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28 Cards in this Set
- Front
- Back
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Grief experienced in advance of the event is called?
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Anticipatory Grief
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A subjective response of a person who has experienced the loss of a significant other through death is? a) Mourning B) Dysfunctional Grief C) Perceived loss d) Bereavement
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Bereavement
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The state in which an individual or group experiences prolonged unresolved grief & engages in detrimental activities is? a) Mourning B) Dysfunctional Grief C) Perceived loss d) Bereavement
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Dysfunctional Grief
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Emotional suffering often caused by bereavement is? a) dysfunctional grief b) mourning c) bereavement d) grief
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Grief
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An actual or potential situation in which a valued ability, object, or person's inaccessible or changed so thit is perceived as no longer valuable is? a) dysfunctional grief b) mourning c) bereavement d) loss
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Loss
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The process through which grief is eventually resolved or altered is? a) dysfunctional grief b) mourning c) bereavement d) grief
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Mourning
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A loss experienced by one person but cannot be verified by others is referred to as: a) Grief B) Anticipatory Loss C) Perceived loss d) Bereavement
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Perceived loss
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A type of loss that can be recognized by others?
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Actual Loss
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Loss experienced by one person but cannot be verified by others is ?
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Perceived Loss
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An emotional response to loss is?
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Grief
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An outward social expression of the loss is called?
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Mourning
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Age group that believes death is like sleeping and is reversible ? a) 1 - 3 years b) 3 - 6 years c) 6 - 9 years d) 9 - 12 years
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3 - 6 years
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After a nurse questions a client about relationship abuse, the client responds the she is ready to leave the abusive relationship, although past attempts were not successful due to fear, lack of support, lack of confidence, and financial considerations. She asks the nurse for help. An example of perceived loss is: a) Loss of partner b) Loss of dreams c) Loss of residence d) Loss of current lifestyle
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Loss of dreams Perceived loss is experienced by one person but cannot be directly verified by others. Loss of partner, residence, and lifestyle can be seen and acknowledged by others, even if they are not favorable. Dreams are something of which only the client is aware. She may have dreamed of a happier relationship that she finally acknowledge was not forthcoming, or the dream may be of a different origin. Only the client knows.
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A 22-year-old client with recent paraplegia lashes out and curses at the nurse about the breakfast meal. The nurse's best response is: A) "I know you are angry, but I cannot let you make me become the object of your anger. I will send up the dietician." b) "This is not about breakfast. Tell me what you are really angry about." c) "I understand you are angry. I'll shut the door and let you cool off." d) "I hear a lot of anger in your voice that is quite normal and healthy to hear. Is it a new breakfast you want or something else?"
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"I hear a lot of anger in your voice that is quite normal and healthy to hear. Is it a new breakfast you want or something else?" Acknowledging the client's anger and helping the client understand the source of the anger is helpful. Do not take the anger personally. Allow choices and control when possible.
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The ability of an individual to cope with death is dependent upon a number of factors. Which person likely have the most difficulty coping with a death? a) A parent whose 17-year-old child died in an auto accident the night before graduation b) A child of 8 years whose grandparent dies a week before a planned visit c) The spouse of an alcoholic who is killed in an automobile accident d) The grandparent of a child born with Tay-Sachs disease
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A parent whose 17-year-old child died in an auto accident the night before graduation Many factors affect the grieving experience. These include age, significance of the loss, culture, spiritual beliefs, gender, socioeconomic status, social support systems, and the cause of the death. In our culture, the death of an older person is accepted more easily than that of a younger person. The death is more easily accepted if it is anticipated, and if the person who died did not contribute to the death. Usually, the closer the individual is to the person who died, the more difficult it is to cope with the death.
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While the nurse is discussing a client's likely death with family members, one of the offspring inquires, "We plan on taking turns being here for now, but we all want to be here at the time of death. Is there any way we can tell when that time is close?" The nurse's best response is: a) "Often, there is a lucid moment during the last hour that lasts about 15 minutes. First look for relaxation followed by clearing of the eyes, looking around, focusing on faces, and clearing of the throat. Call the others in at that time." a) "I wish I could tell you that there was a way to know. It could be minutes from now or another three days. One just never knows." c) "You can expect more muscle relaxation and less movement. Breathing will become irregular and shallow, and change speed. Call me if you hear mucus in the throat. The pulse and blood pressure will decrease." d) "You can expect the muscles to become rigid, with staring eyes and mouth closed. The head is pulled back with nuchal rigidity. Don't be alarmed when you hear a death rattle in the throat. "
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"You can expect more muscle relaxation and less movement. Breathing will become irregular and shallow, and change speed. Call me if you hear mucus in the throat. The pulse and blood pressure will decrease." Muscles relax with decreased activity. Muscle rigidity is not a usual pattern. The gag reflex is lost, and mucus accumulates in the back of the throat. Vision is blurred. A lucid moment is not a pattern in death. It is difficult to pinpoint the exact time when death will occur, but the imminence of clinical death can be detected.
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Following the death of a child, one of the parents begins to falsely accuse other members of the family of blaming the child's death on the parent. This leads to family members avoiding the mentioned parent for fear of the false accusation. The parent takes this as proof that the family truly believes the accusation. This sets up a destructive cycle of family dysfunction. Which nursing diagnosis is most appropriate for this family? a) Impaired family processes related to impaired adjustment b) Impaired adjustment related to loneliness c) Loneliness related to fear d) Dysfunctional grieving related to loss of relationships
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Impaired family processes related to impaired adjustment The first part of the diagnostic statement reflects the concern at hand, while the second part is the etiology or cause. There are a number of concerns present in this scenario. Following the child's death, the whole family is impaired in processing the event, adjusting, and grieving. In addition, the parent is alienating the family with false accusations, resulting in lack of support, dysfunctional grieving, and loneliness. If the parent improved adjustment to the death, family processing would improve.
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A family with five children experiences a stillbirth. While intervening with the family, one member expresses a view that causes special concern for the nurse. This person is: a) A 3-year-old who wonders if the baby will come home after it gets better b) A 5-year-old who cries, believing the death occurred because the child drew with magic markers on one of the baby blankets c) A 13-year-old who assumes blame as punishment for shoplifting d) A 15-year-old who says, "I still can't believe it is true."
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A 13-year-old who assumes blame as punishment for shoplifting A child of 3 does not understand the concept of death, or its permanence. A child of 5 may associate death with unrelated actions. A 15-year-old is expected to follow similar stages of grief, including denial
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A client questions the nurse about the difference between a living will and power of attorney. The nurse's best response is: a) A lawyer carries a living will, while a designated family member or friend carries out advanced directives. b) In a living will, the client specifies medical treatments to be carried out when incapable of making decisions, while durable power of attorney allows the client to include both treatments to be carried out and treatments to be omitted in the event of terminal illness. c) The living will indicates when a client wishes life support to be discontinued, while durable power of attorney give that power to another in the event of terminal illness. d) The living will allows the client to indicate specific medical treatments to be omitted in the event of terminal illness, while durable power of attorney legally appoints another to make those decisions on the behalf of the client.
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The living will allows the client to indicate specific medical treatments to be omitted in the event of terminal illness. Durable power of attorney legally appoints another to make those decisions on the behalf of the client. Physiological defining characteristics are the somatic aspects that describe the problem or diagnosis. In anxiety, sweaty palms and hyperventilation are the physiological characteristics, while decreased concentration, lack of focus, incoherence, and rigidity in thinking are all examples of cognitive ones.
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A 90-year-old client expresses a wish to die at home after being told that an esophageal stricture prevents swallowing. The client refuses a feeding tube. The family fully supports this decision. The nurse plans to: a) Call hospice care b) Call a rabbi c) Call a lawyer d) Call the coroner
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Call hospice care Hospice care specializes in end-of life care. A rabbi is an important person during the end of life, but there is not an immediate need make this call. A lawyer or coroner is not necessary at this time.
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Proper handling of the body following death is an important intervention for the client, family, and nurse. An intervention that reflects an important principle of postmortem care is: a) Preparing the body to look as clean and natural as possible b) Pulling the sheet over the patient's face until the family is comfortably seated in the room c) Humor is helpful in relieving stress. However, use humor only after family has left. d) Calling the physician to verify the time of death before taking the body to the morgue
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Preparing the body to look as clean and natural as possible The body is to be handled with dignity at all times. This does not include using humor at this time After the body is cleaned and the linen freshened, the sheet is pulled to cover the patient's shoulders. Laws and policies differ regarding the nurse's ability to declare death. Even if a physician is required to declare death, the time of death cannot be verified exactly.
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While talking to adult children of a dying client, the nurse finds them tearful, with ambivalent feelings toward the client. The client often expresses beliefs of a wasted life. The children say that the client was a parent who often showed love but followed it with criticism, anger, damaging accusations, and emotional abuse. The nurse suggests an intervention that may be helpful to the client and other family members. The most likely intervention to be helpful is: a) Listening to relaxation tapes before visiting each other. If negative feelings arise, listen to the tapes together. b) Having a nurse present in the room at all times when one of them visits the client. The nurse will intervene with conflict resolution if problems arise. c) Assuring the client and children that the past no longer matters. The only time that matters is the present and the future. d) Making a videotape of each child telling a story of a time when the client showed love, while the client tells of a special love for each child. Plan a time to watch it together.
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Making a videotape of each child telling a story of a time when the client showed love, while the client tells of a special love for each child. Plan a time to watch it together. Relaxation tapes help with stress reduction, but do not help resolve problems experienced by the client and children. Staffing needs do not permit a nurse to be with one client continually, and families require privacy as well. Assurance that the past no longer matters is an assurance lacking concrete properties.
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An age where one begins to accept one's own mortality and seeks ways to prevent it: a) adolescents b) young to middle adults c) middle adulthood d) older adults
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middle adulthood
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Concrete, magical thinking that results in guilt such as "I once told mommy I wish she were dead" is an example of: a) dysfunctional grief b) perceived loss c) anticipatory grief d) uncomplicated grief
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anticipatory grief
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Actual or fear of potential loss of health, loss of independence, loss of a body part, loss of financial stability, loss of choice, and, or loss of mental function are all examples of? a) perceived loss b) actual loss c) anticipatory grief d) uncomplicated grief
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anticipatory grief
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Grief from which survivors resort to self destructive behaviors such as suicide is called: a) chronic grief b) perceived grief c) d) normal grief
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exaggerated grief
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Cognitive grief all the following EXCEPT: a) dreams of deceased b) inability to concentrate c) fleeting tactile, olfactory, visual and auditory hallucinatory experiences d) guilt of self reproach
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guilt of self reproach
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