Deck 28: The Bereaved Individual

Question 1

What type of maladaptive response to loss occurs when an individual becomes fixed in the anger stage of grief? What clinical disorder is associated with this occurrence?

Answer 1

Clinical disorder associated with fixation at the anger stage of grief:
• Sometimes a bereaved individual may respond in a maladaptive manner and display exaggerated symptoms associated with grief such as sadness, helplessness, anger and guilt. When an individual gives an exaggerated grief response he/she may be fixed in the anger stage of the grief process.
• The anger maybe directed towards others whom the individual holds responsible for the loss. However, sometimes the anger might be turned inwards. This leads to depressive mood disorder.

Question 2

Describe various types of loss that trigger the grief response in individuals.

Answer 2

Types of loss that trigger the grief response in individuals:
Loss represent any change or separation from a familiar pattern of existence. There are various types of loss that can lead to grieving. These include the following:
• Loss of a significant other through death, divorce or separation.
• Illness may give rise to loss of emotional wellness and physical independence.
• Bodily changes such as menopause, infertility, impotence or hysterectomy represents loss.
• Loss can also occur when once is unable to meet expectations of self and others. This may give rise to loss of hopes and dreams.
• Separation from external objects that represent an extension of one's self may also be perceived as a loss of a valued object that defined the individual.

Question 3

Which of the following is most likely to initiate a grief response in an individual?

A) Death of the pet dog
B) Being told by her doctor that she has begun menopause
C) Failing an examination
D) Answer a only
E) All of the above.

Answer 3

Greif response is a natural reaction that expresses anything, which is perceived by an individual as a loss. It is a behavior that normally follows a loss of an important thing or person. The duration of grief response varies from individual to an individual.
Thus, the answer is e.

Question 4

Describe the phenomenon of bereavement overload.

Question 5

Discuss theoretical perspectives of grieving as proposed by Elisabeth Kübler-Ross, John Bowlby, George Engel, and J. William Worden.

Question 6

Nancy, who is dying of cancer, says to the nurse, "I just want to see my new grandbaby. If only God will let me live until she is born. Then I'll be ready to go." This is an example of which of Kübler-Ross's stages of grief?

A) Denial
B) Anger
C) Bargaining
D) Acceptance

Question 7

With what types of behaviors is grief manifested in school-age children?

Question 8

Differentiate between normal and maladaptive responses to loss.

Question 9

Gloria, a recent widow, states, "I'm going to have to learn to pay all the bills. Hank always did that. I don't know if I can handle all of that." This is an example of which of the tasks described by Worden?

A) Task I. Accepting the reality of the loss
B) Task II. Processing the pain of grief
C) Task III. Adjusting to a world without the lost entity
D) Task IV. Finding an enduring connection with the lost entity in the midst of embarking on a new life

Question 10

According to Engel, when is the grief response thought to be resolved?

Question 11

Discuss grieving behaviors common to individuals at various stages across the life span.

Question 12

Engel identifies which of the following as successful resolution of the grief process?

A) When the bereaved person can talk about the loss without crying
B) When the bereaved person no longer talks about the lost entity
C) When the bereaved person puts all remembrances of the loss out of sight
D) When the bereaved person can discuss both positive and negative aspects about the lost entity

Question 13

Describe customs associated with grief in individuals of various cultures.

Question 14

Which of the following is thought to facilitate the grief process?

A) The ability to grieve in anticipation of the loss
B) The ability to grieve alone without interference from others
C) Having recently grieved for another loss
D) Taking personal responsibility for the loss

Question 15

Formulate nursing diagnoses and goals of care for individuals experiencing the grief response.

Question 16

When Frank's wife of 34 years dies, he is very stoic, handles all the funeral arrangements, doesn't cry or appear sad, and comforts all of the other family members in their grief. Two years later, when Frank's best friend dies, Frank has sleep disturbances, difficulty concentrating, loss of weight, and difficulty performing on his job. This is an example of which of the following maladaptive responses to loss?

A) Delayed grieving
B) Distorted grieving
C) Prolonged grieving
D) Exaggerated grieving

Question 17

Describe appropriate nursing interventions for individuals experiencing the grief response.

Question 18

A major difference between normal and maladaptive grieving has been identified by which of the following?

A) There are no feelings of depression in normal grieving.
B) There is no loss of self-esteem in normal grieving.
C) Normal grieving lasts no longer than 1 year.
D) In normal grief the person does not show anger toward the loss.

Question 19

Identify relevant criteria for evaluating nursing care of individuals experiencing the grief response.

Question 20

Which grief reaction can the nurse anticipate in a 10-year-old child?

A) Statements that the deceased person will soon return
B) Regressive behaviors, such as loss of bladder control
C) A preoccupation with the loss
D) Thinking that they may have done something to cause the death

Question 21

Describe the concept of hospice care for people who are dying and their families.

Question 22

Which of the following is a correct statement when attempting to distinguish normal grief from clinical depression?

A) In clinical depression, anhedonia is prevalent.
B) In normal grieving, the person has generalized feelings of guilt.
C) The person who is clinically depressed relates feelings of depression to a specific loss.
D) In normal grieving, there is a persistent state of dysphoria.

Question 23

Discuss the use of advance directives for individuals to provide directions about their future medical care.

Question 24

Which of the following is not true regarding grieving by an adolescent?

A) Adolescents may not show their true feelings about the death.
B) Adolescents tend to have an immortal attitude.
C) Adolescents do not perceive death as inevitable.
D) Adolescents may exhibit acting out behaviors as part of their grief.