Question 1

An Aboriginal client has died in hospital and no family or community members were present. What action might the nurse take?

Accepted Answer

A,C,D

Question 2

The client tells the nurse that she has been having problems sleeping since her boss died unexpectedly three weeks ago. She confides that she and the boss had been having a secret extramarital affair for years. The nurse recognises that the sleeping difficulty is most likely a result of which of the following?

Accepted Answer

The client is experiencing disenfranchised grieving, as she cannot openly mourn the loss of her boss due to the secret nature of their relationship. This can manifest in symptoms such as difficulty sleeping. Abbreviated grief occurs when the grieving process is cut short due to external circumstances such as cultural expectations or sudden death. Chronic grief is characterized by prolonged and intense grieving that may not improve over time. External grief refers to grief triggered by external events such as a major disaster or national tragedy, rather than the loss of an individual.

Question 3

A client who has just been diagnosed with a slowly progressive terminal illness asks the nurse about hospice care and how his wife can find out more about it. What information should the nurse share with this client?

Accepted Answer

Hospice care can be provided in a variety of settings, including the client's own home or a care facility, and the focus is on managing symptoms and providing comfort rather than curative treatments. Hospice care is not limited to those who refuse other treatments, nor is it limited to those with private insurance. Additionally, hospice care does not necessarily refer to a specific facility but rather a philosophy of care.

Question 4

The nurse critically evaluates various models of grief used for terminally ill clients and their families. What should the nurse recognise when applying these models to individual cases?

Accepted Answer

The nurse should recognize that no clear timetables exist, nor are there clear-cut stages of grief. While these models can provide a general framework for understanding grief, they should not be applied rigidly or used as definitive predictors of grief behaviors. Each individual's grief experience is unique and should be assessed and addressed in a holistic manner.

Question 5

The nurse who is providing post-mortem care for a client sees that the client is wearing a ring. What is the most important action regarding this observation?

Accepted Answer

The answer of The nurse who is providing post-mortem care...

Question 6

Following the death of an Aboriginal client, the family begins to wail. What would be the most appropriate course of action for the nurse?

Accepted Answer

Adjusting bed allocations to accommodate the family respects their cultural practices and provides them with the space and privacy needed to grieve in their own way. This approach is sensitive to their needs and respects their cultural traditions.

Question 7

The family of a young adult client who has recently been diagnosed with a rapidly progressing terminal illness tells the nurse, "This cannot be happening. There must be some mistake in the testing." What should be the nurse's first step in assisting this family?

Accepted Answer

The nurse's first step in assisting the family should be to examine their own feelings and ensure they are not in a state of denial. This will allow the nurse to provide appropriate support and care for the family during this difficult time. Once the nurse has addressed their own emotional state, they can then allow the family to express their sadness and offer spiritual support if appropriate. Providing structure and continuity can also be helpful, but it is not the first step in this situation.

Question 8

The nurse needs to help prepare the family of an unconscious, terminally ill client. What questions might the nurse ask the family during an assessment interview?

Accepted Answer

All of these questions are appropriate for the nurse to ask during an assessment interview to help prepare the family of an unconscious, terminally ill client. A) helps to identify any previous experiences with death and dying, B) encourages the family to think about their preferences for saying goodbye, C) addresses their potential desire to view the body, and D) assesses their own coping strategies and well-being.

Question 9

A young teenage girl, who as a consequence of sexual assault becomes pregnant, undergoes an abortion. The nurse caring for this client would anticipate that she would be at risk for:

Accepted Answer

Disenfranchised grief occurs when an individual's grief is not acknowledged or validated by society, such as in the case of a young girl who has an abortion following a sexual assault. This situation may lead to feelings of isolation and a sense that her loss is not recognized or supported by others.

Question 10

The nurse is counselling a family in which a member is terminally ill. The family has children of varying ages. What should the nurse teach the family about the reactions of children to death?

Accepted Answer

Around the age of nine, children begin to understand that death is final. Toddlers, on the other hand, may perceive death as unnatural and temporary, and preschool children may view it as a spiritual release. Adolescents may struggle with loss and sometimes have worse outcomes than adults. It is important for the nurse to educate the family about the unique reactions and needs of children of different ages during this difficult time.

Question 11

During the bath, the client suddenly says, "I am not going to get well. I think I am going to die." What response, given by the nurse, is most appropriate?

Accepted Answer

The nurse should acknowledge and address the client's statement by asking open-ended questions to understand the client's concerns and feelings. This response shows empathy and encourages communication, which can help the client feel heard and understood. The other responses either ignore or dismiss the client's statement or offer vague platitudes, which may not be helpful to the client.

Question 12

Following the death of a client, the family have come to perform last rites as part of their cultural beliefs. One of the family members asks the nurse why there is discolouration on the client's hips. The nurse advises that it is:

Accepted Answer

Livor mortis is the discolouration that occurs on the dependent parts of the body after death. This is due to the settling of blood in the blood vessels due to the loss of circulation.

Question 13

The nurse is assigning support personnel to assist families (of clients who have died) in dealing with the stress related to the loss of their family member. Which family would the nurse screen as highest risk for complicated grief? The family of a client who:

Accepted Answer

Families of individuals who die suddenly and violently, such as in a robbery, are at a higher risk for complicated grief due to the unexpected and traumatic nature of the death.

Question 14

Following the death of an ndigenous client in hospital, the nurse should ensure that:

Accepted Answer

In many Indigenous cultures, it is a cultural practice to avoid speaking the name of the deceased to show respect and to help the spirit move on.

Question 15

A nurse is providing end-of-life care for a client. Whilst undertaking hygiene measures for the client he/she notices that the client's hands and feet feel very cold. She contacts the relatives to come in as:

Accepted Answer

Cold hands and feet are often a sign that the body is beginning to shut down and is a common feature in the dying process. It is important to inform the family so that they have the opportunity to be with their loved one during this important time.

Question 16

The nurse is working with a father and his three children, ages 10, 14 and 17. The mother recently died after a long illness. The children are doing poorly in school and the father is having a difficult time keeping up with household chores. He has recently taken on a second job to help pay his late wife's hospital bills. Which of the following nursing diagnoses should the nurse consider in planning care for this family?

Accepted Answer

The answer of The nurse is working with a father...

Question 17

A client who has HIV/AIDS tells the nurse, "I don't know why I should even keep trying. This disease is so horrible and so many people die from it. It will get me, too." The nurse recognises this statement as which of the following?

Accepted Answer

The client's statement is indicative of hopelessness and displays a negative attitude towards their illness. It is important for the nurse to further evaluate the client's mental state and offer support and treatment options. It is not proof of the client accepting the facts of the illness and impending death, as this statement expresses a negative attitude towards it. It is not just a simple statement of facts regarding HIV/AIDS, as it expresses the client's hopelessness and fear of death. While it is common for those facing the end of life to have thoughts and feelings of hopelessness, it is important for the nurse to address and evaluate these feelings to provide appropriate care.

Question 18

The nurse is caring for the family of a terminally ill client. The family members have been tearful and sad since the diagnosis was given. What is the best choice of nursing diagnosis problem statements for this family?

Accepted Answer

Anticipatory Grieving is the best choice because the family is already experiencing grief and sadness at the diagnosis of a terminal illness in a loved one. This diagnosis acknowledges their current emotional state and allows the nurse to provide appropriate support and interventions to facilitate coping. Dysfunctional Grieving and Hopelessness may be appropriate if the family's grief becomes prolonged or significantly interferes with their ability to function, but not at this time. Caregiver Role Strain may be appropriate if the family is struggling with taking care of their loved one, but it is not the best choice given the information provided.

Question 19

The nurse is providing post-mortem care for a client whose family would like to view the body before it is transported to the morgue. Which of the following interventions are necessary for this preparation?

Accepted Answer

Placing absorbent pads beneath the body helps manage any bodily fluids, and placing a pillow under the head gives a more natural appearance.

Question 20

During a home visit, the elderly male client tells the nurse that his wife died three years ago. Which action would the nurse interpret as being a possible indicator that this client is experiencing complicated grief?

Accepted Answer

The answer of During a home visit, the elderly male...

Quiz 44: Loss, Grieving and Death