MI
When a spouse suddenly dies from a myocardial infarction, the surviving partner experiences intense shock and disbelief — this type of grief reaction is most likely to occur.
What is acute grief?
(Rationale: Acute grief is the immediate, intense emotional response following a sudden or unexpected loss.)
A patient who undergoes a below-the-knee amputation after trauma is experiencing grief over the permanent loss of a body part. This is an example of this type of loss.
What is situational or actual loss?
(Rationale: The loss is tangible and occurs suddenly due to a specific event, often resulting in acute grief.)
When parents learn that their newborn has a fatal congenital defect, the nurse recognizes this as an example of this type of loss.
What is anticipatory loss?
(Rationale: The grieving process begins before the actual death occurs, as parents anticipate losing their child.)
The nurse understands that parents who experience the delivery of a stillborn infant are suffering from this type of loss.
What is a perinatal or developmental loss?
(Rationale: The loss of a baby before, during, or shortly after birth is classified as perinatal loss — a profound, multifaceted grief experience.)
A patient’s physician informs them that their illness is terminal, with a prognosis of fewer than six months. The nurse recognizes that this information may trigger this common initial grief response.
What is shock or denial?
(Rationale: Denial is a protective mechanism that allows the patient to gradually process the reality of impending death.)
A patient recovering from an MI says, “If I get through this, I’ll eat right and never miss my medications again.” According to Kübler-Ross, this statement reflects this stage of grief.
What is bargaining?
(Rationale: Bargaining often occurs as patients attempt to regain control or postpone the reality of illness or death.)
A patient says, “If only I had gone to the hospital sooner, maybe they wouldn’t have had to take my leg.” The nurse recognizes this statement as part of this stage of grief.
What is the bargaining stage?
(Rationale: Bargaining reflects an attempt to regain control or reverse the loss through “if only” statements.)
After the sudden death of their 3-month-old infant from SIDS, the parents say, “We just put her down for a nap. We should have checked sooner.” The nurse recognizes this as which stage of grief?
What is guilt or the bargaining stage of grief?
(Rationale: Parents often experience self-blame or bargaining after sudden infant death as a way to cope with shock.)
When informing parents of a stillbirth, the nurse’s most therapeutic approach is this.
What is using clear, compassionate, and honest language, allowing silence, and offering emotional presence?
(Rationale: Honest, empathetic communication helps families process the reality of the loss while feeling supported.)
A patient with terminal cancer says, “I just want to see my children grow up.” The nurse’s most therapeutic response is this.
What is, ‘It sounds like family is very important to you. Can you tell me more about what you hope for in the time you have?’
(Rationale: Reflective listening validates feelings and encourages the patient to express priorities and fears.)
After a patient dies suddenly from a massive MI, the spouse screams, “No! This can’t be true!” The nurse recognizes this as a normal expression of this stage of grief.
What is denial?
(Rationale: Denial acts as an initial protective mechanism that buffers the impact of sudden loss.)
After an amputation, a patient refuses to look at or touch the residual limb. The nurse understands this behavior indicates this response.
What is ineffective coping related to disturbed body image?
(Rationale: Avoidance is a normal early reaction; the nurse supports gradual acceptance through encouragement and open communication.)
A nurse caring for parents whose infant died from SIDS should use this communication approach.
What is offering empathetic presence, listening without judgment, and avoiding clichés like ‘It was meant to be’?
(Rationale: Therapeutic presence and validation of feelings promote healing; false reassurance can block the grieving process.)
After the birth of a stillborn infant, the nurse should encourage the parents to do this before the body is removed.
What is holding, naming, or creating mementos such as photos, footprints, or a lock of hair?
(Rationale: Encouraging meaningful rituals helps families begin grieving and acknowledge the baby’s existence.)
For a terminally ill patient experiencing severe dyspnea and anxiety, the nurse anticipates administration of this type of medication to promote comfort.
What is low-dose opioids (e.g., morphine) with or without anxiolytics?
(Rationale: Opioids relieve dyspnea and pain; anxiolytics reduce anxiety, both improving quality of life.)
When comforting a family whose loved one died of an MI, the nurse’s most therapeutic response is this.
What is sitting quietly with the family, offering presence, and allowing them to express emotions freely?
(Rationale: Silence, presence, and active listening are key therapeutic techniques for supporting grief.)
A patient states tearfully, “I’ll never be the same again.” The nurse’s most therapeutic response is this.
What is, ‘You’re feeling a real sense of loss right now. Can you tell me more about what that means for you?’
(Rationale: Reflective listening validates the patient’s emotions and promotes expression, a key part of grief resolution.)
Following the loss of a newborn with a congenital defect, the nurse can best support the family’s grieving process by doing this.
What is offering the parents the opportunity to hold, bathe, and spend private time with their infant?
(Rationale: Physical contact helps parents say goodbye and supports acceptance of the reality of loss.)
A nurse caring for a mother after a stillbirth notes that she avoids seeing her baby and refuses to talk. The nurse’s best action is this.
What is gently offering opportunities for contact later and providing ongoing emotional support without forcing interaction?
(Rationale: Respecting the mother’s pace of grieving fosters trust and reduces risk of retraumatization.)
When a family struggles to accept the patient’s terminal prognosis, the nurse’s best intervention is this.
What is providing education about the disease process, facilitating discussion, and offering emotional support and referral to counseling or support groups?
(Rationale: Education and support help families cope and prepare emotionally for the patient’s death.)
A spouse six months after their partner’s death from an MI is unable to return to work, isolates from friends, and expresses hopelessness. The nurse recognizes this as a sign of this type of grief.
What is complicated (or dysfunctional) grief?
(Rationale: Persistent, disabling grief that interferes with functioning requires nursing assessment and possible referral for counseling.)
During rehabilitation after amputation, the nurse can best support healthy grieving and adjustment by doing this.
What is encouraging participation in self-care and use of the prosthesis as readiness increases?
(Rationale: Promotes autonomy, body image reintegration, and acceptance of the new physical reality.)
A mother six months after her infant’s SIDS death continues to isolate, avoids family, and says, “I don’t deserve to be happy.” The nurse recognizes this as a sign of this condition.
What is complicated or unresolved grief?
(Rationale: Persistent guilt and impaired functioning indicate pathologic grief, requiring referral for counseling or support.)
Several weeks after a stillbirth, the mother says, “I can’t stop thinking about the baby. I can’t sleep or take care of my other kids.” The nurse recognizes this as a possible sign of this condition.
What is complicated or pathological grief?
(Rationale: Intense, prolonged emotional distress and impaired functioning signal the need for professional mental health support.)
A terminally ill patient requests to stop aggressive treatment and focus on comfort care. The nurse ensures this request is honored through this type of documentation.
What is an advance directive or Physician Orders for Life-Sustaining Treatment (POLST) form?
(Rationale: Legal documentation ensures patient wishes are respected and guides care at end-of-life.)