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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.
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A person whose spouse died 2 years earlier tells friends, 'I think I'm ready to start going out socially, maybe even take someone to dinner.' What does this comment best demonstrate about the individual's state of mind?
- A. Is denying the significance of the loss.
- B. Is in a period of grief resolution.
- C. Is actively working through grief.
- D. Is experiencing intrusion.
Correct Answer: B
Rationale: Toward the end of the grief process, the person renews his or her interest in people and activities. This behavior indicates resolution.
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.
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.
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.
Which actions by a nurse contribute to protecting the rights of patients who are terminally ill? (Select all that apply.)
- A. Maintain hope for a positive prognosis.
- B. Hug the patient when sadness is expressed.
- C. Offer choices that promote personal control.
- D. Provide interventions that convey respect.
- E. Support the patient's quest for spiritual growth.
Correct Answer: C,D,E
Rationale: The answers support the rights of the individual who is dying. Offering choices, providing respectful interventions, and supporting spiritual growth respect the patient's autonomy and dignity.