Deck 28: Caring for the Patient Who Is Grieving

Question 1

What almost universal response to loss should a mental health nurse understand has many cultural determinants?

A) Anger
B) Crying
C) Depression
D) Distancing

Answer 1

Crying

Question 2

The nurse has determined that a parent is experiencing chronic sorrow following the diagnosis of her child with cerebral palsy. What is an appropriate response for the nurse?

A) Suggest the possibility of residential care.
B) Provide information about support services and groups.
C) Caution the parent not to neglect the other children in the family.
D) Suggest that the parent work to disengage from the emotional intensity of the experience.

Answer 2

Provide information about support services and groups.

Question 3

A 79-year-old patient lost his spouse six months ago. What are some risk factors the nurse should consider in assessing this patient? Select all that apply.

A) Impaired health
B) Accident frequency
C) Increased alcohol use
D) Involvement in new relationships
E) Increased involvement with children

Answer 3

Impaired health
Accident frequency
Increased alcohol use

Question 4

A patient experienced a miscarriage one week ago. She reports that her husband is very supportive but she feels very sad and is not sleeping or eating well. Why would the nurse suspect that her symptoms are those of grief rather than depression? Select all that apply.

A) The patient feels connected to others.
B) The patient cannot experience pleasure.
C) The symptoms are related to a specific loss.
D) The patient is not able to function normally.
E) The patient's symptoms are time limited.

Question 5

A nurse is interviewing a 76-year-old patient who lost her spouse of 51 years over a year ago. The patient describes herself as feeling intensely sad and hopeless all the time. What is an appropriate response for the nurse?

A) Assess the patient as experiencing normal grieving.
B) Decide that the patient is experiencing unresolved grief.
C) Determine that the patient is experiencing chronic sorrow.
D) Determine that further assessment for depression is needed.

Question 6

A nurse is working with a patient and realizes that it is almost one year since the death of the patient's spouse. What should the nurse do?

A) Ignore it unless the patient mentions it.
B) Tell the patient to visit the spouse's grave that day.
C) Suggest that the patient make plans to go away that day.
D) Prepare the patient for a possible anniversary reaction and help the patient plan for it.

Question 7

A nurse meets with a patient whose mother died recently. The patient is distressed because her brother returned to work immediately after their mother's funeral. Which is the best response by the nurse?

A) "Every person grieves in their own way."
B) "I guess your brother is just not an emotional guy."
C) "Yes, that is a problem. I think you should suggest that he see a therapist."
D) "There is an association between a lack of expression of grief and negative psychological outcomes."

Question 8

After the death of a child, a patient is experiencing depression and anxiety. The nurse anticipates the need to provide patient education regarding which type of therapy?

A) Hypnosis
B) Desensitization
C) Benzodiazepines
D) Psychotherapy

Question 9

A 44-year-old patient is in the middle of a divorce and just lost his job. Which factors that might affect the patient's resilience will the nurse assess? Select all that apply.

A) Job skills
B) Coping resources
C) Financial resources
D) Supportive relationships
E) Prior experience with successful resolution of loss

Question 10

A 17-year old-patient recently lost her mother. At her annual physical examination, the patient tells the nurse she will not be able to attend the residential college she had planned for because her responsibilities with her siblings at home have increased. Why will the nurse assess the patient for signs and symptoms of depression?

A) All adolescents suffer from depression.
B) Multiple losses increase the likelihood of depression
C) Lack of support increases the likelihood of depression.
D) Pressure to function increases the likelihood of depression.

Question 11

A mental health nurse is interviewing a flood victim whose partner was killed in the disaster. What possible patient response should the nurse anticipate in planning patient care?

A) Anticipatory grief
B) Survivor guilt
C) Unresolved grief
D) Ambiguous loss

Question 12

A patient lost his spouse three years ago. The nurse has been helping him work through his grief using Worden's stage theory of grieving. Which controversial stage might the nurse decide to eliminate?

A) Accept the reality of the loss.
B) Experience the pain of grief.
C) Adjust to an environment in which the deceased is missing.
D) Withdraw from the lost relationship and reinvest energy in new relationships.

Question 13

A nurse is working with the family of a child diagnosed with leukemia. Which nursing interventions are most appropriate? Select all that apply.

A) Offer financial advice
B) Provide active listening
C) Offer referral to a spiritual advisor
D) Work with physicians to provide information
E) Provide information on available support groups

Question 14

A patient tells the mental health nurse that he is unable to get his life back together since the death of his spouse two years ago and that he feels the loss as strongly as he did the day his spouse died. What does the nurse suspect the patient is experiencing?

A) Delayed grief
B) Anticipatory grief
C) Complicated grief
D) Disenfranchised grief

Question 15

Which statement made by the patient indicates the patient is experiencing spiritual distress?

A) "Who is responsible for this?"
B) "Why did this happen to me?"
C) "What should I do about this?"
D) "Who will take care of this problem?"

Question 16

A nurse is assessing a 54-year-old flood victim who reports having difficulty concentrating and functioning. What might the nurse ask to help evaluate whether or not the individual is suffering from depression?

A) "Do you feel anxious?"
B) "Do you have any sleep problems?"
C) "Do you have any appetite problems?"
D) "Did you feel this way before the flood?"

Question 17

A nurse is interviewing a patient who recently lost her spouse. Which symptoms reported by the patient would warrant a referral to a mental health provider? Select all that apply.

A) Prolonged insomnia
B) Crying
C) Severe weight loss
D) Anger
E) Suicidal ideation

Question 18

A patient who has just lost all her family photos in a flood asks the nurse why she seems to be suffering as much as her neighbor, who lost her entire house and all her possessions. What can the nurse say to help explain what can be the most important factor in determining the intensity of a loss?

A) The age of the person is the most important factor in determining the intensity of the loss.
B) The gender of the person is the most important factor in determining the intensity of the loss.
C) The value of the loss is the most important factor in determining the intensity of a person's loss.
D) The meaning of the loss is the most important factor in determining the intensity of the response to loss.

Question 19

A nurse working in a disaster recovery center is interviewing a patient whose home and business were destroyed in a tornado. The patient is determined to recover and rebuild. Which statement by the patient would indicate the need for referral to a social worker?

A) "I almost feel as though God has abandoned me."
B) "I don't know where to begin to get back on my feet."
C) "I don't think I can go back to my old work since the nerves in my hand were damaged."
D) "No matter how hard I try, I can't get to sleep at night and I seem to be crying most of the time."

Question 20

A nurse at a long-term care facility is conducting an initial interview with a patient who has recently been diagnosed with Alzheimer disease. The patient is grieving the death of her spouse of 30 years. What are some appropriate interventions the nurse might consider? Select all that apply.

A) Ask the patient if she wants to talk about her recent losses.
B) Suggest that the patient might consider joining a grief support group at the facility.
C) Advise the patient that she will soon adjust to her new circumstances and feel much better.
D) Ignore the patient's losses since she probably doesn't remember them and it is better not to remind her.
E) Ask the patient if there are any ways in which the nurse could help the patient be more comfortable in her new surroundings.

Question 21

A hospice nurse realizes that her work exposes her to a lot of emotional suffering. How could she respond effectively to these pressures?

A) Take courses on grieving.
B) Organize a peer support group.
C) Take anti-depressant medications.
D) Talk to her patients about her feelings.

Question 22

A patient whose home was destroyed by fire is in a disaster recovery area. A nurse tells the patient, "I know just how you feel. We had a fire in our home when I was a little girl." What type of communication is the nurse using?

A) Active listening
B) Disabling communication
C) Informational communication
D) Therapeutic communication

Question 23

A nurse is designing a hospital program for parents who have lost a child. What intervention might be most useful to include?

A) Support group
B) Educational brochure
C) Informational workshop
D) Medication evaluation

Question 24

A patient who lost a child in an auto accident tells the nurse, "God has abandoned me." What is an appropriate statement for the nurse to make?

A) "I will go and get a clergyman to help you."
B) "God has nothing to do with what happened to you."
C) "You need to strengthen your faith if you want to be able to survives this tragedy."
D) "Tell me more about what your faith means to you and, if you wish, I will get a clergyman to talk to you more about this tragedy."

Question 25

A nurse asks a patient in a shelter for hurricane victims if she can be of help. The patient says, "I don't need your help." Using therapeutic communication, how should the nurse respond?

A) Move away from the patient.
B) Call the nursing supervisor.
C) Tell the patient that anger won't help her situation.
D) Tell the patient that anger is understandable in her situation.

Question 26

A grieving patient asks a nurse what he would get from participating in a grief support group. What benefits can the nurse include when responding? Select all that apply.

A) Social support
B) Connection to resources
C) Validation of experience
D) Direction on how to grieve
E) The opportunity to share his story

Question 27

A patient's husband is dying of cancer. Which statements by the nurse are appropriate? Select all that apply.

A) "He's going to a better place."
B) "Don't worry. Everything will be OK."
C) "Please let me know if I can help in any way."
D) "Would you like to talk about what's happening?"
E) "Do you have any questions about what is happening with your husband?"

Question 28

A patient who lost a grandchild over a year ago recently stopped taking her anti-depressant medication. When assessing the patient, which finding would suggest a relapse of the patient's depression?

A) Changes in the patient's sleep patterns
B) Increased patient talk about her grandchild
C) Continuing patient participation in a grief support group
D) Patient involvement in creating a memorial scholarship fund

Question 29

A nurse is very upset at a patient's death. Her supervisor tells her to get over it and get on with her job. What is the nurse experiencing?

A) Delayed grief
B) Ambiguous loss
C) Complicated grief
D) Disenfranchised grief

Question 30

What other experience might a nurse have had that would contribute to the intensity of grief when a patient dies?

A) Job changes
B) Individual counseling
C) The recent loss of a family member
D) Attending the patient's memorial service

Question 31

The nurse manager knows that one of the nurses working on the unit has experienced several recent deaths. The nurse manager believes the nurse is not dealing with feelings of loss following these losses. Which behaviors by the nurse on the unit would indicate the nurse is having difficulty processing emotions? Select all that apply.

A) Complaining frequently
B) Talking with other nurses
C) Quickly becoming angry at others
D) Having difficulty prioritizing tasks
E) Sitting off to the side during staff meetings

Question 32

A nurse is conducting a follow-up assessment on a patient who lost his best friend several months ago. What patient statement would indicate that interventions have been effective?

A) "I just can't get over it."
B) "I think I'm sleeping better lately."
C) "I don't care about my loss anymore."
D) "I think that I am fine and don't really need treatment."