Question 1

Which of the following are critical components to assess in a grieving person? Select all that apply.

Accepted Answer

The interaction of the dimensions of human response is fluid and dynamic. What a person thinks about during grieving affects his or her feelings, and those feelings influence his or her behavior. The critical factors of perception, support, and coping are interrelated as well and provide a framework for assessing and assisting the client.
Genetic risk and religion are not critical components to assess in a grieving person.

Question 2

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?

Accepted Answer

Choice D would indicate that the client is proceeding as though there is no impending loss, so the nurse would need to assist the client with grieving as the client is in denial. The other choices are positive coping behaviors toward death.

Question 3

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?

Accepted Answer

Finding a support group indicates that the client recognizes her need for help and is taking action to get the support she needs. The other choices are not indications that the client's coping skills are adequate for the situation.

Question 4

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

Accepted Answer

Funerals are often the beginning outward sign of mourning and help begin the grieving process. This couple will need to talk about their son's death repeatedly as they begin to grieve. It will not likely be possible for them to accept that they could do nothing to prevent this death within this time period, but they must begin to hear this. They should not delay the grieving process.

Question 5

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

Accepted Answer

Examples of outcomes for the grieving client are as follows:
- Identify the effects of his or her loss.
- Identify the meaning of his or her loss.
- Seek adequate support while expressing grief.
- Develop a plan for coping with the loss.
- Apply effective coping strategies while expressing and assimilating all dimensions of human response to loss in his or her life.
- Recognize the negative effects of the loss on his or her life.
- Seek or accept professional assistance if needed to promote the grieving process.

Question 6

The nurse approaches a client who looks very sad and is sitting alone crying. The best response by the nurse in this situation is,

Accepted Answer

It is essential to accept the person's feelings without trying to dissuade him or her from feeling angry or upset. The nurse needs to encourage the person to express any and all feelings without trying to calm or placate him or her.

Question 7

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?

Accepted Answer

Adaptive denial, in which the client gradually adjusts to the reality of the loss, can help the client let go of previous (before the loss) perceptions while creating new ways of thinking about himself or herself, others, and the world. While taking in the loss in its entirety all at once seems overwhelming, gradually dealing with the loss in smaller increments seems much more manageable. Help the client shift from an unconscious mechanism of denial to conscious coping with reality by using reflective communication skills.

Question 8

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 client shift from denial to consciously coping with her situation?

Accepted Answer

The nurse can help the client to reach out and accept what others want to give in support of his or her grieving process. Help the client shift from an unconscious mechanism of denial to conscious coping with reality by using reflective communication skills. Do not force people through the coping process by insisting they take certain actions.

Question 9

A client 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?

Accepted Answer

The bereaved person can often take a break from the exhausting process of grieving. Going back to a routine of work or focusing on other members of the family may provide that respite. Familiar routines can affirm the client's talents and abilities and can renew feelings of self-worth.

Question 10

Which of the following are critical components in assessment of a person's grief? Select all that apply.

Accepted Answer

While observing for client responses in the dimensions of grieving, the nurse explores three critical components in assessment:
ï Adequate perception regarding the loss
ï Adequate support while grieving for the loss
ï Adequate coping behaviors during the process
The time to experience the loss varies significantly from person to person, and the reality is that there may not be adequate opportunities to say goodbye to the person.

Question 11

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,

Accepted Answer

The nurse makes an empathetic response, acknowledging the client's loss. At least you and your husband enjoyed life right until the end, is judgmental. It's better to go quickly like your husband did instead of suffering, does not address the client's grief. You'll feel better after you get over the shock of your husband's death, is false reassurance.
Thus, choices A, B, and D would not be the most appropriate responses.

Question 12

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

Accepted Answer

The opportunity to hold the baby may help the woman deal with the first stage of grieving: denial; it also allows her to express emotions over the loss. Asking the client, Can I do anything for you, is a closed-ended question and will likely be replied to with a yes or no answer. Stating, If something was wrong, it's better this way, is not sensitive to the woman's loss. Stating Your son is in heaven with God now, would be inappropriate because it may not be consistent with the woman's beliefs.

Question 13

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

Accepted Answer

Assessment begins with exploration of the client's perception of the loss. A client who is scheduled for a mastectomy would possibly be having anticipatory loss of a physiologic nature. It would not be appropriate to discuss the client's plans for reconstructive
surgery as this is not likely what is causing the client to be quiet and show little emotion. It is important to ascertain whether the client truly understands the surgery when witnessing the client's signature of the operative consent, but there is no indication that this is what is being addressed at this time. It would not be appropriate to assume that the client is depressed or not. It would be better to explore the client's perception of the loss.

Quiz 10: Grief and Loss