Nokea
A woman whose husband is terminally ill says, 'I don't want to cry in front of him. I don't want him to know how soon death will occur or how sad I am.' Which response by the nurse would be most therapeutic?
- A. I'm glad you are protecting him at a time when he is so vulnerable.'
- B. He might be more comforted than disturbed by your tears.'
- C. It's important for you to know that time is running out.'
- D. You definitely need to be honest about your feelings.'
Correct Answer: B
Rationale: Emotional honesty is important to both the patient and the family. The patient may be comforted to know that the family is facing the inevitable.
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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.
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.
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.
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.
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.