chapter 12- grief and loss

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1.After being laid off from work, a client becomes increasingly withdrawn and fatigued, spends entire days in bed, is unkempt, and is eating and sleeping poorly. The nurse would recognize that the client is in which stage of grieving, according to Kubler-Ross? A) Anger B) Bargaining C) Denial D) Depression 2.The client says to the nurse, “I really want to see my first grandchild born before I die. Is that too much to ask?” The nurse would recognize that the client is in which stage of grieving, according to Kubler-Ross? A) Acceptance B) Anger C) Bargaining D) Depression 3.A client comes to the physician's office for an annual checkup. During the interview, the nurse learns that the client's husband died unexpectedly of a heart attack 2 months ago. The most appropriate response by the nurse would be, A) “At least you and your husband enjoyed life right until the end.” B) “It's better to go quickly like your husband did instead of suffering.” C) “The loss of your husband must be very painful for you.” D) “You'll feel better after you get over the shock of your husband's death.” 4.A client is talking with the nurse about the death of her son 3 years ago. Which of the following would indicate successful completion of the mourning process? A) All of the son's belongings are still in his room just as he left them before he died. B) Although they were close, the client reports she has never cried or had any negative feelings over her son's death. C) The client reminisces about the pleasures and disappointments of her son. D) The client speaks of her son as though he was still living, weeping as she does so. 5.A woman has just delivered a stillborn baby boy. Which of the following would be the most appropriate nursing response? A) “Can I do anything for you?” B) “If something was wrong, it's better this way.” C) “Your son is in heaven with God now.” D) “Would you like to hold your son?” 6.A client is scheduled for a mastectomy for breast cancer. She is quiet, shows little emotion, and states that she has no questions. The nurse's assessment would need to focus on A) The client's plans for reconstructive surgery Page 1

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Page 1: Chapter 12- Grief and Loss

1.After being laid off from work, a client becomes increasingly withdrawn and fatigued, spends entire days in bed, is unkempt, and is eating and sleeping poorly. The nurse wouldrecognize that the client is in which stage of grieving, according to Kubler-Ross?

A) AngerB) BargainingC) DenialD) Depression

2.The client says to the nurse, “I really want to see my first grandchild born before I die. Is that too much to ask?” The nurse would recognize that the client is in which stage of grieving, according to Kubler-Ross?

A) AcceptanceB) AngerC) BargainingD) Depression

3.A client comes to the physician's office for an annual checkup. During the interview, the nurse learns that the client's husband died unexpectedly of a heart attack 2 months ago. The most appropriate response by the nurse would be,

A) “At least you and your husband enjoyed life right until the end.”B) “It's better to go quickly like your husband did instead of suffering.”C) “The loss of your husband must be very painful for you.”D) “You'll feel better after you get over the shock of your husband's death.”

4.A client is talking with the nurse about the death of her son 3 years ago. Which of the following would indicate successful completion of the mourning process?

A) All of the son's belongings are still in his room just as he left them before he died.B) Although they were close, the client reports she has never cried or had any negative

feelings over her son's death.C) The client reminisces about the pleasures and disappointments of her son.D) The client speaks of her son as though he was still living, weeping as she does so.

5.A woman has just delivered a stillborn baby boy. Which of the following would be the most appropriate nursing response?

A) “Can I do anything for you?”B) “If something was wrong, it's better this way.”C) “Your son is in heaven with God now.”D) “Would you like to hold your son?”

6.A client is scheduled for a mastectomy for breast cancer. She is quiet, shows little emotion, and states that she has no questions. The nurse's assessment would need to focuson

A) The client's plans for reconstructive surgery

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B) The meaning of the mastectomy to the clientC) Whether the client truly understands the surgeryD) Why the client seems depressed

7.A client with terminal cancer has been told he has 3 or 4 months to live. Which of the following would indicate to the nurse that further interventions are needed?

A) The client says he wants to live life to the fullest.B) The client hopes for a peaceful and dignified death.C) The client is reviewing his life and talking about death.D) The client says he is well and is making future plans.

8.The nurse is working with the family of a client who is near death. The client is unresponsive, his extremities are cool, and respirations are shallow. Which of the following actions by the nurse is most appropriate at this time?

A) Ask the family to leave the room.B) Encourage family members to talk to the client.C) Explain that the client is not aware of their presence.D) Leave the family alone with the client.

9.A young client tells the nurse that her husband died 3 months ago, and she is feeling alone and vulnerable. Which statement by the client would indicate that her coping skills are adequate?

A) “I can't understand why this happened to me.”B) “I'm mentally healthy. I can solve my own problems.”C) “I will find a support group.”D) “What can I do? My husband abandoned me.”

10.A couple came to the emergency department with their 5-month-old son. He was pronounced dead of sudden infant death syndrome (SIDS). In the next day or two, it will be important for this couple to

A) Accept that they could do nothing to prevent this deathB) Delay the grieving process until they are ready to copeC) Minimize their discussion of the death with othersD) Plan funeral arrangements for their son

11.A young couple just dissolved their relationship after a 9 month engagement. The one of the individuals is seeking short-term counseling to assist in grieving this loss. Which typeof loss best describes what this patient is experiencing?

A) Safety lossB) Loss of security and sense of belongingC) Loss of self-esteem

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D) Loss related to self-actualization

12.A married couple has just received the news that the husband has terminal cancer. The wife tells the nurse, “Maybe if we get another opinion and start treatment right way there is a chance of survival.” The nurse documents that the wife is expressing signs of which of Kubler-Ross’s stages of grief?

A) DenialB) AngerC) BargainingD) Depression

13.According to Engel, individuals progress through 5 stages when grieving. In which order does Engel describe the grief experience?

A) Developing awarenessB) Shock and disbeliefC) ResolutionD) RestitutionE) Recovery

14.Friends of a teenage male recently killed in a car accident are discussing their sense of loss. Which of the following comments best indicates that the friends are trying to make sense of the loss cognitively?

A) “Why did he have to die so young?”B) “He shouldn’t have been driving so recklessly.”C) “If we had only stayed longer he would not have been on that road.”D) “It took the ambulance too long to get there.”

15.The nurse is working with a woman who lost her partner nearly 3 weeks prior. The woman has recently become less emotional and expressed that few things in her life have meaning right now. Which response by the nurse is most appropriate at this time?

A) “I am concerned. You are starting to show signs of ineffective grieving.”B) “You must feel some anger. It is alright to let that out.”C) “Let’s look at the things in your life that you still enjoy.”D) “You are just starting to accept that this loss is real.”

16.The nurse is working with a patient who lost her youngest child 2 months ago. When the nurse approaches, the patient, the patient yells, “I don’t want to talk to you. You have no idea what it’s like to lose a child!” The nurse bases her response to the patient on the understanding of which of the following?

A) Hostility is a common behavioral response to griefB) It is too soon after the loss to empathize with the patient

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C) Personality traits such as aggressiveness are exaggerated during the grief process D) The nurse may have non-verbally indicated a judgmental attitude toward the patient

17.The nurse is conducting a history and physical exam on a patient who is grieving the unwanted loss of a marriage by divorce. Which of the following physical symptoms of grief would the nurse most likely expect to detect in the history

A) HeadachesB) InsomniaC) Weight lossD) GI upset

18.The nurse is caring for a hospice patient whose death is imminent. In preparing the familyfor the death of their loved one, then nurse prepares to assist the family in which of the following, regardless of the family’s cultural preferences? (Select all that apply)

A) Dealing with the shock of losing a loved oneB) Burial plans after death had occurredC) Efforts to stay connected to the patient after deathD) Use of support from family and friendsE) Anger at the loss of a loved one

19.The most effective way for the nurse to provide culturally competent care to individuals who are grieving is which of the following?

A) Understand the practices associated with a patient’s cultureB) Suggest developing a new ritual to make mourning meaningfulC) Ask the patient what rituals are personally meaningfulD) Contact a spiritual leader from the patient’s culture to become involved

20.A nurse has been caring for a gunshot victim who has just died. Various family and friends are present. One of the visitors privately discloses to the nurse the she and the patient were having an illicit affair. Which of the following is the best action by the nurse after learning of this relationship?

A) Give the name of a clergy to the visitor and suggest she contact him for supportB) Encourage the visitor to ask for support from the friends who are presentC) Ignore the information about the affair and tend to the familyD) Privately offer support to the visitor who was having the affair with the patient

21.Which of the following data recorded in a patient’s assessment is most likely to prevent the patient from experiencing complicated grief?

A) Tendency to suppress emotionsB) History of depressionC) Places trusts familiar others

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D) Dependent on others to meet needs

22.The nurse is meeting a patient for the first time that has just spontaneously lost her unborn child. After establishing rapport, the priority nursing intervention should focus on which of the following?

A) Assessing the patient’s support systemB) Exploring what this loss means for the patientC) Discuss helpful ways to cope with the lossD) Assess what knowledge the patient desires about the situation

23.Which of the following is NOT essential to include in the framework for facilitating the patient’s grief process?

A) Genetic riskB) Perception of lossC) Support systemD) Coping skills

24.The nurse is establishing outcomes for a grieving patient. Which of the following is an appropriate outcome?

A) Develop a plan for coping with the lossB) Demonstrate self-reliance during the grief processC) Suppress emotions related to the lossD) Verbalize that loss will not adversely affect the quality of life

25.Which of the following terms is used to describe the process by which a person experiences the grief?

A) Anticipatory grievingB) Disenfranchised griefC) BereavementD) Mourning

26.Kubler-Ross developed a model of five stages to explain what people experience as they grieve and mourn. Which of the following is Phase V of Kubler-Ross's stages of grieving?

A) DenialB) BargainingC) AcceptanceD) Anger

27.The nurse approaches a patient who looks very sad and is sitting alone crying. The best

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response by the nurse in this situation is:A) “I’m sorry you are sad. Is there anything I can do to help you feel better?”B) “Please don’t cry. It will get better.”C) “You look very sad. What is happening?”D) “What is bothering you?”

28.A woman has just been served divorce papers from her husband. She has no financial resources and little social support. She states, “He’s not really leaving. He’ll be back.” The most appropriate response by the nurse would be which of the following:

A) “Has he done this before?”B) “I’ll call social services and get you signed up for financial assistance.”C) “You have to face reality. Here are the papers.”D) “How is this affecting you right now?”

29.An elderly woman who lives alone is beginning to have difficulty maintaining her household and performing daily tasks. The nurse asks her to identify someone who can help her. The woman replies, “I don’t need help. I’ve been managing for years.” Which of the following responses helps the patient shift from denial to consciously coping with her situation?

A) “You don’t think you need any help? But your family is worried about you.”B) “It must be hard to lose your independence. I’ll ask a social worker to see what can

be arranged.”C) “You said you have been having trouble at home. Who would you call if you needed

anybody?” D) “If you don’t ask for some help then the only option is to move to an assisted living

facility.”

30.A patient who has been grieving the loss of his wife 2 weeks ago says to the nurse, “The best part of my day is when I am back at work. Is that wrong?” The nurse educates that work and other daily activities serve which purpose?

A) “You cannot work effectively this soon. You should finish grieving first.”B) “Working reminds you of your loss. It may be too early to go back.” C) “Working is your way of avoiding grief which will make it harder for you to move

on.”D) “Working is letting you take an emotional break from grieving. There’s nothing

wrong with that.”

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Answer Key

1.D2.C3.C4.C5.D6.B7.D8.B9.C

10.D11.B12.C13.A, B, C, D, E14.A15.D16.A17.B18.A, C, E19.C20.D21.C22.B23.A24.A25.C26.C27.C28.D29.C30.D

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