Deck 18: Loss and End-Of-Life Issues

Question 1

A nurse is assisting a patient with a life review.What action by the nurse is best?

A)Ask the patient what his or her job was.
B)Ask about memories the patient is proud of.
C)Ask the patient about special holiday foods.
D)Ask the patient to name children and grandchildren.

Answer 1

Ask about memories the patient is proud of.

Question 2

A man who recently lost his wife of 50 years shares with the nurse that he'll "never get over missing her." The nurse is most therapeutic when responding:

A)"We are here to help you anyway we can."
B)"Focus on the beautiful memories you have of her and your life together."
C)"Time will help you adjust to your loss."
D)"You'll never get over your loss but you can learn to live with it."

Answer 2

"You'll never get over your loss but you can learn to live with it."

Question 3

The nurse in the emergency department cared for a patient who had a fatal heart attack.The nurse goes to meet the family in the private waiting room.The nurse is acting most appropriately when responding:

A)"What do you know about what happened today?"
B)"I'm so sorry but your loved one has died."
C)"We did all we could,but unfortunately it was not enough."
D)"Is there someone I can call for you?"

Answer 3

"What do you know about what happened today?"

Question 4

A hospice nurse shows the best understanding of the personal commitment to the dying patient by:

A)providing the patient with sufficient,effective pain management therapies.
B)addressing the patient's need to feel valued by those attending to his or her death.
C)being available emotionally and physically throughout the dying process.
D)empathizing with the patient and his or her family and friends during the process.

Question 5

A novice hospice nurse shows the best understanding of the nursing role related to an older adult patient's mourning over the loss of an adult child when stating:

A)"I see mourning as a very individualized process."
B)"The patient's coping skills need to be assessed regularly."
C)"The patient needs all the help I can give to get better."
D)"Hopefully the patient will be in a healthy mental state soon."

Question 6

An older patient is near the end of life and the family is concerned that the patient has a pressure ulcer because,in their view,this denotes poor care.What explanation by the nurse is best?

A)"You're right;we will try harder to care for her."
B)"I'm so sorry this is upsetting for you to see."
C)"We are doing the best we can to care for your loved one."
D)"Age-related changes can make it impossible to prevent ulcers."

Question 7

The nurse documents that a newly widowed older adult patient is likely experiencing physical grief responses when she:

A)becomes hypotensive.
B)has difficulty getting up from the chair.
C)reports having tightness in the chest.
D)develops a red rash over her upper chest and back.

Question 8

Although the family of a newly widowed older adult patient lives several hours away,they are interested in providing appropriate support.The nurse suggests it would be most helpful if they would:

A)telephone daily and arrange for a neighbor to help with the shopping.
B)assume responsibility for paying the bills and upkeep of the home.
C)encourage the patient to move into a smaller home and learn to drive.
D)include the patient in their yearly vacation plans

Question 9

A hospice nurse is caring for a patient and notes the patient's spouse engaged in anticipatory grieving.What action by the spouse best demonstrates this reaction?

A)Spending time learning about the business owned by the patient
B)Receiving many visitors from church and social organizations
C)Delegating household tasks so the spouse can stay with the patient
D)Taking long walks outside then napping for extended periods

Question 10

An older adult man has been the primary caregiver for his chronically ill wife for the past 10 years.When his wife dies,the nurse prepares the family for the likely possibility that their father will express:

A)guilt that he is alive while she is dead.
B)deep despair for his loss.
C)personal relief that she has died.
D)concern that he could have cared for her better.

Question 11

The nurse is caring for an older adult who recently lost an adult child as a result of automobile accident.They shared a home and enjoyed a healthy parent-child relationship.The nurse is confident that the patient has progressed appropriately through the mourning process when the patient is observed doing which action?

A)Tells family members that her child is "in a better place."
B)Arranges for personal grief counseling.
C)Cries softly during the family's first year memorial service.
D)Plans a summer vacation with friends from work.

Question 12

The nurse knows a family whose adult child killed several people before taking his own life.The funerals of all involved were held on the same 2 days.The nurse notes the family seems embarrassed,uncomfortable with expressions of sorrow,and wants a very quiet funeral.What type of grief does the nurse suspect the family has?

A)Anticipatory
B)Disenfranchised
C)Masked
D)Complicated

Question 13

The nurse evaluates how an older adult patient will react to the death of a spouse based on how the patient:

A)expresses concern for his spouse during a prolonged illness.
B)reacts when their beloved dog was sent to live with an adult child.
C)demonstrates his or her philosophy of health and happiness.
D)expresses how his spouse's illness has impacted their life together.

Question 14

The nurse documents that a patient is likely experiencing exaggerated grief when observing which behavior?

A)Keeps telling family and friends that her spouse "can't be dead."
B)Re-reads her late spouses diaries nightly since the death 2 years ago.
C)Develops severe abdominal pains on each anniversary of her spouse's death.
D)Becomes agitated whenever someone refers to the spouse's death or "moving on."

Question 15

When a 66-year-old patient dies as a result of surgical complications,the nurse begins to facilitate the family's acceptance of their loss by:

A)preparing each family member sufficiently prior to viewing the body of their loved one.
B)presenting the body of their loved one in an appropriate,respectful manner.
C)assuring them that the patient received the best possible care postsurgery.
D)providing them with an effective explanation of the problems that caused the patient's death.

Question 16

A patient has been grieving the loss of a spouse and seems to be doing surprisingly well when a beloved pet dies.The patient demonstrates extreme signs of sadness and despair,saying,"I cannot possibly go on without Kitty." When working with the family,what does the nurse suggest?

A)Get the patient another cat.
B)Suggest the patient see the physician.
C)Refer the patient to a grief therapist.
D)Suggest they take the patient on a trip.

Question 17

The nurse shows an understanding of the primary factor that facilitates the adjustment to the loss of a spouse when asking:

A)"Are you planning to continue to run your flower shop?"
B)"How long were you and your spouse married?"
C)"Does your son and his family live nearby?"
D)"Do you consider yourself a religious person?"

Question 18

The family members of a dying patient are distressed at the patient's restlessness and lack of sleep.They ask the nurse to "just give her something." What response by the nurse is best?

A)Administer a sedative or hypnotic.
B)Tell the family she'll soon be sleeping enough.
C)Try nonpharmacologic comfort measures.
D)Explain that medications are not used in this case.

Question 19

The nurse determines that the daughter of a widowed older adult patient has a poor understanding of the grieving process when she reports that:

A)"Mom is going to be okay;she is a strong,independent woman."
B)"It's been 16 months since Dad died,but Mom still hasn't moved on with her life."
C)"My mother has agreed to come and live with me for at least a little while."
D)"My mom cries when she looks at pictures of Dad,but I think she needs to cry."

Question 20

The nurse is confident that an older adult is successfully completing the tasks associated with mourning his wife's death when he:

A)shares that,"No amount of wishing will bring her back."
B)openly cries in the presence of family and friends.
C)takes cooking classes at the local community college.
D)takes a female acquaintance to the movies.

Question 21

A dying patient is being cared for at home.The family relates to the hospice nurse that they are distressed that the patient no longer wants favorite food items.What response by the nurse is best?

A)"Dying people don't usually want to eat."
B)"Your loved one won't starve to death."
C)"Why do you insist of trying to feed her?"
D)"Is there another way you can show caring?"

Question 22

A nurse working with a dying patient would expect to add interventions to the care plan to address which needs? (Select all that apply. )

A)Pain
B)Dyspnea
C)Delirium
D)Dementia
E)Restlessness

Question 23

A dying older patient has dyspnea,which causes anxiety.What action by the nurse is best?

A)Provide oxygen for a saturation less than 90%.
B)Provide a cool fan to blow on the patient.
C)Administer prescribed morphine sulfate.
D)Administer a prescribed bronchodilator.