Grief Loss Death (Pearson)

Question 1

An adult patient reports a parent dying when the patient was 4 years of age. In which way should the nurse suspect the patient experienced grief while growing up?

Answer 1

Reprocessing

Question 2

The family of a patient who is dying will not leave the bedside. Which information should the nurse instruct the family about grief?

Answer 2

It is a social process (Grief is a social process; it is best shared and carried out with the assistance of others. Experiencing grief alone can be detrimental to the individual experiencing the grief. Grief can be explored in and out of therapy.

Question 3

A patient whose only child has died no longer identifies as a parent. Which behavioral response to grief should the nurse recognize the patient is exhibiting?

Answer 3

Relinquishing of roles (In the healing phase of Sander’s phases of bereavement, the patient relinquishes past roles, such as that of a parent, and learns to live without the loved one) [Additional behavioral responses in the healing phase of bereavement include:
Assuming control.
Restructuring identities.
Forgiving and forgetting.
Searching for meaning.]

Question 4

A patient who is terminally ill reports being afraid to die. Which symptoms should the nurse expect to find upon assessment?

Answer 4

Anorexia, dry mouth, tachycardia, and tachypnea (An individual who is fearful can experience increased pulse and respirations, dry mouth, and anorexia. The other symptoms are not associated with fear.)
Additional symptoms of fear include:

Crying.
Immobility.
Insomnia.
Nightmares.

Question 5

A patient is scheduled for a below-the-knee amputation. For which type of grief should the nurse plan care?

Answer 5

Anticipatory

Question 6

A patient who is a recent widow describes missing the spouse too much to ever imagine being with someone new. Which stage of grief according to Engel should the nurse identify for this patient?

Answer 6

Resolving the loss (Resolving the loss occurs when the individual is unable to replace the lost individual.)
Engel’s stages of grieving are:
* Shock and disbelief.
* Developing awareness.
* Restitution.
* Resolving the loss.
* Idealization.
* Outcome.

Question 7

The nurse is assessing a patient who is terminally ill. Which statement should indicate a patient is in the depression stage of grieving?

Answer 7

“I’ve made so many mistakes in my life, and it’s too late to change them.”

Question 8

A patient is actively dying from metastatic breast cancer. Which intervention should the nurse prioritize?

Answer 8

Pain management

Question 9

A dying patient yells at the nurse because there is no ice in the water delivered with a meal.
Which action should the nurse take?

Answer 9

Help the patient understand the feelings of anger.

Question 10

A patient whose only child has died no longer identifies as a parent.
Which behavioral response to grief should the nurse recognize the patient is exhibiting?

Answer 10

Relinquishing of roles

Question 11

A patient has not met the goal of resolving grief.
Which question should the nurse ask to evaluate why the goal was unachieved?

Answer 11

Is the patient experiencing additional stressors?

Question 12

A patient whose spouse died refuses visitors and stays home alone, reminiscing about happy memories. Which stage of the phases of bereavement should be identified for this patient?

Answer 12

Conservation

Question 13

The nurse is caring for a patient who is in a persistent vegetative state (PVS).
Which information should the nurse share with the family?

Answer 13

The patient’s respiratory system is still functioning. (A PVS is characterized by loss of cognitive function and awareness, but maintenance of respiration and circulation. The patient in a PVS may have a variety of facial, eye, and limb movements, but does not speak.)

Question 14

The nurse assesses a patient’s grieving process.
Which statement should demonstrate that the patient is in the resolving the loss stage?

Answer 14

“I miss my spouse very much and can’t imagine remarrying.”
(Resolving the loss occurs when the individual is unable to replace the lost individual. Refusing to accept the loss demonstrates shock and disbelief. Beginning to understand the reality of the loss demonstrates developing awareness. Feeling guilty about past acts toward the deceased demonstrates idealization.)

Question 15

The nurse is caring for a patient who is terminally ill. For which health problem should the nurse expect morphine to be prescribed?

Answer 15

Acute dyspnea (Morphine helps ease the work of breathing in a patient who is terminally ill and experiencing dyspnea.)

Question 16

A patient who has recently experienced the loss of a spouse shouts at the nurse in anger. Which stage of grief according to Engel should the nurse recognize the patient is experiencing?

Answer 16

Developing awareness (Grieving patients can lash out in anger during the developing awareness stage of Engel’s stages of grieving - During the developing awareness stage, the reality of the loss begins to penetrate the patient’s consciousness.)

Question 17

The family of a patient who is dying will not leave the bedside. Which information should the nurse instruct the family about grief?

Answer 17

It is a social process.

Question 18

A patient who did not cry during a spouse’s funeral breaks down and sobs weeks later. Which type of grief should be identified for this patient?

Answer 18

Delayed

Question 19

An older patient misses having the ability to drive independently. Which type of loss should the nurse suspect the patient is experiencing?

Answer 19

Perceived

Question 20

The family of a dying patient asks what they can do to make the patient more comfortable. Which suggestion should the nurse make?

Answer 20

Give massages to decrease pain. (The family can use massage to reduce pain and promote comfort in the patient who is terminally ill.)

Question 21

The nurse is caring for a patient in hospice. For which reason should the nurse encourage the patient to tell stories about the past to grandchildren?

Answer 21

Know life has meaning

Question 22

A patient who recently lost a spouse reports that their 10-year-old child has started wetting the bed again. Which information should the nurse provide?

Answer 22

Children who experience the loss of a parent may regress to an earlier developmental stage.

Question 23

The nurse coordinates referrals for patients. Which patient should the nurse refer to hospice care?

Answer 23

Patient with end-stage renal disease and a prognosis of 3 months

Question 24

A patient with a terminal illness is experiencing a dry mouth, tachycardia, and tachypnea. Which feeling should be associated with these symptoms?

Answer 24

Fear (An individual who is fearful can experience increased pulse and respirations, dry mouth, and anorexia - Additional symptoms of fear include: Crying. Immobility. Insomnia.
Nightmares.)

Question 25

A patient who is terminally ill is experiencing anorexia. Which action should the nurse take?

Answer 25

Encourage liquid foods as tolerated. (A small amount of an alcoholic beverage can be used to stimulate a patient’s appetite. - Many patients with a terminal illness experience anorexia.)

Question 26

The family of a patient who is terminally ill refuses to discuss the patient’s prognosis.

In which way should the nurse document this dynamic?

Answer 26

Mutual pretense (the patient and family know the prognosis is terminal but do not talk about it and make an effort not to raise the subject.)

Question 27

A patient with a terminal illness feels sad about not being able to watch grandchildren grow up. Which concept of grief should be included in the patient’s plan of care?

Answer 27

Anticipatory (Anticipatory grief is experienced in advance of the event, such as the patient feeling sad about not being alive long enough to see grandchildren grow up)

Question 28

The family of a dying patient asks what they can do to make the patient more comfortable. Which suggestion should the nurse make?

Answer 28

Give massages to decrease pain.

Question 29

A patient who is a recent widow describes missing the spouse too much to ever imagine being with someone new. Which stage of grief according to Engel should the nurse identify for this patient?

Answer 29

Resolving the loss (Resolving the loss occurs when the individual is unable to replace the lost individual.)

Question 30

A patient begins to express feelings of grief to the nurse.

Which action should the nurse take?

Answer 30

Use silence to encourage exploration of feelings.