Deck 44: Loss, Grieving and Death

Question 1

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

A) Contact the family to come and escort the body home.
B) Call the client's medical practitioner for direction.
C) Account for all of the client's personal items so they can be sent to their community.
D) Smoke the room where the Aboriginal person has died.

Answer 1

Contact the family to come and escort the body home.
Account for all of the client's personal items so they can be sent to their community.
Smoke the room where the Aboriginal person has died.

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?

A) Disenfranchised grieving.
B) Abbreviated grieving.
C) Chronic grief.
D) External grief.

Answer 2

Disenfranchised grieving.

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?

A) Provision of hospice services is reserved only for those who refuse other palliative treatments.
B) Hospice care can be carried out in a variety of settings and services focus on symptom control and pain management.
C) Hospice care refers to a type of facility and they are always clearly identified as hospices.
D) Only those clients with private insurance can receive hospice benefits.

Answer 3

Hospice care can be carried out in a variety of settings and services focus on symptom control and pain management.

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?

A) The Kubler-Ross model is primarily used to describe anticipatory grief.
B) No clear timetables exist, nor are there clear-cut stages of grief.
C) There is strong research proving that these models are not useful for many dying clients.
D) The models serve as clear and definitive predictors of grief behaviours.

Question 5

Match the following terms and definitions.
1. Actual loss
2. Perceived loss
3. Situational loss
4. Developmental loss
A. Retirement from a career
B. Spinal injury
C. Loss of independence
D. Loss of wallet

Question 6

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?

A) Remove the ring and give it to the family.
B) Tape the ring to the client's finger.
C) Remove the ring before algor mortis sets in.
D) Call the presence of the ring to the attention of the funeral director.

Question 7

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

A) Ask the family politely to grieve quietly and advise them that if that is not possible, that the other option would be that the client can be moved to the morgue and they can openly grieve there.
B) Ask the family if they can afford to pay for a private room so they can then have some privacy.
C) Ask the family to accompany you outside of the hospital saying to them that you understand it would be important for them to be outside at this time and that you will stay with them.
D) Adjust the bed allocations to accommodate the family.

Question 8

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?

A) Offer spiritual support.
B) Provide structure and continuity to promote feelings of security.
C) Examine the nurse's own feelings to ensure denial is not shared.
D) Allow the family to express sadness.

Question 9

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?

A) Have you ever been close to someone who was dying?
B) How do you think you'd like to say goodbye?
C) Will you want to view the body after death?
D) How are you taking care of yourself?
E) All of the above.

Question 10

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:

A) abbreviated grief.
B) anticipatory grief.
C) disenfranchised grief.
D) complicated grief.

Question 11

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?

A) Toddlers perceive death as irreversible and unnatural.
B) Preschool children view death as a spiritual release.
C) Adolescents tend to have better outcomes than adults after a loss.
D) At about age nine, children begin to understand death is final.

Question 12

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?

A) "You are doing so well, don't talk like that."
B) "Let's think of something more cheerful."
C) "What makes you think you are dying?"
D) "Whatever is meant to be will happen."

Question 13

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:

A) rigor mortis.
B) algor mortis.
C) livor mortis.
D) prior injury.

Question 14

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:

A) was killed in the robbery of a bank.
B) died after developing diabetes-induced renal failure.
C) died from chronic heart disease.
D) died after a long battle against cancer.

Question 15

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

A) the name of the deceased is not verbalised.
B) the smoke ritual is undertaken somewhere else.
C) the client's belongings are kept separate.
D) any wailing is discouraged as disruptive to others.

Question 16

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:

A) the client will need extra blankets.
B) the family will be able to massage them.
C) it is a sign of impending death.
D) hygiene will stop until the client warms up.

Question 17

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?

A) Complicated Grieving
B) Interrupted Family Processes
C) Risk-prone Health Behaviour
D) Caregiver Role Strain
E) Risk for Loneliness

Question 18

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?

A) Proof that the client is accepting the facts of the illness and impending death.
B) Common and expected in those facing the end of life.
C) A simple statement of the facts regarding HIV/AIDS.
D) An indication of hopelessness that should be further evaluated for treatment.

Question 19

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?

A) Dysfunctional Grieving.
B) Hopelessness.
C) Anticipatory Grieving.
D) Caregiver Role Strain.

Question 20

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?

A) Provide a total bed bath.
B) Place absorbent pads beneath the body.
C) Remove dentures.
D) Dress the client in street clothes.
E) Place a pillow under the head.
F) Tape the eyelids closed.

Question 21

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?

A) He shows the nurse his wife's sewing room that remains just as she left it before she died.
B) The client has an album of photographs of his wife open on the living room table.
C) He tells the nurse that his wife was an awful cook and that he has eaten better meals since she died.
D) He indicates that he sends his laundry out to be done because he had never figured out how the washer works.