Question 1

The experience of parting with an object, person, belief, or relationship that one values is defined as:

Accepted Answer

Loss is defined as the experience of parting with an object, person, belief, or relationship that one values; the loss requires a reorganization of one or more aspects of the person's life.

Question 2

The term bereavement is best defined as:

Accepted Answer

Bereavement is a state of desolation that occurs as the result of a loss, particularly the death of a significant other.

Question 3

Which stage of grieving is exhibited by the husband of a victim of sudden death who refuses to accept that she is dead?

Accepted Answer

In the shock and disbelief stage, the survivor either refuses to accept the loss or shows intellectual acceptance of the loss but denies the emotional impact.

Question 4

A widow has just returned home from the funeral of her husband. She feels alone in her home. Her family has left to go back to their home in another area of the country. What stage of Engel's model does this represent?

Accepted Answer

Developing awareness occurs as the reality and meaning of the loss penetrate the person's consciousness.

Question 5

In the Parkes model, a person uses denial as a psychological defense in the stage of:

Accepted Answer

In the numbness stage, which is usually brief, trauma so overwhelms the bereaved survivor that must use denial as a psychological defense.

Question 6

The nurse is providing care for a client who is increasingly depressed and withdrawn following the death of the client's spouse. According to Parkes, in what stage of grief is this client?

Accepted Answer

The disorganization stage is characterized by severe depression, social withdrawal, and lack of interest in people and activities. Shock and protest are not explicit stages of Parkes's model. Reorganization is the final stage in the model, in which the individual comes to terms with his loss.

Question 7

A widower who continues to improve his level of functioning better than before the loss is best described at which stage of the grief cycle model?

Accepted Answer

People who have sufficient resources during this period are likely to continue to improve their level of functioning and often emerge from the grief cycle at a higher level of functioning than before the loss.

Question 8

A pediatric nurse recognizes that preschoolers think of death as:

Accepted Answer

Preschoolers think of death as a long sleep.

Question 9

Which statement regarding perceptions of death by children is accurate?

Accepted Answer

At about 9 years of age, the child's concept of death matures, and the child perceives death realistically as irreversible, universal, inevitable, and natural.

Question 10

Which statement about grief should the nurse include in the teaching plan developed to address a group of young adults?

Accepted Answer

Young adults often experience many losses within a short period of time, which places them particularly at risk for poor outcomes. These multiple losses, coupled with their inexperience with loss and grief, make them particularly at risk.

Question 11

As a nurse is assisting a client and family from a different culture with the death and dying process, the first action the nurse must take is to:

Accepted Answer

Nurses should gain knowledge of the specific cultural and religious beliefs of the clients they are serving. They should help their clients deal with loss in a manner that is congruent with their cultural and religious beliefs and practices.

Question 12

Which manifestation of grief by the client who lost his wife 3 years earlier is considered abnormal?

Accepted Answer

Bereavement experts reported that they considered almost all bereavement manifestations to be normal during the early stages of grief, but considered most of the manifestations to be abnormal if they continue beyond 3 years.

Question 13

A widow develops cancer within 6 months of her husband's death. This may be a result of:

Accepted Answer

Physical health and psychosocial adjustment are intricately intertwined. The bereaved are known to be at greater risk for mortality and morbidity than are comparable nonbereaved people.

Question 14

The hospice nurse is caring for a client with lung cancer. The client's daughter states, "My mom isn't happy with anything I do for her. She is constantly yelling at me." The nurse understands that the client is in which stage of grief according to Kübler-Ross?

Accepted Answer

Kübler-Ross proposed five stages of grief: (a) denial, (b) anger, (c) bargaining, (d) depression, and (e) acceptance. Denial may range from complete denial of the illness and impending death to denial of the effect that dying will have on self and others. In the second stage, anger may be directed toward fate, God, family members, healthcare providers, or others. Bargaining occurs as the client seeks to delay the dreaded event; the client bargains with God for more time and, in return, promises to do something to repay God for this favor. Depression occurs when the client acknowledges the reality and inevitability of the impending death. In the final stage, acceptance, the client comes to terms with the loss, begins to detach from supportive people, and loses interest in worldly activities.

Question 15

A nurse has finished presenting information to a group of staff members on the factors that influence the grieving process. Which statement by a member would indicate a need for further education?

Accepted Answer

A loss that occurs under violent or frightening conditions is much more difficult to cope with than is a loss that occurs under more peaceful conditions. A death that occurs as a result of homicide or suicide is usually more stressful than is a death from natural causes. Some people find strength in dealing with loss through their faith, whereas others experience greater distress due to their beliefs. Sociocultural resources include the social support that is available from family, friends, coworkers, and formal institutions. Absence of these social supports creates additional stressors for the grieving person. The age at which a loss occurs has a major impact: The loss of a parent has different meanings to an infant, a child, and an adult.

Question 16

The hospice nurse is assessing the wife of a client who died 14 months ago. The nurse is concerned that the wife is still grieving the death of her husband. Which objective assessment finding would suggest that the wife is resolving?

Accepted Answer

Many of the subjective manifestations of grief have concomitant objective manifestations: dejected physical appearance, slowed motor function, weeping, outbursts of anger, emotional blunting, unkempt appearance, sleep, appetite disturbance (excessive weight loss or gain). Direct quotes are subjective data.

Question 17

The nurse is preparing a care plan for a client with the nursing diagnosis of Dysfunctional Grieving. Which nursing intervention should the nurse include? Select all that apply.

Accepted Answer

Encourage the mourner to remember and talk about both negative and positive memories of the deceased. Encourage clients to continue contact with their primary healthcare provider (physician or nurse) as well, because the grief process often decreases resistance to disease and exacerbates existing illnesses. Support groups and grief specialists can offer additional support to the client.

Question 18

A nurse has just finished a presentation on hospice and palliative care. Which statement by a participant would indicate a need for further education?

Accepted Answer

The philosophy of hospice is that clients and families are empowered to achieve as much control over their lives as possible. Hospice focuses on relieving symptoms and supporting clients with a life expectancy of 6 months or less, rather than years, and their families. However, palliative care may be given at any time during a client's illness, from diagnosis to end of life.

Question 19

The nurse is preparing the body of a client who was killed in a car accident for the family to view. Which step would be contraindicated?

Accepted Answer

In an effort to limit exposure to the disturbing sight of equipment and medical supplies, the nurse should, if possible, remove unneeded items and clean, position, and cover the client. However, under some circumstances (such as an unexpected death), intravenous and other lines and tubes should not be removed, as the body may need to be examined by a medical examiner. Having time alone with the client is an important step for some families, whereas others appreciate the presence of a nurse, a spiritual leader, or friends. Religious and cultural beliefs and customs should be observed as much as possible.

Question 20

The wife of recently deceased client states that she can't think of anything other than her husband. She wakes up at night and goes to look for him before realizing that he is dead. The nurse understands that the wife is in which stage of Demi's model of grief?

Accepted Answer

In the protest stage of grief, the client may exhibit preoccupation with thoughts of the deceased, searching for the deceased, dreams/nightmares, hallucinations, and concerns about others' health and safety. In the shock stage, the client may exhibit slowed and disorganized thinking, blocking of thoughts, and wish to join the deceased. In the disorganization stage of grief, the client may exhibit difficulty making decisions, aimlessness, and loss of interest in people, work, and usual activities. In the reorganization stage of grief, the client may exhibit a realistic memory of the deceased, be comfortable when remembering the deceased, and a return to previous level of ability.

Quiz 42: Loss and Grieving