loss, death
To best assist a patient in the grieving process, which of the following is most helpful to determine?
1. Previous experiences with grief and loss
2. Religious affiliation and denomination
3. Ethnic background and cultural practices
4. Current financial status.
Answer: 1.
Previous experiences with loss and grief help individuals develop coping skills and set a pattern of response to future episodes of loss and grief.
A young mother is dying of breast cancer with bone metastasis and tells the nurse, “My body hurts so much. I can hardly move. Why is God making me suffer when I have done nothing bad in my life? I feel like giving up. How can I care for my children when I can't even care for myself?” What is the most appropriate nursing diagnosis for this patient?
1. Spiritual Distress related to questioning God
2. Hopelessness related to terminal diagnosis
3. Pain related to disease process
4. Anticipatory Grief related to impending death
Answer: 3.
Pain control is always the priority.
When providing postmortem care, which action is a priority for the nurse?
1. Locating the patient's clothing
2. Providing culturally and religiously sensitive care in body preparation
3. Transporting the body to the morgue as soon as possible
4. Providing postmortem care to protect the family of the deceased from having to view the body
Answer: 2.
Various cultures and religions have specific postmortem care practices. Honoring these practices is important for the family as they prepare to mourn their loved one.
Which of the following is the best intervention to help a hospitalized patient maintain some autonomy?
1. Use therapeutic techniques when communicating with the patient.
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2. Allow the patient to determine timing and scheduling of interventions.
3. Encourage family to only visit for short periods of time.
4. Provide the patient with a private room close to the nurse's station.
Answer: 2.
Providing the opportunity for patients to have control of decisions concerning care allows them to maintain autonomy and dignity.
A grieving patient complains of confusion, inability to concentrate, and insomnia. What do these symptoms indicate?
1. These are normal symptoms of grief.
2. There is a need for pharmacological support for insomnia.
3. The patient is experiencing complicated grief.
4. These are common complaints of the admitted patient.
Answer: 1.
Symptoms of normal grief include a variety of feelings, thought patterns, physical sensations, and behaviors.
A year after her husband's death, a widow visits the unit on which he died. She talks about the anniversary and how much she misses him. Which type of grief is she experiencing? 1. Normal 2. Complicated 3. Chronic 4. Disenfranchised
Answer: 1.
It is normal for anniversaries to prompt feelings of sadness and grief.
Which factors influence a person's approach to death? (Select all that apply.)
1. Culture
2. Age
3. Spirituality
4. Personal beliefs
5. Previous experiences with death
6. Gender
7. Level of education
8. Degree of social support
Answers: 1, 3, 4, 5, 8.
Culture, spirituality, personal beliefs and values, previous experiences with death, and degree of social support influence how a person approaches death.
A patient is receiving palliative care for symptom management related to anxiety and pain. A family member asks if the patient is dying and now in “hospice.” What does the nurse tell the family member about palliative care? (Select all that apply.)
1. Palliative care and hospice are the same thing.
2. Palliative care is for any patient, any time, any disease, in any setting.
3. Palliative care strategies are primarily designed to treat the patient's illness.
4. Palliative care relieves the symptoms of illness and treatment.
5. Palliative care selects home health care services.
Answer: 2, 4.
Palliative care focuses on the prevention, relief, reduction, or soothing of symptoms of disease or disorders throughout the entire course of an illness. It can also include, but is not solely, care of the dying. The primary goal of palliative care is to help patients and families achieve the best possible quality of life.
What is the palliative care team's primary obligation for the patient with severe pain? 1. Providing postmortem care. 2. Teaching about grief stages. 3. Enhancing the patient's quality of life. 4. Supporting the family after the death.
Answer: 3.
Palliative care focuses on enhancing the patient’s quality of life.
A family member of a dying patient talks casually with the nurse and expresses relief that she will not have to visit at the hospital anymore. Which theoretical description of grief best applies to this family member? 1. Denial 2. Anticipatory grief 3. Yearning and searching 4. Dysfunctional grief
. Answer: 2.
Family members often grieve the impending loss of companionship, control, and sense of freedom and the mental and physical changes to be experienced by their loved one. Ultimately they grieve the impending death.
Which comment to a patient by a new nurse regarding palliative care needs to be corrected?
1. “Even though you're continuing treatment, palliative care is something we might want to talk about.”
2. “Palliative care is appropriate for people with any diagnosis.”
3. “Only people who are dying can receive palliative care.”
4. “Children are able to receive palliative care.”
Answer: 3.
Palliative care is available to all patients regardless of age, diagnosis, and prognosis.
What are the physical changes that occur as death approaches? (Select all that apply.) 1. Unresponsiveness 2. Erythema 3. Mottling 4. Restlessness 5. Increased urine output 6. Weakness 7. Incontinence
Answer: 1, 3, 4, 6, 7.
Patients experience physical changes that accompany the body shutting down.
On entering a room the nurse sees the patient crying softly. What is the most therapeutic response?
1. Using silence
2. Asking, “Why are you crying today?”
3. Using therapeutic touch
4. Stating, “I see that you're crying.”
Answer: 4.
Stating an observation encourages patients to share without putting the patient on the defensive.
A nurse has the responsibility of managing a deceased patient's postmortem care. What is the proper order for postmortem care?
1. Bathe the body of the deceased.
2. Collect any needed specimens.
3. Remove all tubes and indwelling lines.
4. Position the body for family viewing.
5. Speak to the family members about their possible participation.
6. Ensure that the request for organ/tissue donation and/or autopsy was completed.
7. Notify support person (e.g., spiritual care provider, bereavement specialist) for the family.
8. Accurately tag the body, including the identity of the deceased and safety issues regarding infection control.
9. Elevate the head of the bed.
Answer: 6, 9, 2, 5, 7, 3, 1, 4, 8.
What are the physical changes that occur as death approaches? (Select all that apply.)
1. Unresponsiveness
2. Erythema
3. Mottling
4. Restlessness
5. Increased urine output
6. Weakness
7. Incontinence
Answer: 1, 2, 4, 5, 6.
A sense of dignity includes a person’s positive self-regard, the ability to find meaning in life, feeling valued by others, and the way one is treated by caregivers.