Deck 37: The Bereaved Individual

Question 1

Bob Taylor's home was recently destroyed in a fire.Margaret Smith is 35 years old and has just learned that she must have a hysterectomy.Which scenario will most likely trigger a grief response?

A)Taylor's home destroyed by fire.
B)Smith's pending hysterectomy.
C)Neither scenario by itself could trigger the grief response.
D)Both scenarios could trigger individual grief responses.

Answer 1

Both scenarios could trigger individual grief responses.

Question 2

Which is the most accurate description of the nursing diagnosis of spiritual distress?

A)The client reports no church affiliations.
B)The client struggles to identify meaning and purpose in life.
C)The client reports seeing the spirit of his deceased wife.
D)The client reports that meditation helps him feel connected spiritually.

Answer 2

The client struggles to identify meaning and purpose in life.

Question 3

A woman returns home after delivering a stillborn infant to find that neighbors have dismantled the nursery that she and her husband planned.According to Worden,which indicates the effect the neighbors' action may have on the woman's grieving task completion?

A)It may hamper the woman from accepting the reality of the loss.
B)It would help the woman forget the sorrow and move on with life.
C)It communicates full support from her neighbors.
D)It would motivate the woman to look to the future and not the past.

Answer 3

It may hamper the woman from accepting the reality of the loss.

Question 4

Rebecca expresses to the nurse that she feels like she didn't do enough to prevent the loss of her father.Which of the following interventions should the nurse use to address Rebecca's feelings?

A)Encourage Rebecca to examine the guilt and validate the appropriateness of this feeling.
B)Review the circumstances of the loss and the reality that it could not be prevented.
C)Role-play the events and assist Rebecca with understanding the decisions leading to the loss.
D)Explain that this feeling is a pathological defense that will prevent her from progressing through the stages of grief.

Question 5

Which of the following types of care should the interdisciplinary team of hospice provide? Select all that apply.

A)Physical care available on a 24/7 basis
B)Counseling on the addictive properties of pain management medications
C)Discussions related to death and dying
D)Explorations of new,aggressive treatments
E)Assistance with obtaining spiritual support and guidance

Question 6

Jorge and Hugette were proud parents of a 6-month old daughter.Their joy was short-lived,however,when Hugette was diagnosed with a terminal illness and died just 4 days after their daughter's first birthday.At the 1-year well visit,Jorge told the pediatrician that he was concerned about the changes in his daughter's normal behavior.Which of the following are common changes in children from birth to age 2,when they are separated from their mother? Select all that apply.

A)Weight loss
B)Increased bowel movements
C)Sleeplessness
D)Reduced eye contact

Question 7

An instructor is teaching nursing students about Worden's grief process.Which of the following client behaviors serve to delay or prolong the grieving process? Select all that apply.

A)Refusing to allow self to think painful thoughts
B)Indulging in the pain of loss
C)Using alcohol and drugs
D)Idealizing the object of loss
E)Recognizing that time will heal

Question 8

Aisha has just experienced the unexpected death of her father.Which of the following criteria may the nurse use for measurement of outcomes in Aisha's grief care? Select all that apply.

A)Acknowledges awareness of the loss
B)Expresses feelings about the loss
C)Verbalizes positive aspects about her life at present and in the future
D)Expresses anger toward the loss appropriately
E)Expresses personal satisfaction and support from spiritual practices

Question 9

The nurse assesses a client as experiencing maladaptive grieving.Which of the following factors confirms the nurse's assessment?

A)The client's spouse died 12 months ago.
B)The client still cries when recalling memories of the deceased.
C)The client reports feelings of worthlessness.
D)The client reports intermittent anxiety.

Question 10

The nurse assesses a woman whose husband died 13 months ago.She isolates herself,screams at her deceased spouse,and is increasingly restless and aimless.According to Bowlby,this widow is in which stage of the grieving process?

A)Stage I: Numbness or Protest
B)Stage II: Disequilibrium
C)Stage III: Disorganization and Despair
D)Stage IV: Reorganization

Question 11

A teenager has recently lost a parent.Which grieving behavior should the school nurse expect when assessing this client?

A)Denial of personal mortality
B)Preoccupation with the loss
C)Clinging behaviors and personal insecurity
D)Aggressive and defiant behaviors

Question 12

The nurse is caring for an Irish client who has recently lost a spouse.The client states to the nurse,"I'm planning an elaborate wake and funeral." According to George Engel,Which purpose do these rituals serve?

A)To delay the recovery process initiated by the loss of the client's spouse
B)To facilitate the acceptance of the loss of the client's spouse
C)To avoid dealing with grief associated with the loss of the client's spouse
D)To eliminate emotional pain related to the loss of the client's spouse

Question 13

Missy is 12 years old and a sixth-grade student at Lincoln Middle School.Her family was involved in car accident this past weekend,resulting in the death of her father and brother.As school nurse,you have been asked to help Missy's classmates who ask questions about the death of her family members at school on Monday.What question would likely be asked by her classmates?

A)"Is Missy going to die too?"
B)"When will Missy's dad and brother come back home?"
C)"What did they do with her dad and brother's body after the accident?"
D)"Did Missy's dad and brother die because she was being bad?"

Question 14

Which of the following are considered part of the grief response? Select all that apply.

A)Bereavement
B)Mourning
C)Denial
D)Loss

Question 15

In 1991,the U.S.Congress passed the Patient Self-Determination Act,which requires which of the following? Select all that apply.

A)States must define how and under what circumstances individuals can refuse life-sustaining medical interventions.
B)All health-care facilities must advise clients of their rights to refuse treatment.
C)Advance directives are made available to patients on admission.
D)Records of whether a client has an advanced directive or designated health-care proxy exist.

Question 16

Which possible grieving behaviors should the nurse anticipate when caring for a Southwest Navajo Indian client?

A)Celebrating the life of a deceased person with festivities and revelry
B)Not expressing grief openly and reluctance to touch a dead body
C)Holding a prayerful vigil for a week following the person's death
D)Expressing grief openly and publicly,and erecting an altar in the home to honor the dead

Question 17

A client is diagnosed with Terminal Cancer.Which situation should the nurse assess as reflecting Kübler-Ross's grief stage of anger?

A)The client registers for an iron-man marathon to be held in 9 months.
B)The client is a devoted Catholic but refuses to attend church and states that his faith has failed him.
C)The client promises God to give up smoking if allowed to live long enough to witness a grandchild's birth.
D)The client gathers family to plan a funeral and make last wishes known.

Question 18

When a person is at risk for spiritual distress,for which reasons is it an appropriate nursing intervention to stay with the client,and to be accepting and nonjudgmental when the client expresses anger and bitterness (toward God,the universe,etc. )? Select all that apply.

A)It increases the client's feelings of self-worth.
B)It promotes trust in the nurse-client relationship.
C)It validates the client's feelings.
D)It serves to provide relief from spiritual distress.

Question 19

The nurse is leading a bereavement group.Which of the following group members should the nurse identify as being at high risk for having difficulty grieving? Select all that apply.

A)A widower who has recently experienced the death of two good friends
B)A man whose wife died suddenly after a cerebrovascular accident
C)A widow who,after a year,allowed removal of life support from her terminally ill husband
D)A woman who had a competitive relationship with her recently deceased brother
E)A young couple whose child recently died of a genetic disorder

Question 20

A nursing instructor is teaching about the typical grieving behaviors of Chinese Americans.Which student statement indicates that further instruction is needed?

A)"In this culture,the color red is associated with death and is considered bad luck."
B)"In this culture,there may be an innate fear of death."
C)"In this culture,emotions may not be expressed openly."
D)"In this culture,death and bereavement are sometimes centered on ancestor worship."

Question 21

A(n)____________________________________ is a written document made by a competent individual that provides instructions that should be used when that individual is no longer able to express his or her wishes for health-care treatment.

Question 22

_______________ is the inability to feel pleasure.

Question 23

When a client is accepted into a hospice program,the ________________________ continues to write orders for the hospice patient;pain and symptom management comes from the ____________________________.