Question 1

After the anticipated demise of a chronically ill patient,the unit nurse is found crying in the staff lounge.What would be the best response to her crying?

Accepted Answer

Nurses often witness suffering on a daily basis.Nurses,as humans,also experience grief and loss when they have been intensely involved in the patient's suffering and death.Offer comfort and understanding to colleagues,and maintain a stable patient care environment.It is inappropriate to create guilt by telling a grieving nurse to hurry back to her patients or by indicating that she is a bad role model.Suggesting that a colleague take sedative during a shift is dangerous for the safety of patients in her care.

Question 2

A correctional facility nurse is called to the scene of death of an inmate under suspicious circumstances.The correction officer wants to move the body to the funeral home quickly because he is not comfortable with death.The inmate's body will need to be transported where?

Accepted Answer

A physician will often request that an autopsy be performed if death occurred under unusual circumstances;as the result of foul play,homicide,or suicide;or as an accidental death,as occurs in car accidents.The nurse must understand the policies that are applied in cases of foul play death and must ensure that the decedent's body is properly cared for after death,despite the emotional feelings of individuals in close contact with the decedent.

Question 3

"I know it seems strange,but I feel guilty being pregnant after the death of my son last year," said a woman during her routine obstetrical examination.The nurse spends extra time with this woman,helping her to better bond with her unborn child.This demonstrates which nursing technique?

Accepted Answer

The nurse facilitates mourning in family members who are still surviving.By acknowledging the pregnant woman's emotions,the nurse helps the mother bond with her fetus and recognize the emotions that still exist for the deceased child.The nurse is not attempting to help the patient eradicate grief,which would be unrealistic.Curative therapy and spiritual promotion are not addressed by the nurse's statement.

Question 4

A family is grieving after learning of a family member's accidental death.The transplant coordinator requests to talk with the family about possible organ and tissue donation.The nurse recognizes which of the following?

Accepted Answer

The transplant coordinator should always meet with family members in a private,quiet area.Not all religions allow for organ donation.A patient may be on life support during organ removal to preserve organ tissues.Autopsy compromises organ integrity;removal should occur before that.

Question 5

A patient with cancer asks the nurse when he or she will be able to access palliative care.On the basis of the knowledge about palliative care,what will the nurse's response be?

Accepted Answer

Palliative care can help patients achieve optimal pain management.It is for any age,any diagnosis,and at any time,not just during the last few months of life.Hospice care is an option when the patient is expected to live less than 6 to 12 more months.An advance directive can include information about palliative care but is not required for such care to be initiated.

Question 6

A couple is informed that their fetus's condition is incompatible with life after birth.Nurses can best help the couple with their end-of-life decision making by offering them which of the following?

Accepted Answer

Families can have limited knowledge when asked to make important ethical decisions.Nurses have the time,patience,and knowledge base to help the family understand their ethical situation and to help them make their own educated decision,rather than giving them instructions.Advance directives are completed by the person who is dying.Funeral guidance is best provided by a chaplain or a caretaker.

Question 7

Three of the nurse's patients have died during the past 2 days.Which approach is most appropriate to manage the nurse's sadness?

Accepted Answer

Self-care strategies for nurses include talking with a close colleague and reflecting on feelings by writing in a journal.It is inappropriate for a nurse to talk with patients to resolve the nurse's grief.Although exercise is important for self-care,sleep is also important.Shutting oneself away from friends is not self-care;the nurse should spend time with people who are nurturing.

Question 8

A severely depressed patient cannot state any positive attributes to his or her life.The nurse patiently sits with this patient and assists the patient to identify several activities the patient would actually look forward to in life.The nurse is helping the patient to demonstrate which spiritual concept?

Accepted Answer

The concept of hope is vital to human beings;it enables a person to anticipate positive experiences.Being patient and friendly and creating positive relationships are key concepts in all areas of nursing,but especially with depressed patients.The nurse's actions do not address time management,charity,or faith.

Question 9

Validation of a dying person's life would be demonstrated by which nursing action?

Accepted Answer

Listening to family members' stories validates the importance of the dying patient's life and reinforces the patient's dignity.Taking pictures of visitors does not address the value of a person's life.Calling an organ donation coordinator and providing private visiting time are components of the dying process,but they do not validate a dying person's life.

Question 10

A terminally ill patient is experiencing constipation secondary to pain medication.What is the best way for the nurse to improve the patient's constipation problem?

Accepted Answer

Opioid medication is known to slow gastrointestinal transit time,which places the patient at high risk for constipation.Stimulant laxatives are indicated for opioid-induced constipation.Added water to the diet allows water to be pulled into the gastrointestinal tract,which helps soften stool.Massaging the patient's abdomen may cause further discomfort.Discontinuing pain medication is inappropriate for a terminally ill patient.Enema administration is not the first step in the treatment of opioid-induced constipation.

Question 11

The father has recently begun to attend his children's school functions since the death of his wife.This would best be described as which task in the Worden's grief tasks model?

Accepted Answer

The Worden grief tasks model consists of four tasks.In Task III,the surviving family member begins to adjust to life without the deceased.Task I is accepting the reality of the loss;Task II is working through the pain of grief;and Task IV is emotionally relocating the deceased and moving on with life.

Question 12

The nurse is discussing future treatments with a patient who has a terminal illness.The nurse notes that the patient has not been eating and responds to the nurse's information by stating,"What does it matter?" What is the most appropriate nursing diagnosis for this patient?

Accepted Answer

A defining characteristic for the nursing diagnosis of Powerlessness may include a statement by the patient such as "What does it matter?" when offered choices or information concerning him or her.The patient's behaviour and verbalization is not an example of social isolation.The patient is not avoiding others or being restricted from seeing others.Hopelessness is more reflective of the comment,"I have no future" than of "What does it matter?" The patient's behaviour and verbalization does not indicate denial.

Question 13

The newly graduated nurse is assigned to his or her first dying patient.How can the nurse best prepare to care for this patient?

Accepted Answer

When caring for patients experiencing grief,it is important for the nurse to assess his or her own emotional well-being and to understand his or her own feelings about death.The nurse who is aware of his or her own feelings will be less likely to place personal situations and values before those of the patient.Although coursework on death and dying may add to the nurse's knowledge base,it does not best prepare the nurse for caring for a dying patient.The death of a patient can raise many emotions.Being able to control one's own emotions is important;however,it is unlikely that the nurse would be able to do so if he or she has not first acknowledged his or her own feelings about death.The death of a loved one is not a prerequisite to caring for a dying patient.The experience of caring for a dying patient may help a nurse mature in dealing with loss,or it may bring up many negative emotions if complicated grief is present.

Question 14

A nurse encounters a family whose adult child died last year.The parents are talking about the upcoming anniversary of their child's death.The nurse spends time with them discussing their child's life and death.The nurse's action best demonstrates which nursing principle?

Accepted Answer

Anniversaries can reopen grief processes.A nurse should openly acknowledge the loss and talk about the common renewal of grief around the anniversary of the individual's death.This facilitates normal mourning.The nurse is not attempting to alleviate a physical pain.The actions are of open communication,not evaluation.Palliative care refers to comfort measures for relief of physical symptoms.

Question 15

A woman is called into her supervisor's office regarding her deteriorating work performance since the loss of her husband 2 years ago.The woman begins sobbing and saying that she is "falling apart" at home as well.The woman is escorted to the nurse's office,where the nurse recognizes the woman's symptoms as which of the following?

Accepted Answer

An individual undergoing a complicated grieving process that interferes with common routines of life for excessively long periods of time is experiencing complicated (dysfunctional)grief.Normal grief is the most common reaction to death;it involves a complex range of normal coping strategies.Disenfranchised grief involves a relationship that is not socially sanctioned.Perceived grief is not a type of grief;perceived loss is a loss that is not obvious to other people.

Question 16

A man is hospitalized after surgery in which both lower extremities were amputated because of injuries sustained during military service.The nurse should recognize his need to grieve for what type of loss?

Accepted Answer

Loss of a body part from injury is a situational loss.Maturational losses occur as part of normal life transitions.Perceived loss is not obvious to other people.Uncomplicated loss is not a type of loss;it is a description of normal grief.

Question 17

When teaching a group of older persons about cultural beliefs and death,the nurse indicates which of the following?

Accepted Answer

Maintaining the integrity of rituals and mourning practices gives families a sense of acceptance of the patient's death and an inner peace.The nurse should be familiar with policies and procedures,but ethical decisions should be made with an understanding and appreciation of the patient's culture.The nurse must assess the terminally ill patient's and family's wishes for end-of-life care and develop a plan of care by integrating patient culture and spiritual beliefs.On the contrary,the nurse must assess the terminally ill patient's and family's wishes for end-of-life care and develop a plan of care that integrates patient culture and spiritual beliefs with nursing actions.

Question 18

The palliative team's primary obligation to a patient in severe pain includes which of the following?

Accepted Answer

The primary goal of palliative care is to help patients and families achieve the best quality of life.Providing support for the patient's nurse is not the primary obligation when the patient is experiencing severe pain.Not all collaborative team members would be able to provide post-mortem care;nor would nutritionists,social workers,or pharmacists.Teaching about stages of grief should not be the focus when a patient is in severe pain.

Question 19

An identified outcome for the family of the patient with a terminal illness is that family members will be able to provide psychological support to the dying patient.To help the family achieve this outcome,the nurse will develop a teaching plan that will include teaching about which of the following?

Accepted Answer

A dying patient's family is better prepared to provide psychological support if the nurse discusses with them ways to listen and respond to needs and fears of the dying person.Demonstration of bathing techniques and application of oxygen devices may help the family meet the patient's physical needs but would not provide psychological support for the patient.Information on when to contact the hospice nurse is important for the family to have and may help them feel they are being supported in caring for the dying patient.However,contact information does not help the family provide psychological support to the dying patient.

Question 20

Family members gather in the emergency department after learning that a family member was involved in a motor vehicle accident.After learning of the family member's unexpected death,the surviving family members begin to cry and scream in despair.The nurse recognizes this as which stage of Bowlby's attachment theory?

Accepted Answer

Yearning and searching characterize the second bereavement phase in Bowlby's attachment theory.Emotional outbursts are common in this phase.During the numbing phase,the family may feel a sense of unreality.During disorganization and despair,the reason why the loss occurred is constantly questioned.Bargaining is part of the Kübler-Ross stages,not of the Bowlby attachment theory.

Quiz 25: The Experience of Loss, death, and Grief