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The nurse is conducting a history and physical exam on a client who is grieving the unwanted loss of a marriage by divorce. Which of the following physical symptoms of grief would the nurse most likely expect to detect in the history?
- A. Headaches
- B. Insomnia
- C. Weight loss
- D. GI upset
Correct Answer: B
Rationale: Insomnia is among the most frequent and persistent physical symptoms associated with bereavement.
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Kubler-Ross developed a model of five stages to explain what people experience as they grieve and mourn. Which is stage V of Kubler-Ross's stages of grieving?
- A. Denial
- B. Bargaining
- C. Acceptance
- D. Anger
Correct Answer: C
Rationale: Stage V of Kubler-Ross's model is acceptance, where the person comes to terms with the loss.
A client is scheduled for a mastectomy for breast cancer. She is quiet, shows little emotion, and states that she has no questions. The nurse's assessment would need to focus on
- A. the client's plans for reconstructive surgery.
- B. the meaning of the mastectomy to the client.
- C. whether the client truly understands the surgery.
- D. why the client seems depressed.
Correct Answer: B
Rationale: Exploring the client's perception of the mastectomy is critical to understanding her anticipatory grief and emotional response.
An elderly woman who lives alone is beginning to have difficulty maintaining her household and performing daily tasks. The nurse asks her to identify someone who can help her. The woman replies, 'I don't need help. I've been managing for years.' Which of the following responses helps the client shift from denial to consciously coping with her situation?
- A. If you don't think you need any help? But your family is worried about you.
- B. It must be hard to lose your independence. I'll ask a social worker to see what can be arranged.
- C. If you were to need help with your house, who might you ask for help?
- D. If you don't ask for some help, then the only option is to move to an assisted living facility.
Correct Answer: C
Rationale: Encouraging the client to consider potential support helps her gradually face the reality of her situation.
Which of the following persons are most likely experiencing complicated grieving? Select all that apply.
- A. The spouse of a person who died 7 years ago and visits the grave several times a day.
- B. The grandchild of a soldier killed in war who visits the grave once a year on Memorial Day.
- C. A driver whose spouse and children all died as a result of his driving drunk.
- D. An adult who insisted for many years that he or she hated his or her deceased parent.
- E. The parent of a child who died after the having left the child in a car on a hot day.
Correct Answer: A,C,D,E
Rationale: Complicated grieving is indicated by prolonged or exaggerated grief, guilt, or ambivalent attachments, as seen in excessive grave visits, guilt from causing a loss, or unresolved feelings toward the deceased.
After being laid off from work, a client becomes increasingly withdrawn and fatigued, spends entire days in bed, is unkempt, and is eating and sleeping poorly. The nurse would recognize that the client is in which stage of grieving, according to Kubler-Ross?
- A. Anger
- B. Bargaining
- C. Denial
- D. Depression
Correct Answer: D
Rationale: The client's symptoms of withdrawal, fatigue, and poor self-care indicate depression, where awareness of the loss becomes acute.