Deck 20: Loss and Bereavement

Question 1

Which of the following are the two major factors in children's reaction to loss?

A) number of siblings and birth order
B) self-esteem and body image
C) caregiver emotions and reactions
D) age and cognitive development

Answer 1

age and cognitive development

Question 2

Young children experience loss, separation, or bereavement in a myriad of situations. These early experiences:

A) are almost always totally repressed and of little help to a person
B) help shape an individual's ability to cope with loss later in adult life
C) determine to a large extent whether a person will experience situational depression later
D) cloud one's ability to think clearly and logically about similar experiences as an adult

Answer 2

help shape an individual's ability to cope with loss later in adult life

Question 3

Caregivers may be excited about the family relocating to another city so they can have better jobs and a bigger home. After the move, however, the children will most likely:

A) reflect the excitement modeled by the caregivers and suffer little emotional upset
B) do better emotionally than the caregivers, as the children will acclimate to their new surroundings with greater ease
C) grieve for the loss of comfortable and familiar people, surroundings, and things left behind
D) appreciate the better surroundings and seek new friendships in the neighborhood

Answer 3

grieve for the loss of comfortable and familiar people, surroundings, and things left behind

Question 4

Most preschoolers have a favorite toy or belonging that goes with them to the babysitter, the day care, or the health care provider. When the caregivers fail to bring that toy or belonging along on an outing, the child will most likely:

A) start to learn how to rely on people for security rather than on objects
B) suffer feelings of anxiety associated with loss and separation issues
C) be angry with the caregivers for several days or weeks
D) reject the toy or belonging then it is next presented

Question 5

When a child loses a pet, the way the child feels about the loss will:

A) greatly depend on whether the pet died or was lost due to other causes
B) depend on the age of the pet and how close the pet was to dying of natural causes
C) be associated with how well-liked the pet was by the rest of the family
D) be much the same, regardless of how the loss came about or other factors

Question 6

A leading cause of separation in families is:

A) military assignment
B) divorce
C) temporary separation
D) jail or prison time

Question 7

A mother shares with the pediatric nurse that her 3-year-old has started thumb sucking and bed-wetting again after about a year of not engaging in these behaviors. The pediatric nurse notices the child clinging to the mother. Based on the child's behaviors, the pediatric nurse would in the assessment phase most need to ask the mother:

A) "Has there been any loss or change in your lives such as separation, divorce, or relocation?"
B) "Are you rewarding your child whenever she urinates in the potty or does not suck her thumb?"
C) "Has your child been sick or had a contagious disease, fever, diarrhea, or vomiting?"
D) "Has your child been getting enough attention from you in the past few weeks?"

Question 8

The nurse is working with a custodial father of a preschooler who has become more aggressive in his play. This preschooler's increase in aggression occurred about the time the caregivers divorced. The nurse will talk to the father about the most probable cause of the escalation in violence, which is:

A) watching more television after the divorce
B) a decrease in the gentle influence of the mother
C) confusion and acting out feelings of confusion
D) an increase in the more masculine influence of the father

Question 9

A mother is talking with the school nurse about her school-aged child, who thinks up reasons for her mother to meet with her ex-husband, the child's father. The child even acts out then visiting with the father so the mother will come and talk with the father. When something breaks in the mother's home, the child says, "Dad could fix this." The nurse talks to the mother about a common theme with school-aged children, which is:

A) the mother will be carried away by an evil person and the child needs help to keep her
B) a fantasy that the caregivers will reunite and efforts to make this fantasy come true
C) only the biological parents can fulfill the emotional needs of the children
D) the mother is sad and only the father can fix the sadness that the mother is experiencing

Question 10

Which of the following best describes the term parentification?

A) raising the caregivers up onto a pedestal
B) assuming the caregiver (parental) role
C) believing one's caregivers can do nothing right
D) holding onto caregivers out of a fear of abandonment

Question 11

The school nurse is working with a group of school-aged children whose caregivers are in the process of divorcing or who have recently divorced. Which of the following topics will be most important for this age group to explore?

A) which of their caregivers is at fault in the breakdown of relationships in the family
B) how they would like the custody battles to be resolved and who they would like to live with
C) the impact of the divorce on understanding the day-to-day schoolwork
D) feelings of guilt, believing their caregivers' emotional distress is related to how they behaved

Question 12

Parentification is common in children and adolescents who are 9 years old or older and is especially common in which of the following circumstances?

A) then daily activities of the home are neglected
B) then the caregivers are very authoritarian
C) during the holiday season
D) then there are several older siblings

Question 13

A school nurse notices that one of the adolescents has begun spending a lot of time and energy at school, volunteering for projects and doing extra work. The nurse knows that often then adolescents begin to spend all their energies in school activities, they are doing so because they want to:

A) get good recommendations from teachers for entering college
B) avoid thinking about a difficult or troubling situation at home
C) get praise from teachers and peers for a job well done
D) do things for others in an altruistic period of their life

Question 14

You are the nurse working with a 4-year-old child who was injured in an automobile accident in which the child's mother was killed. From your knowledge of children and how they view death, you will suspect that this child will view the death of the mother from which of the following ideas of death?

A) universal
B) temporary
C) nonfunctional
D) causal

Question 15

A caregiver asks the nurse for advice on how to explain the death of a grandfather to a 5-year-old child. The nurse shares with the caregiver that children of this age look at death differently than adults do and that children would best understand and benefit from the explanation:

A) "Your grandfather has gone to rest."
B) "Your grandfather worked too hard."
C) "His body and his heart fore out."
D) "He has gone to a much better place."

Question 16

A father is concerned that his 14-year-old son is engaging in high-risk behavior by inline-skating in traffic. He is afraid the son will kill himself accidentally. The nurse explains that this behavior in adolescents is believed to be due to which of the following attitudes?

A) underlying suicidal wish
B) need for attention
C) belief that "death won't happen to me"
D) need to excel in some skill or activity

Question 17

The school nurse becomes aware that a student has experienced the loss of a family member and is returning to school after a few days' absence. The best action on the part of the nurse is to plan with other members of the school team for:

A) opportunities for this student to talk about her feelings and to have supportive counseling
B) making sure the student gets to spend lots of time with peers at school and out of school
C) psychological testing of the student to see what impact the death had on her
D) the teachers to reduce the homework assignments to about half that of other students

Question 18

In working with children and families who have experienced a loss of a family member, the nurse keeps in mind:

A) people experiencing a loss follow a predictable pattern in terms of grief and bereavement
B) individuals who have a mental illness themselves, or in the family, will grieve differently
C) each person's response to a loss is different and each person's bereavement is different
D) people who are close to the grieving person can often predict their grieving pattern

Question 19

Which of the following best defines the term grieving?

A) an individual's reaction to a loss
B) an adaptation to a loss
C) the process from the loss to the adaptation
D) a time of shock and disbelief

Question 20

According to Kubler-Ross, the first stage of the grieving process is:

A) denial
B) anger
C) bargaining
D) depression

Question 21

According to Kubler-Ross, the last stage of the grieving process is called:

A) anger resolution
B) mood norming
C) acceptance
D) final peace

Question 22

The nurse is working with a family going through a divorce. The mother tells the nurse how good her young son has been in washing windows and doing household chores. The nurse realizes that this child is most likely:

A) in denial
B) bargaining
C) depressed
D) angry

Question 23

Which of the following statements by a child would indicate her acceptance of a mother's death?

A) "She is taking a long nap."
B) "I am going to be a good girl."
C) "God is not very loving."
D) "My mother is in heaven."

Question 24

According to Worden's four tasks of mourning, before children can deal with the loss, they must:

A) be at least 6 years old
B) be able to do abstract thinking
C) have at least one close relative, adult, or friend to talk to
D) believe the deceased person is dead and will not return to life

Question 25

A child's ability to process the pain of loss will depend most on:

A) the child's intelligence quotient
B) how verbal the child is
C) observations of the adult's experiences of loss
D) emotional maturity

Question 26

You are the nurse working with a child whose grandparent died. When the child has completed the first three tasks of mourning according to Worden and is ready to work on the fourth task, you would most help him by:

A) keeping the child busy so he doesn't have time to think about his loss
B) reminding the child that the grandparent is not returning to life
C) keeping the child focused on the family members he has left in his life
D) helping the child make a scrapbook or write a poem about the grandparent

Question 27

Caregivers share with the school nurse that their child, who was so depressed and upset for a month by the death of a grandparent, is now engaging in all his old activities, laughing and enjoying life, and acting as if nothing ever happened. The nurse will tell the caregivers that the most likely explanation for this change in behavior is that:

A) "Children do not grieve the same as adults, and this is probably normal."
B) "The child received a lot of attention for the depressed behavior and has gotten enough attention."
C) "Children are very resilient, and your child is more so than most."
D) "Your child is just in an emotional plateau and resting from the depression."

Question 28

A school-aged child reacted very little to the death of an older brother who had lived away from the family for several years and yet seemed overcome with grief at the death of an elderly lady who was her babysitter. The most logical and likely explanation for this difference in the amount of observable grief is which of the following?

A) She is hiding the grief for her brother because it is so painful.
B) There was a closer relationship with the babysitter than with the brother.
C) This child values the elderly more than she does younger people.
D) She was mad at her brother for being so uncaring as to die.

Question 29

A school-aged child's great-uncle dies, and the child expresses a desire to go to the funeral. The best action on the part of the caregivers is most often to:

A) have the child stay at home with a relative
B) send the child to school as usual
C) include the child in appropriate activities related to the funeral and burial
D) call all the other caregivers and see if anyone else is taking their child

Question 30

A caregiver talks with the nurse about how badly her surviving child has behaved after the death of a sibling. Which of the following statements by the nurse would most likely be true?

A) "When children have a tendency to misbehave, it gets worse during a crisis."
B) "Children always misbehave to an extreme degree after the death of a sibling."
C) "The closer the relationship was between siblings before the death of one, the more behavior problems the surviving siblings demonstrate afterward."
D) "You probably were distracted by all that was going on during this crisis and did not discipline this child as much as you normally would have, so the child misbehaved."

Question 31

When a child in a family dies, the most neglected member of the family during the grieving process is usually the:

A) mother
B) father
C) grandparents
D) siblings

Question 32

You are assigned to care for a young adolescent who is in the terminal stage of an illness. This early adolescent says to you: "I don't want to die." What would be your best response?

A) "You may not die, as miracles do sometimes happen."
B) "Tell me more about what you are thinking."
C) "I don't want you to die either."
D) "Why do you think you might die?"

Question 33

When planning the nursing care for a child admitted with a terminal illness, which of the following interventions would be important in working with the child and family?

A) Minimize the number of staff interacting with the child and family.
B) Do as much as possible for the child so the caregivers don't have to work.
C) Limit the amount of time the caregivers can be with the child so they don't tire out.
D) Let the family guide the amount of communication related to grieving.

Question 34

Which of the following groups best lists those who must be supported then a shooting occurs in a school?

A) students and their teachers
B) students, school staff, families, and community
C) only those who ask for and accept help and support
D) those who demonstrate symptoms indicating a need

Question 35

You are responsible for preparing a deceased newborn for the family to view. Which of the following descriptions represents the best way for you to prepare the newborn?

A) naked and wrapped in a sheet
B) clothed in an outfit of clothes
C) in a diaper and small hospital shirt
D) in a diaper and wrapped in a blanket

Question 36

You have prepared a deceased newborn for the family to visit. You would invite them to:

A) visit the child in the utility room for a few minutes
B) provide chairs and allow them to hold the baby as long as they wish
C) visit with the deceased newborn until the funeral home personnel come
D) enter alone without any presentation or remarks by the nurse