Question: Which finding indicates the successful completion of an individual’s grieving process?
Answer Choices: a. For 2 years, a person has kept the deceased spouse’s belongings in their usual places. b. After 15 months, a widowed person realistically remembers both the pleasures and disappointments of the relationship with the spouse. c. 3 years after the death, a person talks about the spouse as if the spouse was still alive and weeps when others mention the spouse’s name. d. 18 months after the spouse’s death, a person says, “I never cry or have feelings of loss even though we were always very close.”
Answer: b. After 15 months, a widowed person realistically remembers both the pleasures and disappointments of the relationship with the spouse.
Question: A child drowned while swimming in a local lake 4 years ago. Which behavior indicates that the parents are effectively coping with their loss?
Answer Choices: a. Prohibits their other children from swimming. b. Sets a place for the deceased child at the family dinner table. c. Keeps the child’s room unchanged. d. Throws flowers into the lake at the child’s anniversary date of the accident.
Answer: d. Throws flowers into the lake at the child’s anniversary date of the accident.
Question: A patient diagnosed with metastatic brain cancer says, “I’m dying, but I’m still living. I want to be in control as long as I can.” Which reply shows the nurse was actively listening?
Answer Choices: a. “Our staff will do their best to help you feel comfortable.” b. “Most people do not know how to help and are afraid of death.” c. “Although your body is frail, your mind and spirit are healthy.” d. “You want people to stop focusing on your weaknesses.”
Answer: c. “Although your body is frail, your mind and spirit are healthy.”
Question: A terminally ill patient says, “I know I’m not going to get well, but still.” and the patient’s voice trails off. Which response by the nurse is therapeutic?
Answer Choices: a. “What do you hope for?” b. “No, you’re not going to get well.” c. “Do you have questions about what is happening?” d. “I’m happy you are being realistic about your future.”
Answer: a. “What do you hope for?”
Question: A woman whose husband is terminally ill says, “I don’t want to cry in front of him. I don’t want him to know how soon death will occur or how sad I am.” Which response by the nurse would be most therapeutic?
Answer Choices: a. “I’m glad you are protecting him at a time when he is so vulnerable.” b. “He might be more comforted than disturbed by your tears.” c. “It’s important for you to know that time is running out.” d. “You definitely need to be honest about your feelings.”
Answer: b. “He might be more comforted than disturbed by your tears.”
Question: A family of a terminally ill patient asks the nurse, “What can we say when our family member mentions death is coming soon?” Which response could the nurse suggest?
Answer Choices: a. “We think you will be around for a long time.” b. “We don’t want you to give up trying to get well.” c. “We don’t think we’re ready to talk about this yet.” d. “We feel so sad when we think of life without you.”
Answer: d. “We feel so sad when we think of life without you.”
Question: As death approaches, a patient diagnosed with acquired immunodeficiency syndrome (AIDS) says, “I don’t want to see a lot of visitors anymore. Just my parents and my sibling can come in for a while each day.” What action should the nurse take?
Answer Choices: a. Arrange a meeting so the patient can explain the decision to family members. b. Suggest to the patient that family members are here to provide support. c. Restrict visitors to the patient’s parents and sibling each day. d. Explain to the patient that family will need more time with the patient.
Answer: c. Restrict visitors to the patient’s parents and sibling each day.
Question: A nurse manager notices that a staff member spends minimal time with a patient diagnosed with AIDS who is terminally ill. The patient says, “I’m having intense emotional reactions to this illness. Sometimes I feel angry, but other times I feel afraid or abandoned.” The nurse manager can correctly hypothesize that the most likely reason for the staff member’s avoidance is triggered by what?
Answer Choices: a. Fear of infection transmission. b. Feelings of inadequacy in dealing with complex emotional needs. c. Belief that the patient needs time alone with family and friends. d. Knowledge that the patient’s former lifestyle included high-risk behaviors.
Answer: b. Feelings of inadequacy in dealing with complex emotional needs.
Question: A terminally ill patient tells the nurse, “Life has been good. I am proud of my education. I overcame adversity with willpower. I always gave my best and expected things to turn out well. I intend to die as I lived: optimistically.” The nurse planning care for this patient recognizes a critical need to focus on maintaining the patient’s state of mind?
Answer Choices: a. Providing aggressive pain and symptom management b. Helping the patient reassess and explore existing conflicts c. Assisting the patient to focus on the meaning in life and death d. Supporting the patient’s use of personal resources to meet challenges
Answer: d. Supporting the patient’s use of personal resources to meet challenges
Question: The partner of a patient in hospice care angrily tells the nurse, “The care provided by the aide and other family members is inadequate, so I must do everything myself. Can’t anyone do anything right?” How best should the palliative care nurse respond?
Answer Choices: a. Providing teaching about anticipatory grieving b. Assigning new personnel to the patient’s care c. Arranging hospitalization for the patient d. Refer the partner for crisis counseling
Answer: a. Providing teaching about anticipatory grieving
Question: An individual was killed during a store robbery 2 weeks ago. The widowed spouse, who was diagnosed 6 years ago with schizoaffective disorder, cries spontaneously when talking about the death. Which is the nurse’s most therapeutic comment?
Answer Choices: a. “I’m worried about how much you’re crying. Your grief over your spouse’s death has gone on too long.” b. “The unexpected death of your spouse must be painful. I’m glad you’re able to talk to me about your feelings.” c. “This loss is harder to accept because of your mental illness. Let’s refer you to the partial hospitalization program.” d. “Every day shows me you aren’t coping well. I made an appointment for you to see the psychiatrist for medication adjustment.”
Answer: b. “The unexpected death of your spouse must be painful. I’m glad you’re able to talk to me about your feelings.”
Question: Children of a widowed parent confer with the nurse; their surviving parent repeatedly relates the details of finding the deceased parent not breathing, performing cardiopulmonary resuscitation, going to the hospital by ambulance, and seeing the pronouncement of death. The family asks, “What can we do?” How should the nurse best counsel the family?
Answer Choices: a. Encouraging them to share their own feelings with the surviving parent and ask for the retelling to stop b. Support the ideas that retelling the story should be limited to once daily to avoid unnecessary stimulation c. Share with them that retelling memories is to be expected as part of the aging process d. Reassure them that repeating the story is a helpful and a necessary part of grieving
Answer: d. Reassure them that repeating the story is a helpful and a necessary part of grieving
Question: A widow grieving her husband’s sudden and unexpected death tells the nurse, “I’m not feeling well. Yesterday, I saw my husband walk through the door, stop, and smile at me. Then he just faded away.” Which is the nurse’s most appropriate action?
Answer Choices: a. Assess for recent substance abuse. b. Suggest a referral to the mental health clinic. c. Arrange for an evaluation for antidepressant medication. d. Counsel the widow that visualizations are a normal part of grieving.
Answer: d. Counsel the widow that visualizations are a normal part of grieving.
Question: A grieving patient tells a nurse, “It’s been 8 months since my spouse died. I thought I would feel better by now, but lately I feel worse. I have no energy. I am lonely, but I don’t want to be around people. What should I do?” What is the nurse’s best counseling?
Answer Choices: a. Join a support group. b. Become active in a church. c. Go to the spouse’s grave every day. d. Understand this is a normal response.
Answer: d. Understand this is a normal response.
Question: A nurse cared for a terminally ill patient for over a month and always looked forward to spending time with the patient. When the patient died, the nurse experienced sadness and felt mildly depressed. Eventually, the nurse explains these feelings to a mentor. What should be the mentor’s focus should counseling the nurse?
Answer Choices: a. Implementing stress-reduction strategies b. Seeking therapy for dysfunctional grief c. Discussing the experience of disenfranchised grief d. Considering taking a leave of absence to pursue healing
Answer: c. Discussing the experience of disenfranchised grief
Question: Which actions by a nurse contribute to protecting the rights of patients who are terminally ill? (Select all that apply.)
Answer Choices: a. Maintain hope for a positive prognosis. b. Hug the patient when sadness is expressed. c. Offer choices that promote personal control. d. Provide interventions that convey respect. e. Support the patient’s quest for spiritual growth.
Answer: c. Offer choices that promote personal control. d. Provide interventions that convey respect. e. Support the patient’s quest for spiritual growth.
Question: What statements by a patient who is terminally ill give the nurse information relevant to spiritual assessment? (Select all that apply.)
Answer Choices: a. “I feel an inner peace with my decision to use hospice services.” b. “I trust my health care provider to prescribe enough medication to keep me free of pain.” c. “I have prepared advance directives to spare my children the need to make difficult decisions.” d. “I plan to use these last weeks to experience the process of dying as fully as I experienced the richness of living.” e. “Listening to hymns helps deepen my relaxation and the relief I get from my pain medication.”
Answer: a. “I feel an inner peace with my decision to use hospice services.” d. “I plan to use these last weeks to experience the process of dying as fully as I experienced the richness of living.” e. “Listening to hymns helps deepen my relaxation and the relief I get from my pain medication.”
Question: Psychotherapy for individuals at risk for complicated grief focuses on which goals? (Select all that apply.)
Answer Choices: a. Exploring cognitive-behavioral techniques. b. Integrating losses into the patient’s life. c. Relieving the pain of grief. d. Providing support to the patient’s family. e. Identifying and resolving conflicts.
Answer: b. Integrating losses into the patient’s life. c. Relieving the pain of grief. e. Identifying and resolving conflicts.