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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?
- A. Seek psychotherapy.
- B. Become active in a church.
- C. Go to the spouse's grave every day.
- D. Understand this is a normal response.
Correct Answer: D
Rationale: The patient needs understanding and support that the feelings are normal. Loneliness and aimlessness are most pronounced 6 to 9 months after the death.
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A nurse 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. What should be the mentor's focus when counseling the nurse?
- A. Implementing stress-reduction strategies
- B. Seeking therapy for dysfunctional grief
- C. Discussing the experience of disenfranchised grief
- D. Considering taking a leave of absence to pursue healing
Correct Answer: C
Rationale: The nurse is experiencing disenfranchised grief, which is not openly acknowledged or publicly mourned.
As death approaches, a patient diagnosed with acquired immunodeficiency syndrome (AIDS) says, 'I don't want to see a lot of visitors anymore. Just my parents and my sibling can come in for a while each day.' What action should the nurse take?
- A. Ask the patient to reconsider the decision because many interested and caring friends can be sources of support.
- B. Discuss the request with the parents and sibling. Suggest that they explain the patient's decision to friends.
- C. Suggest that the patient discuss these wishes with the health care provider.
- D. Place a 'no visitors' sign on the patient's door.
Correct Answer: B
Rationale: As many patient's approach death, they begin to withdraw. The correct response demonstrates the nurse's advocacy for the patient's preferences.
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.
What situation makes the mourning process more difficult for the bereaved?
- A. They were relatively independent of the deceased.
- B. They have experienced many previous losses.
- C. They accept that death is expected for everyone.
- D. They had resolved conflicts with the deceased.
Correct Answer: B
Rationale: Factors that have negative effects on the mourning process include a high number of past losses or other recent losses.
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.