Deck 84: the Experience of Loss, death, and Grief

Question 1

In preparation for the eventual death of a female hospice patient of the Muslim faith,the nurse organizes a meeting of all hospice caregivers.A plan of care to be followed when this patient dies is prepared.This plan of care would include

A) Male health care workers care for the body after death has occurred.
B) Body preparation for autopsy.
C) Body preparation for cremation.
D) Female health care workers care for the body after death has occurred.

Answer 1

D
Islamic culture calls for modesty and same-sex caregivers whenever possible.Muslim faith discourages cremation and autopsy to preserve the sanctity of the soul of the deceased.

Question 2

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

A) Supporting the patient's nurse in her grief
B) Providing postmortem care for the patient
C) Teaching the patient the stages of grief
D) Enhancing the patient's quality of life

Answer 2

D
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 postmortem care,as is the case for nutritionists,social workers,and pharmacists.Teaching about stages of grief should not be the focus when severe pain is present.

Question 3

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?

A) Massage the patient's abdomen.
B) Contact the provider to discontinue pain medication.
C) Administer enemas twice daily for 7 days.
D) Use a stimulant laxative and increase fluid intake.

Answer 3

D
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 will allow water to be pulled into the GI tract,softening up 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 4

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

A) Coroner's office for an autopsy
B) Police department for an investigation
C) Directly to the inmate's family
D) Warden for inspection

Question 5

A cancer patient asks the nurse what the criteria are for hospice care.What should the nurse answer?

A) Having a terminal illness, such as cancer
B) Needing assistance with pain management
C) Expected to live less than 6 to 12 more months
D) Completion of an advance directive

Question 6

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

A) Taking pictures of visitors
B) Calling the organ donation coordinator
C) Listening to family stories about the person
D) Providing quiet visiting time

Question 7

A nurse encounters a family that experienced the death of their adult child 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?

A) Pain management technique
B) Facilitating normal mourning
C) Grief evaluation
D) Palliative care

Question 8

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

A) "It is normal to feel this way. Give yourself some time to mourn."
B) "Your other patients still need you, so hurry back to them."
C) "You're being a bad role model to the unit's nursing students."
D) "Why don't you take a sedative to cope?"

Question 9

"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?

A) Facilitating mourning
B) Providing curative therapy
C) Promoting spirituality
D) Eradicating grief

Question 10

The mother of a recently murdered child keeps the child's room intact.Family members are encouraging her to redecorate and move forward in life.The visiting nurse recognizes this behavior as _____ grief.

A) Normal
B) End-of-life
C) Abnormal
D) Complicated

Question 11

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 that

A) All religions allow for organ donation.
B) Life support must be removed before organ and tissue retrieval occurs.
C) The best time for organ and tissue donation is immediately after the autopsy.
D) The transplant coordinator is working in accordance with federal law.

Question 12

The nurse has had three patients die during the past 2 days.Which approach is most appropriate to manage the nurse's sadness?

A) Telling the next patients why the nurse is sad
B) Talking with a colleague or writing in a journal
C) Exercising vigorously rather than sleeping
D) Avoiding friends until the nurse feels better

Question 13

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?

A) Normal grief
B) Complicated grief
C) Disenfranchised grief
D) Perceived grief

Question 14

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

A) Maturational loss
B) Situational loss
C) Perceived loss
D) Uncomplicated loss

Question 15

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 is actually looking forward to in life.The nurse is helping the patient to demonstrate which spiritual concept?

A) Time management
B) Hope
C) Charity
D) Faith

Question 16

An Orthodox Jewish Rabbi has been pronounced dead.The nursing assistant respectfully asks family members to leave the room and go home as postmortem care is provided.Which of the following statements from the supervising nurse reflects correct knowledge of Jewish culture?

A) "I wish they would go home because we have work to do here."
B) "Family members stay with the body until burial the next day."
C) "I should have called a male colleague to handle the body."
D) "I thought they would quietly leave after praying and touching the Rabbi's head."

Question 17

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 the Bowlby Attachment Theory stage of

A) Numbing.
B) Disorganization and despair.
C) Bargaining.
D) Yearning and searching.

Question 18

A dying patient with liver and renal failure requires pain medication.The nurse anticipates that the medication dose will be

A) Given at appropriate milligrams per kilogram medication levels.
B) A decreased dose from milligrams per kilogram levels.
C) An increased dose from milligrams per kilogram levels.
D) Given at midrange for dosing at recommended levels.

Question 19

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 Grief Tasks Model?

A) Task I
B) Task II
C) Task III
D) Task IV

Question 20

A couple is informed that their fetus' 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?

A) An advance directive to complete
B) Brief discussion and funeral guidance
C) Time and careful explanations
D) Instructions on how to proceed

Question 21

Mrs.Harrison's father died a week ago.Mr.Harrison is experiencing headaches and fatigue,and keeps shouting at his wife to turn down the television,although he has not done so in the past.Mrs.Harrison is having trouble sleeping,has no appetite,and says she feels like she is choking all the time.How should the nurse interpret these assessment findings as the basis for a follow-up assessment?

A) Mrs. Harrison is grieving and Mr. Harrison is angry.
B) Mrs. Harrison is ill and Mr. Harrison is grieving.
C) Both Mr. and Mrs. Harrison likely are in denial.
D) Both Mr. and Mr. Harrison likely are grieving.

Question 22

Enuresis is reported in a previously toilet trained toddler.While gathering a health history from the grandparent,the nurse asks about which factor as the most likely cause?

A) Lack of outside playtime
B) Having too many toys
C) Dietary changes
D) Recent parental death

Question 23

During a follow-up visit,a woman is describing new onset of marital discord with her terminally ill spouse.Using the Kübler-Ross behavioral theory,the nurse recognizes that the spouse is in which stage of dying?

A) Denial
B) Bargaining
C) Anger
D) Depression

Question 24

A patient cancels a scheduled appointment because she will be attending a Shiva for a family member.Recognizing the importance of this cultural ritual,the nurse's best comment would be which of the following?

A) "Congratulations, what's the baby's name?"
B) "I'm so sorry for your loss."
C) "Missionary church outreach is so important."
D) "Can I buy a ticket to this fundraiser?"