Deck 21: Communicating With Clients and Families at the End of Life

Question 1

The nurse is caring for a client who is expected to die within a month.The client states,"I can't go on anymore,help me!" Which of the following best describes this client's stage of dying?

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

Answer 1

Depression

Question 2

The nurse is caring for an 8-year-old child in the school nurse's office because the child received a bloody nose in a scuffle with another child during recess.The nurse discovers that the child's parents have recently divorced.The nurse recognizes that the child

A) still has both parents and should not be experiencing a sense of loss.
B) has gotten over his grief because he is able to play outside.
C) needs to be referred for grief counseling.
D) demonstrates behavior that is a common response when grieving.

Answer 2

demonstrates behavior that is a common response when grieving.

Question 3

A client's adult children call the nurse hourly with concerns about their mother's death and end-of-life care.The nurse's best response is to

A) provide detailed, scientific information.
B) discuss physical symptoms.
C) withhold information to avoid unnecessary fears.
D) provide frequent updates.

Answer 3

provide frequent updates.

Question 4

The nurse is caring for a client who has just experienced the death of her mother.The nurse best demonstrates support for the client by

A) sitting quietly with the client and not discussing the loss.
B) reminding the client that her mother lived a long life.
C) changing the subject so the client won't get upset.
D) offering spiritual support for the client and family.

Question 5

Stoicism and denial of grief are examples of how a family coping with death is affected by

A) Kübler-Ross.
B) culture.
C) developmental level.
D) prior experience.

Question 6

The nurse is caring for a client who has been given 6 months to live after being diagnosed with stage 4 cancer of the lung.Evidence that the client is in the bargaining stage of death and dying is demonstrated by which of the following statements?

A) "Not me."
B) "Why me?"
C) "Yes, me."
D) "Let me."

Question 7

Which of the following statements is true about grief?

A) Grief always occurs immediately after a loss.
B) Support for a grieving client includes closed communication.
C) Recurring, wavelike feelings of sadness and loss are common feelings in a client who is grieving.
D) It is normal for grief to be exaggerated.

Question 8

A client has just been transferred to a new facility from another hospital at his insistence.The client is demanding a second opinion because he feels that "They must have made a mistake." The nurse recognizes that the best communication technique to use with this client is to

A) clarify the client's response.
B) reflect the client's behavior.
C) summarize the client's behavior.
D) acknowledge the client's feelings.

Question 9

Which of the following is a dimension of palliative care?

A) It involves only care of the client.
B) It provides grief support for family only while the client is alive.
C) It bears no resemblance to hospice care.
D) It intends neither to hasten nor postpone death.

Question 10

The nurse is caring for a client who has just received biopsy reports that indicate recurrence of metastatic stage IV breast cancer.The client's statement that indicates the acceptance stage of death and dying is,

A) "The test results are incredible."
B) "The test results are positive."
C) "The test results are negative."
D) "The test results will be repeated next week."

Question 11

A 21-year-old client informs the nurse that he is not sleeping.The nurse learns that the client's girlfriend was killed in a car accident 1 month ago.Which statement would be of most concern to the nurse?

A) "I am moving on and plan to start dating again."
B) "It's my fault. I shouldn't have let her go out that night."
C) "I wish I died in the car accident instead of her."
D) "I cannot sleep because I keep reliving the car accident."

Question 12

An 89-year-old client recently lost his wife of 69 years to cancer.He reports "I had the strangest thing happen to me last night.I woke up and saw my wife sitting in her chair." The nurse's best response would be:

A) "How long have you been hallucinating?"
B) "Hallucinations are often caused by disturbance in brain chemicals."
C) "Hearing or seeing things that are not real can be a normal response to extreme stress."
D) "I recommend you speak to your doctor to review your medications."

Question 13

When evaluating care of dying clients,the nurse recognizes that interventions have been unsuccessful if the

A) client does not get past the stage of denial.
B) client dies in peace surrounded by loved ones.
C) client dies while experiencing pain.
D) nurse refuses to allow the client to be sad.

Question 14

Which of the following is an inappropriate intervention for communicating with terminally ill clients?

A) Allowing the client to lead discussions about the future
B) Offering automatic responses and trite reassurances
C) Respecting the individual's pattern of communication
D) Maintaining a sense of calm

Question 15

Which of the following individuals is most likely experiencing a delayed grief reaction?

A) A 22-year-old army pilot on leave from the Iraq war who talks about the death of his crew member
B) A 93-year-old women, whose husband of 73 years died 1 year ago, who reminisces about their life together
C) A 54-year-old man suffering from alcoholism who just completed a 28-day inpatient rehabilitation talking about the death of his wife 3 years ago
D) A child whose parents were divorced 3 months ago and is acting out at school

Question 16

The nurse is caring for a 15-year-old client who is dying.The client tells the nurse,"I know I am not going home again.I think it is harder for my parents than me.Will you talk to them for me?" Which of the following is the best response by the nurse?

A) "It is true that you will be dying soon, but you must be honest with your parents."
B) "That's not true, but I will talk to your parents."
C) "You are having a bad day, so I will be back later to see if you need anything else."
D) "Yes, I will talk to your parents, but you need to talk to them also. I will help you with that."

Question 17

Which of the following best describes anticipatory grief?

A) It occurs after the actual death.
B) It occurs when death was sudden and unexpected.
C) Only the family of the dying client experiences it.
D) It can be colored by ambivalent feelings.

Question 18

Which of the following is defined as a normal grief response associated with an ongoing living loss that is permanent,progressive,recurring,and cyclic in nature?

A) Somatization disorder
B) Chronic sorrow
C) Chronic grief
D) Absent grief