Nokea
A 62-year-old man experienced the loss of his 87-year-old father a week ago. The hospice nurse is making a follow-up visit to determine how he is handling his father?s death. Which of the following statements made indicates to the hospice nurse that patient is in the acute mourning stage of bereavement?
- A. I keep thinking about my father; I have trouble believing he?s dead. I feel guilty because I didn?t go to the nursing home to visit him last week!
- B. I?ve been grieving my father; losing him is a tremendous loss, but I have to get on with my life.
- C. My father was a saint. I am so angry at God for taking him away! I?m crying all the time; I haven?t been able to work for days.
- D. I?m going to spend the weekend with my children; they understand what I?ve been going through, and I can relax around them.
Correct Answer: C
Rationale: The acute mourning stage involves intense emotional reactions such as anger, crying, and inability to work, as seen in the statement about anger at God and persistent crying. The other statements reflect denial/guilt (A), acceptance (B), or coping (D), which align with different stages of grief.
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As part of a community program on crisis prevention, a nurse is describing the phases of crisis. Which of the following would the nurse identify as occurring first?
- A. Problem stimulating usual problem solving
- B. Trial and error attempts to alleviate problem
- C. Automatic relief behaviors take over
- D. Serious personality disorganization
Correct Answer: A
Rationale: The first phase of a crisis involves the individual attempting to use usual problem-solving methods to address the stressor. If ineffective, it progresses to trial-and-error (B), relief behaviors (C), and potentially disorganization (D).
A nurse is part of team working with hurricane victims. One of the hurricane victims is staying in a temporary shelter provided by the Red Cross. To determine the extent to which this victim can cognitively cope with his situation and how much support he needs, which question would be most appropriate for the nurse to ask?
- A. What kind of help do you need from us?
- B. What are your thoughts about what you will do during the next few days?
- C. How are you feeling about all that you have gone through?
- D. Are you feeling guilty because you survived and some of your neighbors did not?
Correct Answer: B
Rationale: Asking about the victim?s thoughts on next steps assesses their cognitive coping and planning ability, indicating their level of functioning and support needs. The other questions focus on practical needs (A), emotions (C), or specific guilt (D), which are less directly tied to cognitive coping.
A nursing instructor who is lecturing to students about how to respond to individuals who are in the midst of a disaster. Which statement would be most appropriate to include about initial nursing interventions for such individuals?
- A. You should ask them to give you a brief medical history so their physical needs can be met.
- B. Focus on safety needs and provide simple, clear instructions to help them function effectively.
- C. Help them determine what their long-term goals will be so they can maintain a sense of hope.
- D. Try to redirect their attention away from the problems at hand so you can decrease their anxiety.
Correct Answer: B
Rationale: In a disaster, initial interventions prioritize safety and clear communication to help individuals function despite stress. Medical history (A), long-term goals (C), or redirection (D) are less immediate and may not address acute needs effectively.
The nurse is providing follow-up care to victims of a disaster that occurred several months ago. Assessment of which of the following would lead the nurse to suspect that the victims are experiencing possible aftereffects of the disaster?
- A. Tachycardia
- B. Profuse perspiration
- C. Unexplained gastrointestinal disturbance
- D. Tremors
Correct Answer: C
Rationale: Unexplained gastrointestinal disturbances can be a psychosomatic aftereffect of disaster-related stress, indicating lingering psychological impact. Tachycardia, perspiration, and tremors are more acute stress responses, less likely months later.
A nursing instructor is describing uncomplicated grief to a class. Which of the following would the instructor most likely include in the discussion?
- A. Uncomplicated grief differs from normal grief because it lasts longer.
- B. Most bereaved persons experience uncomplicated grief.
- C. Uncomplicated grief is primarily loss associated with death.
- D. This type of grief is less painful and disruptive than normal grief.
Correct Answer: B
Rationale: Uncomplicated grief is the typical, adaptive response to loss experienced by most bereaved individuals, resolving naturally over time. It is not longer (A), not limited to death (C), and not less painful (D) than normal grief, as they are synonymous.