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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 nurse is assessing the parents of a 6-year-old child who has died from leukemia. The nurse is integrating the dual process model for the assessment. Which of the following would the nurse identify as reflecting the parents? loss-oriented coping?
- A. Engaging in new activities
- B. Denying the grief
- C. Developing new relationships
- D. Thinking about the lost child
Correct Answer: D
Rationale: The dual process model distinguishes loss-oriented coping (focusing on the loss, e.g., thinking about the child) from restoration-oriented coping (e.g., new activities or relationships). Denying grief (B) is not a healthy coping mechanism.
A 25-year-old legal secretary is seeking counseling because she recently lost her job unexpectedly. Which question would be most appropriate for the nurse to use in assessing the patient?s response to losing her job?
- A. What happened to cause you to lose your job?
- B. How did you feel immediately after being told you no longer had a job?
- C. How do you expect yourself to be able to handle this situation?
- D. How have you responded to previous stressful situations?
Correct Answer: B
Rationale: Assessing the patient?s emotional response immediately after the job loss provides insight into the impact of the event and her coping mechanisms. Understanding her feelings helps evaluate the crisis?s severity. The other questions focus on causes, expectations, or past behavior, which are less directly tied to her current response.
A patient?s 5-year-old poodle ran in front of a car and was killed. The patient continues to be upset by her pet?s death, and she explains to a community counseling center nurse that she can?t stop crying because, 'My Precious meant the world to me, and now my world will never be the same!' If the nurse were to determine that the patient was experiencing a crisis, which of the following types of crisis would it most likely be?
- A. Maturational
- B. Situational
- C. Traumatic
- D. Developmental
Correct Answer: B
Rationale: A situational crisis arises from an external event, such as the sudden loss of a pet. The patient?s intense grief and sense of a changed world suggest a situational crisis triggered by the pet?s death. Maturational and developmental crises relate to life transitions, and traumatic crises involve life-threatening events, which do not apply here.
A group of nursing students is reviewing information about the types of crisis. The students demonstrate understanding of the information when they identify which of the following as a developmental crisis?
- A. Going away to college
- B. Obtaining a job promotion
- C. Loss of a pet
- D. Earthquake
Correct Answer: A
Rationale: A developmental crisis occurs during life transitions, such as going away to college, which involves significant role changes. Job promotion (B) is positive, loss of a pet (C) is situational, and an earthquake (D) is traumatic, not developmental.
A nurse is part of team working with hurricane victims. One of the hurricane victims is staying in a temporary shelter provided by the Red Cross. To determine the extent to which this victim can cognitively cope with his situation and how much support he needs, which question would be most appropriate for the nurse to ask?
- A. What kind of help do you need from us?
- B. What are your thoughts about what you will do during the next few days?
- C. How are you feeling about all that you have gone through?
- D. Are you feeling guilty because you survived and some of your neighbors did not?
Correct Answer: B
Rationale: Asking about the victim?s thoughts on next steps assesses their cognitive coping and planning ability, indicating their level of functioning and support needs. The other questions focus on practical needs (A), emotions (C), or specific guilt (D), which are less directly tied to cognitive coping.