Question 1

A client whose child is diagnosed with terminal breast cancer is constantly crying and depressed. Which type of grieving is she experiencing?&#10;A) Delayed grieving&#10;B) Anticipatory grieving&#10;C) Prolonged grieving&#10;D) Distorted grief&#10;

Accepted Answer

1.This is incorrect. Delayed grieving is when the individual does not grieve when it is expected; they are not acknowledging the reality of the loss.
2.This is correct. The client is experiencing anticipatory grieving. The client is grieving the loss of her child before it actually occurs.
3.This is incorrect. Prolonged grieving occurs when the grief inhibits an individual from performing activities of daily living.
4.This is incorrect. Distorted grief occurs when all symptoms of normal grieving are exaggerated. This type of grief interferes with daily life.

Question 2

Which situation will most likely lead to maladaptive grief in the survivor?&#10;A) A woman loses her spouse, who was the primary breadwinner of the family.&#10;B) A man loses a sibling 15 years after losing his other sibling.&#10;C) A man loses his spouse and has been attending a support group for 3 months.&#10;D) A woman loses her colleague to a heroin overdose.&#10;

Accepted Answer

1.This is correct. This individual is at highest risk since she has financial problems posed by the loss of her spouse, who was the primary breadwinner.
2.This is incorrect. Individuals who suffer losses close together are at high risk for maladaptive grieving, but 15 years has gone by since this individual lost his brother.
3.This is incorrect. Individuals who suffer a loss without support are at risk for maladaptive grief, but this individual is attending a support group.
4.This is incorrect. Substance abuse places an individual at risk for maladaptive grief; however, this individual's colleague died due to substance use. There is nothing to indicate the survivor abuses substances.

Question 3

The mother of a 6-month-old child was diagnosed with a terminal illness and died just 4 days after her child's first birthday. At the 1-year well-child visit, the spouse shares some concerns with the pediatrician regarding changes in the child's normal behavior. Which are common changes in children from birth to age 2 years when they are separated from their mothers? Select all that apply.

A) Weight loss
B) Increased bowel movements
C) Sleeplessness
D) Reduced eye contact

Weight loss
Sleeplessness

Accepted Answer

1.This is correct. Infants are unable to recognize and understand death, but they can experience the feelings of loss and separation. Infants who are separated from their mother may lose weight. They will likely sense changes in the home atmosphere and often react to the emotions of adults by becoming more irritable and crying more often.
2.This is incorrect. At this life stage, children may lose weight, but that is not related to increased bowel movements.
3.This is correct. Infants are unable to recognize and understand death, but they can experience the feelings of loss and separation. Infants who are separated from their mothers may sleep less. They will likely sense changes in the home atmosphere and often react to the emotions of adults by becoming more irritable and crying more often.
4.This is incorrect. Irritability may increase; however, reduced eye contact is atypical of grieving at this life stage.

Question 4

_______________ is the inability to feel pleasure.&#10;A) Dysphoria&#10;B) Melancholy&#10;C) Disequilibrium&#10;D) Anhedonia&#10;

Accepted Answer

1.This is incorrect. Dysphoria is a state of unease or generalized dissatisfaction with life.
2.This is incorrect. Melancholy is a feeling of gloom, especially when it is prolonged.
3.This is incorrect. Disequilibrium describes a sense of being imbalanced or lacking stability.
4.This is correct. When a person is experiencing a normal grief reaction, they are able to experience moments of pleasure. If a person is clinically depressed, anhedonia (inability to feel pleasure) is prevalent.

Question 5

Place in order Elizabeth K&#252;bler-Ross's stages of grief.&#10;1. _____ Depression&#10;2. _____ Bargaining&#10;3. _____ Denial&#10;4. _____ Anger&#10;5. _____ Acceptance

Accepted Answer

The answer of Place in order Elizabeth K&#252;bler-Ross's stages of...

Question 6

A nursing instructor is teaching students about the Mental Health Parity and Addictions Equity Act of 1980. What requirement did this act establish?&#10;A) The cost of inpatient and outpatient mental health and substance abuse treatments must be the same as that charged for medical/surgical issues.&#10;B) No individuals can be denied inpatient or outpatient treatment for mental health and substance abuse treatment, no matter their legal situation.&#10;C) Health insurance benefits for mental health and substance abuse disorders cannot be less favorable than for medical/surgical issues.&#10;D) Health insurance premiums cannot have their rate increased more than the cost-of-living rate in the United States the previous year.&#10;

Accepted Answer

1.This is incorrect. The Mental Health Parity and Addictions Act of 1980 required that health insurance benefits for mental health and substance abuse disorders could not be less favorable than for medical/surgical issues. The law did not mandate that the cost of those services be the same.
2.This is incorrect. The Mental Health Parity and Addictions Act of 1980 required that health insurance benefits for mental health and substance abuse disorders could not be less favorable than for medical/surgical issues. The law was not about the topic of treatment denial.
3.This is correct. The Mental Health Parity and Addictions Act of 1980 required that health insurance benefits for mental health and substance abuse disorders could not be less favorable than for medical/surgical issues.
4.This is incorrect. The Mental Health Parity and Addictions Act of 1980 required that health insurance benefits for mental health and substance abuse disorders could not be less favorable than for medical/surgical issues. The law was not about the topic of premium increase rates.

Question 7

A client in the inpatient unit tells a student nurse, "My life has no purpose. I can't think about living another day, but please don't tell anyone about the way I feel. I know you are obligated to protect my confidentiality." Which is the most appropriate reply by the student nurse?

A) "The treatment team is composed of many specialists who are working to improve your ability to function. Sharing this information with the team is critical to your care."
B) "Let's discuss steps that will resolve negative lifestyle choices that may increase your suicidal risk."
C) "You seem to be preoccupied with self. You should concentrate on hope for the future."
D) "This information is secure with me because of client confidentiality."

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Accepted Answer

1.This is correct. The most appropriate response by the student nurse is to explain that sharing the information with the treatment team is critical to the client's care. The nurse's priority is to ensure client safety and to inform others of the client's suicidal ideation.
2.This is incorrect. The most appropriate response by the student nurse is to explain that sharing the information with the treatment team is critical to the client's care. The nurse's priority is to ensure client safety and to inform others of the client's suicidal ideation. The statement about negative lifestyle choices is inappropriate. Not directly answering the client's request may lead the client to mistakenly believe that the student intends to keep the information private.
3.This is incorrect. The most appropriate response by the student nurse is to explain that sharing the information with the treatment team is critical to the client's care. The nurse's priority is to ensure client safety and to inform others of the client's suicidal ideation. The statement about being preoccupied with self dismisses the client's feelings.
4.This is incorrect. The most appropriate response by the student nurse is to explain that sharing the information with the treatment team is critical to the client's care. The nurse's priority is to ensure client safety and to inform others of the client's suicidal ideation. This statement about client confidentiality is inappropriate and does not protect the client from harm.

Question 8

A newly admitted homeless client diagnosed with schizophrenia states, &#34;I am looking forward to curing my mental problem, once and for all.&#34; Which is the appropriate nursing reply?&#10;A) &#34;We can talk about how to make sure that happens. It is good to see you so positive about your outcome.&#34;&#10;B) &#34;As soon as we find you permanent shelter, you will find you have many fewer problems to deal with.&#34;&#10;C) &#34;We will work together to create a personal plan to help you deal with your problems before you leave here.&#34;&#10;D) &#34;Taking a different medication will make a huge difference in how you feel about your problem.&#34;&#10;

Accepted Answer

1.This is incorrect. The most accurate nursing reply is to explain to the client the reasonable and realistic expectations that the client can have for hospitalization. Appearing to agree with the client about a cure will not be a useful approach.
2.This is incorrect. The most accurate nursing reply is to explain to the client the reasonable and realistic expectations that the client can have for hospitalization. The client has more problems than just needing housing; the client has a mental illness to deal with.
3.This is correct. The most accurate nursing reply is to explain to the client the reasonable and realistic expectations that the client can have for hospitalization.
4.This is incorrect. The most accurate nursing reply is to explain to the client the reasonable and realistic expectations that the client can have for hospitalization. The nurse should not make promises about the effect of medication changes.

Question 9

The county health department nurse is offering a workshop for high-school students on marriage. Which workshop objective acts at the primary level of preventing a high-risk choice of partners?&#10;A) To learn techniques for helping future spouses permanently change undesirable traits&#10;B) To know the risks associated with choosing a partner raised in an abusive, dysfunctional family&#10;C) To better exercise attendees' personal freedom, self-fulfillment, and individual choice&#10;D) To feel comfortable in the future when ending marriages not meeting expectations&#10;

Accepted Answer

1.This is incorrect. The nurse's education about the risks associated with choosing a partner raised in an abusive, dysfunctional family is an example of primary prevention. Workshop attendees should not expect to learn techniques to change their future spouses' traits.
2.This is correct. The nurse's education about the risks associated with choosing a partner raised in an abusive, dysfunctional family is an example of primary prevention.
3.This is incorrect. The nurse's education about the risks associated with choosing a partner raised in an abusive, dysfunctional family is an example of primary prevention. Workshop attendees should not expect to learn more about personal freedom, self-fulfillment, and individual choice.
4.This is incorrect. The nurse's education about the risks associated with choosing a partner raised in an abusive, dysfunctional family is an example of primary prevention. Workshop attendees should not expect to learn about how to be comfortable ending their future marriages.

Question 10

The psychiatric nurse is planning home visits for the day. Which diagnoses are the clients most likely to have? Select all that apply.&#10;A) Posttraumatic stress disorder (PTSD)&#10;B) Major depressive disorder&#10;C) Alzheimer's disease&#10;D) Dysthymia&#10;E) Schizophrenia&#10;

Accepted Answer

1.This is incorrect. Homebound clients most often have a diagnosis of depressive disorder, neurocognitive disorder, anxiety disorder, bipolar disorder, or schizophrenia. Clients with PTSD are less likely to have home visits.
2.This is correct. Clients with a diagnosis of depressive disorder are among the most commonly homebound clients.
3.This is correct. Clients with a diagnosis of neurocognitive disorder, such as Alzheimer's disease, are among the most commonly homebound clients.
4.This is incorrect. Homebound clients most often have a diagnosis of depressive disorder, neurocognitive disorder, anxiety disorder, bipolar disorder, or schizophrenia. Clients with dysthymia are less likely to have home visits.
5.This is correct. Clients with a diagnosis of schizophrenia are among the most commonly homebound clients.

Deck 19: Community Mental Health Nursing and the Bereaved Individual