Question 1

Which actions by a nurse contribute to protecting the rights of patients who are terminally ill? Select all that apply.

Accepted Answer

The answers support the rights of the individual who is dying.Touch should be nurturing but may leave the patient uncomfortable and confused if inappropriate.Acting on false information robs a patient of the opportunity for honest dialog and places barriers to achieving end-of-life developmental opportunities.

Question 2

A widow grieving her husband's sudden death tells the nurse,"I'm not feeling well.Yesterday,I saw my husband walk through the door,stop,and smile at me.Then he just faded away." Which is the nurse's most appropriate action?

Accepted Answer

Grieving patients often dream about,visualize,think about,or search for the lost loved one.The patient should be told that this is considered a normal phenomenon and not a sign of mental illness.Visualization does not suggest substance use or mental illness in this case.

Question 3

The spouse of a patient in hospice care angrily tells the nurse,"The care provided by the aide and other family members is inadequate,so I must do everything myself.Why can't anyone do things right?" The palliative care nurse should:

Accepted Answer

The behaviors described in this scenario are consistent with anticipatory grieving.The spouse needs to be taught about the process of anticipatory grieving and to receive counseling to validate what she is experiencing and to enhance coping.The other options are not appropriate to the situation.

Question 4

A grieving patient tells a nurse,"It's been 8 months since my spouse died.I thought I would feel better by now,but lately I feel worse.I have no energy.I am lonely,but I don't want to be around people.What should I do?" What is the nurse's best counsel?

Accepted Answer

The patient needs understanding and support that the feelings are normal.Although feelings of depression generally decline over the period of a year after the death of a loved one,the decline is not linear.Loneliness and aimlessness are most pronounced 6 to 9 months after the death.The patient should be educated about phenomena experienced during bereavement.The other options are not clearly indicated.

Question 5

Psychotherapy for individuals at risk for complicated grief focuses on which goals? Select all that apply.

Accepted Answer

Grief therapy is offered when a problem-not necessarily dysfunctional grief-exists or is anticipated.It focuses on emotional responses to loss and problem solving related to moving forward in life.Anxiety and/or depression may develop,even with normal grief,and require the short-term use of anxiolytic or antidepressant medications;however,antipsychotic drugs would not be expected.Physical symptoms such as weakness,anorexia,shortness of breath,tightness of the chest,dry mouth,and gastrointestinal disturbances may accompany acute grief,but the development of actual complications indicates dysfunctional grief.

Question 6

A nurse had cared for a terminally ill patient for over a month and always looked forward to spending time with the patient.When the patient died,the nurse experienced sadness and felt mildly depressed.Eventually,the nurse explains these feelings to a mentor.The mentor should counsel the nurse:

Accepted Answer

The nurse is experiencing disenfranchised grief.Nurses often incur loss that is not openly acknowledged or publicly mourned.The loss of a patient may not be recognized or acknowledged by others;therefore the grief is solitary and uncomforted and may be difficult to resolve.

Question 7

Which statements by a patient who is terminally ill give the nurse information relevant to spiritual assessment? Select all that apply.

Accepted Answer

Spirituality encompasses finding meaning in the process of living and dying,as well as hope and inner peace.Listening to hymns identifies an activity that connects the patient to his or her beliefs and is helpful in calming anxieties.The other options are not directly related to spiritual aspects.

Question 8

Children of a widowed parent confer with the nurse;their surviving parent repeatedly relates the details of finding the deceased parent not breathing,performing cardiopulmonary resuscitation (CPR),going to the hospital by ambulance,and seeing the pronouncement of death.The family asks,"What can we do?" The nurse should counsel the family:

Accepted Answer

Nurses are encouraged to tell bereaved patients that telling the personal story of loss as many times as needed is acceptable and healthy;repetition is a helpful and necessary part of grieving.

Question 9

An individual was killed during a store robbery 2 weeks earlier.The widowed spouse,who has schizoaffective disorder,cries spontaneously when talking about the death.Which is the nurse's most therapeutic comment?

Accepted Answer

The patient is expressing feelings related to the loss,and this is an expected and healthy behavior.This patient is at risk for dysfunctional grieving because of the history of a severe psychiatric illness,but the nurse's priority intervention is to form a therapeutic alliance and support the patient's expression of feelings.The patient's crying 2 weeks after the spouse's death is expected and normal.

Question 10

A terminally ill patient tells the nurse,"Life has been good.I am proud of being self-educated.I overcame adversity with willpower.I always gave my best and expected things to turn out well.I intend to die as I lived: optimistically." The nurse planning care for this patient recognizes a critical need to:

Accepted Answer

The patient whose intrinsic strength and endurance have been a hallmark often wishes to approach dying by staying optimistic and in control.Helping the patient use his or her resources to meet challenges is appropriate.

Quiz 25: Care for the Dying and Those Who Grieve