Nokea
A recently widowed patient tells the health care provider, 'I have so much epigastric discomfort. I wonder if I have an ulcer.' Diagnostic tests are negative. What does the symptom likely demonstrate?
- A. Early reorganization behavior
- B. Disorganization and depression
- C. Preoccupation with the deceased
- D. Normal phenomenon of mourning
Correct Answer: D
Rationale: Sensations of somatic distress are often experienced during the acute stage of grieving.
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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.
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.
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.
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 widow grieving her husband's sudden and unexpected death tells the nurse, 'I'm not feeling well. Yesterday, I saw my husband walk through the door, stop, and smile at me. Then he just faded away.' Which is the nurse's most appropriate action?
- A. Assess for recent substance abuse.
- B. Suggest a referral to the mental health clinic.
- C. Arrange for an evaluation for antidepressant medication.
- D. Counsel the widow that visualizations are a normal part of grieving.
Correct Answer: D
Rationale: Grieving patients often dream about, visualize, think about, or search for the lost loved one. This is considered a normal phenomenon.