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A nurse counsels a person whose spouse recently died. The nurse uses cheer and humor to lift the person's spirits. At one point, the widowed person smiles briefly. What analysis of this scenario is correct?
- A. The nurse's technique was effective.
- B. Use of humor should be added to the plan of care.
- C. This approach may prove useful in other, similar situations.
- D. The nurse needs help developing therapeutic communication skills.
Correct Answer: D
Rationale: The nurse needs help to arrive at a more therapeutic approach. Attempts at cheering up a patient who is grieving serve only to emphasize the disparity between the patient's mood and that of others. Active listening should be the technique used by the nurse.
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The partner of a patient in hospice care angrily tells the nurse, 'The care provided by the aide and other family members is inadequate, so I must do everything myself. Can't anyone do anything right?' How best should the palliative care nurse respond?
- A. Providing teaching about anticipatory grieving
- B. Assigning new personnel to the patient's care
- C. Arranging hospitalization for the patient
- D. Refer the partner for crisis counseling
Correct Answer: A
Rationale: The behaviors described in this scenario are consistent with anticipatory grieving. The spouse needs to be taught about the process of anticipatory grieving.
A terminally ill patient tells the nurse, 'Life has been good. I am proud of my education. I overcame adversity with willpower. I always gave my best and expected things to turn out well. I intend to die as I lived: optimistically.' The nurse planning care for this patient recognizes a critical need to focus on maintaining the patient's state of mind?
- A. Providing aggressive pain and symptom management
- B. Helping the patient reassess and explore existing conflicts
- C. Assisting the patient to focus on the meaning in life and death
- D. Supporting the patient's use of personal resources to meet challenges
Correct Answer: D
Rationale: The patient whose intrinsic strength and endurance have been a hallmark often wishes to approach dying by staying optimistic and in control.
A nurse manager notices that a staff member spends minimal time with a patient diagnosed with AIDS who is terminally ill. The patient says, 'I'm having intense emotional reactions to this illness. Sometimes I feel angry, but other times I feel afraid or abandoned.' The nurse manager can correctly hypothesize that the most likely reason for the staff member's avoidance is triggered by what?
- A. Fear of infection transmission.
- B. Feelings of inadequacy in dealing with complex emotional needs.
- C. Belief that the patient needs time alone with family and friends.
- D. Knowledge that the patient's former lifestyle included high-risk behaviors.
Correct Answer: B
Rationale: Many nurses tend to be more comfortable with meeting physical needs than in focusing on complex emotional needs.
After the death of a spouse, an adult repeatedly says, 'I should have made him go to the doctor when he said he didn't feel well.' What response is this individual likely experiencing?
- A. Preoccupation with the image of the deceased
- B. Sensations of somatic distress
- C. Anger
- D. Guilt
Correct Answer: D
Rationale: Guilt is evident by the bereaved person's self-reproach. Preoccupation refers to dwelling on images of the deceased. Somatic distress would involve bodily symptoms. Anger is not evident from data given in this scenario.
A patient's fianc?© died in an automobile accident several days ago. The patient reports crying and experiencing feelings of guilt and anger. This behavior is characteristic of which aspect of grief?
- A. Denial
- B. Reorganization
- C. Development of awareness
- D. Preoccupation with the loss
Correct Answer: C
Rationale: As denial fades, an awareness of the finality of the loss develops and is accompanied by painful feelings of loss, anger with others, and guilt for taking or not taking specific actions.