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A family of a terminally ill patient asks the nurse, 'What can we say when our family member mentions death is coming soon?' Which response could the nurse suggest?
- A. We think you will be around for a long time.'
- B. We don't want you to give up trying to get well.'
- C. We don't think we're ready to talk about this yet.'
- D. We feel so sad when we think of life without you.'
Correct Answer: D
Rationale: This response is emotionally honest. It will allow the family opportunities to express emotions and further resolve issues in the relationship.
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A terminally ill patient says, 'I know I'm not going to get well, but still.' and the patient's voice trails off. Which response by the nurse is therapeutic?
- A. What do you hope for?'
- B. No, you're not going to get well.'
- C. Do you have questions about what is happening?'
- D. I'm happy you are being realistic about your future.'
Correct Answer: A
Rationale: This open-ended response is an example of following the patient's lead. It provides an opportunity for the patient to speak about whatever is on his or her mind.
Psychotherapy for individuals at risk for complicated grief focuses on which goals? (Select all that apply.)
- A. Exploring emotional responses to a loss
- B. Identifying ways to break bonds with the deceased
- C. Solving problems related to moving forward in life
- D. Learning about the stages and symptoms of grieving
- E. Using antipsychotic medications for dysfunctional grief
Correct Answer: A,C,D
Rationale: Psychotherapy focuses on emotional responses, problem-solving for moving forward, and understanding grief stages. Antipsychotic medications are not typically used for grief.
An adult who was widowed 18 months ago says, 'I can now remember good times we shared without getting upset. Sometimes I even think about the disappointments. I've become accustomed to sleeping in our bed alone.' How is the work of mourning best characterized?
- A. It is beginning.
- B. It is progressing abnormally.
- C. It is at or near completion.
- D. It has not yet begun.
Correct Answer: C
Rationale: The work of mourning has been successfully completed when the bereaved can remember both the positive and negative memories about the deceased and when the task of restructuring the relationship with the deceased is completed.
Which statements by a patient who is terminally ill give the nurse information relevant to spiritual assessment? (Select all that apply.)
- A. I feel an inner peace with my decision to use hospice services.'
- B. I trust my health care provider to prescribe enough medication to keep me free of pain.'
- C. I have prepared advance directives to spare my children the need to make difficult decisions.'
- D. I plan to use these last weeks to experience the process of dying as fully as I experienced the richness of living.'
- E. Listening to hymns helps deepen my relaxation and the relief I get from my pain medication.'
Correct Answer: A,D,E
Rationale: Spirituality encompasses finding meaning in the process of living and dying, as well as hope and inner peace. Statements A, D, and E reflect these aspects.
A patient diagnosed with metastatic brain cancer says, 'I'm dying, but I'm still living. I want to be in control as long as I can.' Which reply shows the nurse was actively listening?
- A. Our staff will do their best to help you feel comfortable.'
- B. Most people do not know how to help and are afraid of death.'
- C. Although your body is frail, your mind and spirit are healthy.'
- D. You want people to stop focusing on your weaknesses.'
Correct Answer: C
Rationale: The patient is asking for acknowledgment that he or she is not totally sick; even in the terminal state, strengths and capabilities are present.