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Assessment of a patient indicates complicated grief. Which statements would the nurse identify as supporting this reaction? Select all that apply.
- A. It?s been 2 months, and I still want my son back.
- B. I still wait for him to come right through the door every day.
- C. I?m really struggling with trusting anybody anymore.
- D. I wish I could go back to the days before he died.
- E. Life seems so empty now that he?s gone. What will I do?
Correct Answer: A,B,C,D,E
Rationale: Complicated grief involves persistent, intense symptoms such as longing (A), denial of the loss (B), trust issues (C), yearning for the past (D), and feelings of emptiness (E), indicating difficulty moving forward.
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A 62-year-old man experienced the loss of his 87-year-old father a week ago. The hospice nurse is making a follow-up visit to determine how he is handling his father?s death. Which of the following statements made indicates to the hospice nurse that patient is in the acute mourning stage of bereavement?
- A. I keep thinking about my father; I have trouble believing he?s dead. I feel guilty because I didn?t go to the nursing home to visit him last week!
- B. I?ve been grieving my father; losing him is a tremendous loss, but I have to get on with my life.
- C. My father was a saint. I am so angry at God for taking him away! I?m crying all the time; I haven?t been able to work for days.
- D. I?m going to spend the weekend with my children; they understand what I?ve been going through, and I can relax around them.
Correct Answer: C
Rationale: The acute mourning stage involves intense emotional reactions such as anger, crying, and inability to work, as seen in the statement about anger at God and persistent crying. The other statements reflect denial/guilt (A), acceptance (B), or coping (D), which align with different stages of grief.
A patient is experiencing traumatic grief resulting from the suicide of a family member. In addition to the usual emotions experienced with bereavement and grief, which of the following would the person most likely exhibit? Select all that apply.
- A. Acceptance of the loss
- B. Sense of rejection
- C. Disgust
- D. Stigmatization
- E. Self-blame
Correct Answer: B,D,E
Rationale: Traumatic grief from suicide often includes feelings of rejection (B), stigmatization (D) due to societal views, and self-blame (E) for not preventing the death. Acceptance (A) is less likely in traumatic grief, and disgust (C) is not typical.
As part of a community program on crisis prevention, a nurse is describing the phases of crisis. Which of the following would the nurse identify as occurring first?
- A. Problem stimulating usual problem solving
- B. Trial and error attempts to alleviate problem
- C. Automatic relief behaviors take over
- D. Serious personality disorganization
Correct Answer: A
Rationale: The first phase of a crisis involves the individual attempting to use usual problem-solving methods to address the stressor. If ineffective, it progresses to trial-and-error (B), relief behaviors (C), and potentially disorganization (D).
A nurse is working with a patient who is in crisis. Which of the following would be least appropriate for the nurse to do?
- A. Support the patient?s cultural beliefs about expressing feelings.
- B. Encourage the patient to focus on one aspect at a time.
- C. Provide the patient with an understanding that everything will be okay.
- D. Explain information clearly to clarify any misconceptions or myths.
Correct Answer: C
Rationale: Promising that 'everything will be okay' is inappropriate as it may dismiss the patient?s reality and undermine trust. Supporting cultural beliefs (A), focusing on one aspect (B), and clarifying information (D) are therapeutic interventions.
The nurse is providing follow-up care to victims of a disaster that occurred several months ago. Assessment of which of the following would lead the nurse to suspect that the victims are experiencing possible aftereffects of the disaster?
- A. Tachycardia
- B. Profuse perspiration
- C. Unexplained gastrointestinal disturbance
- D. Tremors
Correct Answer: C
Rationale: Unexplained gastrointestinal disturbances can be a psychosomatic aftereffect of disaster-related stress, indicating lingering psychological impact. Tachycardia, perspiration, and tremors are more acute stress responses, less likely months later.