulseless electrical activity
C)   Ventricular fibrillation
D)   Ventricular tachycardia A

Question 3

An elderly man lost his wife a year ago to cardiovascular disease.During a healthcare visit,he tells the nurse he has begun adjusting to life without his wife.According to John Bowlby,which stage of grief does this comment most likely indicate?

Accepted Answer

A)   Shock and numbness
B)   Yearning and searching
C)   Disorganization and despair
D)   Reorganization D

Question 4

Which of the following might be a warning sign that a child needs professional help after the death of a loved one? Choose all that apply.

Accepted Answer

A)   Interest in his usual activities
B)   Extended regression
C)   Withdrawal from friends
D)   Inability to sleep
E)   Intermittent sadness

Question 5

What emotional response is typical during the Rando's confrontation phase of the grieving process?

Accepted Answer

A)   Anger and bargaining
B)   Shock with disbelief
C)   Denial
D)   Emotional upset

Question 6

A 73-year-old patient who suffered a stroke is being transferred from the acute care hospital to a nursing home for ongoing care because she is unable to care for herself at home.Which type of loss is this patient most likely experiencing?

Accepted Answer

A)   Environmental loss
B)   Internal loss
C)   Perceived loss
D)   Psychological loss

Question 7

According to the Uniform Determination of Death Act,which bodily function must be lost to declare death?

Accepted Answer

A)   Consciousness
B)   Brain stem function
C)   Cephalic reflexes
D)   Spontaneous respirations

Question 8

The nurse has been explaining advance directives to a patient.Which response by the patient would indicate that he has correctly understood the information? "An advance directive is a document

Accepted Answer

A)   Specifying your healthcare intentions should you become unable to make self-directed decisions"
B)   Identifying the activities considered to be evidence of quality care"
C)   Verifying your understanding of the risks and benefits associated with a procedure"
D)   Allowing you the autonomy to leave the hospital when you decide, even if it is against medical advice"

Question 9

How should the nurse respond to a family immediately after a patient dies?

Accepted Answer

A)   Ask the family to leave the patient's room so postmortem care can be performed.
B)   Leave tubes and IV lines in place until the family has the opportunity to view the body.
C)   Express sympathy to the family (e.g., "I am sorry for your loss") .
D)   Tell the family that they will have limited time with their loved one.

Question 10

A patient with a history of chronic obstructive pulmonary disease has a living will that states he does not want endotracheal intubation and mechanical ventilation as a means of respiratory resuscitation.As the patient's condition deteriorates,the patient asks whether he can change his decision.Which response by the nurse is best?

Accepted Answer

A)   "I'll call your physician right away so he can discuss this with you."
B)   "You have the right to change your decision about treatment at any time."
C)   "Are you sure you want to change your decision?"
D)   "We must follow whatever is written in your living will."

Question 11

According to William Worden,which task in the grieving process takes longest to achieve?

Accepted Answer

A)   Accepting that the loved one is gone
B)   Experiencing the pain from the loss
C)   Adjusting to the environment without the deceased
D)   Investing emotional energy

Question 12

When providing postmortem care,the nurse places dentures in the mouth and closes the eyes and mouth of the patient within 2 to 4 hours after death.Why is the timing of the action so important?

Accepted Answer

A)   To prevent blood from settling in the head, neck, and shoulders
B)   To perform these actions more easily before rigor mortis develops
C)   To set the mouth in a natural position for viewing by the family
D)   To prevent discoloration caused by blood settling in the facial area

Question 13

Throughout the course of his illness,a patient has denied its seriousness,even though his health professionals have explained prognosis of death very clearly.Physiologic signs now indicate that he will probably die within a short period of time,but he is still firmly in a state of emotional denial.The patient says to the nurse,"Tell my wife to stop hovering and go home.I'm going to be fine." How should the nurse respond?

Accepted Answer

A)   "Your physical signs indicate that you will likely not live more than a few more days."
B)   "You seem very sure that you are not going to die. Please tell me more about what you are feeling."
C)   "It seems to me you would be feeling some anger and wondering why all this is happening to you."
D)   "It would be best for your family if you were able to work through this and come to accept the reality of your situation."

Question 14

A patient dying of heart failure has changed his choice about his end-of-life treatment measures several times.He says,"I just can't make up my mind about it." Which nursing diagnosis is most appropriate for this patient?

Accepted Answer

A)   Deficient Knowledge
B)   Spiritual Distress
C)   Decisional Conflict
D)   Death Anxiety

Question 15

Which of the following patient goals is most appropriate when managing the patient dying of cancer? The patient will

Accepted Answer

A)   Request pain medication when needed
B)   Report or demonstrate satisfactory pain control
C)   Use only nonpharmacological measures to control pain
D)   Verbalize understanding that it may not be possible to control his pain

Question 16

Which patient is at most risk for experiencing difficult grieving?

Accepted Answer

A)   The middle-aged woman whose grandmother died of advanced Parkinson's disease
B)   The young adult with three small children whose wife died suddenly in an accident
C)   The middle-aged person whose spouse suffered a slow, painful death
D)   The older adult whose spouse died of complications of chronic renal disease

Question 17

During a health history,a patient whose wife died unexpectedly 6 months ago in a motor vehicle accident admits that he drinks at least six bourbon and waters every night before going to bed.Which type of grief does this best illustrate?

Accepted Answer

A)   Delayed
B)   Chronic
C)   Disenfranchised
D)   Masked

Question 18

To be eligible for insurance benefits covering hospice care,a physician must certify that which of the following apply to the patient? Choose all that apply.

Accepted Answer

A)   Life expectancy is not more than 6 months.
B)   Life expectancy is not more than 12 months.
C)   Condition is expected to improve slightly.
D)   Condition is not expected to improve.

Question 19

Which intervention is appropriate for a client receiving palliative care? Choose all that apply.

Accepted Answer

A)   Surgical insertion of a device to decrease the workload of the heart in a patient awaiting heart transplantation
B)   Administering IV dopamine to raise blood pressure of a patient with end-stage lung cancer
C)   Providing moisturizing eye drops to an unconscious patient whose eyes are dry
D)   Administering a medication to relieve the nausea of a patient with end-stage leukemia

Question 20

Which intervention should be included in the plan of care for a patient in the end-stage death process?

Accepted Answer

A)   Encourage the patient to accept as much help as possible.
B)   Avoid administering laxatives.
C)   Wet the lips and mouth frequently.
D)   Administer pain medication on an as-needed basis.

Exam 17: Loss,Grief, Dying