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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.
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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.
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.
Children of a widowed parent confer with the nurse; their surviving parent repeatedly relates the details of finding the deceased parent not breathing, performing cardiopulmonary resuscitation, going to the hospital by ambulance, and seeing the pronouncement of death. The family asks, 'What can we do?' How should the nurse best counsel the family?
- A. Encouraging them to share their own feelings with the surviving parent and ask for the retelling to stop
- B. Support the ideas that retelling the story should be limited to once daily to avoid unnecessary stimulation
- C. Share with them that retelling memories is to be expected as part of the aging process
- D. Reassure them that repeating the story is a helpful and a necessary part of grieving
Correct Answer: D
Rationale: Nurses are encouraged to tell bereaved patients that telling the personal story of loss as many times as needed is acceptable and healthy.
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.
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.