Answer Options:
a. “I understand you’re feeling upset. Let’s go to our conference room, and I’ll stay with you until your family comes.”
b. “Your husband’s heart was severely damaged and could no longer pump. There’s nothing anyone could have done.”
c. “I will call the nursing supervisor to discuss this matter with you.”
d. “It will be all right if you cry. Crying is a normal grief response.”
Answer: a. “I understand you’re feeling upset. Let’s go to our conference room, and I’ll stay with you until your family comes.”
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 Options:
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: A patient’s fiancé died in an automobile accident several days ago. The patient reports crying a lot and feeling bouts of guilt and anger. This behavior is most characteristic of which stage of grief?
Answer Options:
a. Denial
b. Bargaining
c. Development of awareness
d. Preoccupation with the loss
Answer: c. Development of awareness
Question: Shortly after a man’s wife dies, the man approaches the nurse who cared for his wife during her final hours of life and says angrily, “If you had given your undivided attention, she would still be alive.” Which analysis applies?
Answer Options:
a. The husband will pursue legal action regarding the nurse’s negligence.
b. Anger is a phenomenon experienced during grieving.
c. The husband had ambivalent feelings about his wife.
d. In some cultures, grief is expressed exclusively by anger.
Answer: b. Anger is a phenomenon experienced during grieving.
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 Options:
a. Ask the patient to reconsider the decision because many interested and caring friends can be sources of support.
b. Discuss the request with the parents and sibling. Suggest that they explain the patient’s decision to friends.
c. Suggest that the patient discuss these wishes with the health care provider.
d. Place a “no visitors” sign on the patient’s door.
Answer: b. Discuss the request with the parents and sibling. Suggest that they explain the patient’s decision to friends.
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 Options:
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 behavior.
Answer: b. Feelings of inadequacy in dealing with complex emotional needs.
Question: A patient cries as the nurse explores the patient’s relationship with a deceased parent. The patient says, “I shouldn’t be crying like this. It happened a long time ago.” Which responses by the nurse will facilitate communication? (Select all that apply.)
Answer Options:
a. “Why do you think you are so upset?”
b. “I can see that you feel sad about this situation.”
c. “The loss of your parent is very painful for you.”
d. “Crying is a way of expressing the hurt you’re experiencing.”
e. “Let’s talk about something else because this subject is upsetting you.”
Answer: A. “Why do you think you are so upset?”
B. “I can see that you feel sad about this situation.”
C. “The loss of your parent is very painful for you.”
D. “Crying is a way of expressing the hurt you’re experiencing.”
Question: A patient diagnosed with severe and persistent mental illness lives independently. This patient often has command hallucinations and shouts warnings to neighbors. After a short hospitalization, the patient’s landlord says, “You can’t come back here. You cause too much trouble.” What problem is the patient experiencing?
Answer Options:
a. Grief
b. Stigmatization
c. Recidivism
d. Lack of insurance parity
Answer: b. Stigmatization
Question: A college student reports that, “My vision is too blurry to read effectively, especially when it’s time to be studying for a test.” Which health problem should be considered initially?
Answer Options:
a. Malingering
b. Illness anxiety
c. Factitious disorder
d. Functional neurological disorder
Answer: A. Malingering
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 Options:
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: 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 Options:
a. Prohibits their other children from swimming lessons.
b. Sets a place for the deceased child at the family dinner table.
c. Keeps their child’s room exactly as the child left it.
d. Throw flowers on the lake at each anniversary date of the accident.
Answer: d. Throw flowers on the lake at each anniversary date of the accident.
Question: The partner of a patient in hospice care 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 Options:
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: 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 Options:
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 recently widowed patient tells the health care provider, “I have so much epigastric discomfort. I wonder if I have an ulcer.” Diagnostic tests are negative. What does the symptom likely demonstrate?
Answer Options:
a. Early reorganization behavior
b. Disorganization and depression
c. Preoccupation with the deceased
d. Normal phenomenon of mourning
Answer: d. Normal phenomenon of mourning
Question: What situation makes the mourning process more difficult for the bereaved?
Answer Options:
a. They were relatively independent of the deceased.
b. They have experienced many previous losses.
c. They accept that death is expected for everyone.
d. They had resolved conflicts with the deceased.
Answer: b. They have experienced many previous losses.
Question: When a widowed man states, “It’s difficult getting used to sleeping in our bed alone.” How is the work of mourning best characterized?
Answer Options:
a. It is beginning.
b. It is progressing abnormally.
c. It is at or near completion.
d. It has not yet begun.
Answer: c. It is at or near completion.
Question: After the death of a spouse, an adult repeatedly says, “I should have made him go to the doctor when he said he didn’t feel well.” What response is this individual likely experiencing?
Answer Options:
a. Preoccupation with the image of the deceased
b. Sensations of somatic distress
c. Anger
d. Guilt
Answer: d. Guilt
Question: Which finding indicates the successful completion of an individual’s grieving process?
Answer Options:
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: 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 Options:
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 person whose spouse died 2 years earlier tells friends, “I think I’m ready to start going out socially, maybe even take someone to dinner.” What does this comment best demonstrate about the individual’s state of mind?
Answer Options:
a. Is denying the significance of the loss.
b. Is in a period of grief resolution.
c. Is actively working through grief.
d. Is experiencing intrusion.
Answer: b. Is in a period of grief resolution.
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 Options:
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