Chapter 24: Loss, Grief, Dying, and Death My Nursing Test Banks

Chapter 24: Loss, Grief, Dying, and Death

Cooper and Gosnell: Foundations and Adult Health Nursing, 7th Edition

MULTIPLE CHOICE

1.What is the final stage of human growth and development?

a. Integrity
b. Death
c. Despair
d. Resolution

ANS: B

Death is the final stage of growth and development.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Pages 735-736

OBJ: 3 TOP: Death KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

2.A young nurse caring for a dying patient hastens through the care and leaves the room as quickly as possible. What common reaction to the care of the dying is the nurse exhibiting?

a. Efficiency
b. Anger
c. Withdrawal
d. Anxiety

ANS: C

Withdrawal is a common reaction to the care of the dying.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 744

OBJ: 5 TOP: Withdrawal KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity

3.Changes in health care reimbursement measures have resulted in which of the following changes regarding care of the terminally ill?

a. Patients spend more time in hospitals
b. Nurses provide more care in hospitals
c. More patients die at home
d. Patients spend more time in rehab facilities

ANS: C

Due to changes in reimbursement measures, more patients are dying at home.

PTS: 1 DIF: Cognitive Level: Application REF: Page 736

OBJ: 2 TOP: Death KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

4.How does a perceived loss differ from an actual loss?

a. A perceived loss is more quickly resolved.
b. A perceived loss is situational.
c. A perceived loss is easily overlooked.
d. A perceived loss has a superficial response.

ANS: C

Perceived losses are easily overlooked.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 736

OBJ: 1 TOP: Loss KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity

5.Upon being told of her fathers death, the daughter cries out, No! Oh, God, no! What stage of grief is the daughter in?

a. Anger
b. Bargaining
c. Denial
d. Prayer

ANS: C

The daughter is exhibiting signs of denial, which is commonly one of the first stages of grief.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 740, Box 24-3

OBJ: 4 TOP: Grief KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity

6.What should the nurse do before approaching a grieving family member?

a. Offer sympathy
b. Assess level of resolution
c. Give assurance that the pain will pass
d. Encourage the family member to return to normal activities

ANS: B

The nurse should assess each aspect of grieving to fully understand where family members are in their grief in order to offer the most effective assistance.

PTS: 1 DIF: Cognitive Level: Application REF: Page 745

OBJ: 6 TOP: Grief KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity

7.A dying patient uses the call light frequently to ask the nurse to do simple tasks. The nurse recognizes this as a fear of:

a. increased pain.
b. failure.
c. abandonment.
d. isolation.

ANS: C

A major fear of the dying patient is fear of abandonment.

PTS: 1 DIF: Cognitive Level: Application REF: Page 754

OBJ: 10 TOP: Death KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity

8.What is the first thing the nurse should do before involving the family in the care of a dying patient?

a. Ask the patient if he or she wants family care
b. Ask family members if they want to assist with care
c. Check the hospital policy on the family giving care
d. Set a caring example

ANS: B

Ascertaining whether the family wants to assist in the patients daily care will clarify what the family members are comfortable doing.

PTS: 1 DIF: Cognitive Level: Application REF: Page 744

OBJ: 13 TOP: Death KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

9.Which of the following would lead the home health nurse to make a nursing diagnosis of unresolved grief for a patient who was widowed 5 months ago?

a. Seeing that the patient keeps a picture of the husband by her bed
b. The patient said tearfully, I cant believe he is gone.
c. Assessing that the patient eats out frequently rather than cooking at home
d. The patient says that she attends church three times a week.

ANS: B

Unresolved grief results when a grieving person does not move past some stage of the grief process.  The widow is still in denial. It would be expected for the widow to keep pictures of her husband in the home. Eating out frequently and attending church would not lead to a diagnosis of unresolved grief, but instead would be encouraged.

PTS: 1 DIF: Cognitive Level: Analysis REF: Pages 741, 742, Table 24-1

OBJ:4TOP:Unresolved grief

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

10.When the nurse is developing a care plan for a terminally ill patient, what might be a realistic goal?

a. The patient will remain pain-free.
b. The patient will function optimally.
c. The patient will spend time out of bed.
d. The patient will demonstrate improved nutritional status.

ANS: B

The goal of the care plan for a terminally ill patient is to assist the patient to function optimally. The other options are not realistic.

PTS: 1 DIF: Cognitive Level: Application REF: Page 747

OBJ: 10 TOP: Care plan KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance

11.Following the death of a day-old infant, the nurse brings the baby to the parents. What is the rationale for the parents visit with the deceased baby?

a. Bond with the family
b. Reinforce the individuality of the baby
c. Generate preparation for another child
d. Make the death a reality

ANS: D

When possible, the parents should see, touch, and hold the infant to cope better with the reality of the death.

PTS: 1 DIF: Cognitive Level: Application REF: Page 748

OBJ: 6 TOP: Death KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

12.The nurse spends a great deal of time in the room of a dying 12-year-old because the nurse knows that most children are aware of their condition and want the nurse to do which of the following?

a. Keep them clean
b. Help them eat
c. Care about them
d. Keep them comfortable

ANS: C

Children, like adults, fear abandonment as death approaches and gain comfort from the presence of the nurse.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 748

OBJ:6TOP:Childhood death

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

13.After a physician in the emergency department has pronounced a 2-year-old dead following a swimming pool accident, the mother tearfully says to the father, I am so sorry. I am so sorry. What is the mother expressing?

a. Fear
b. Guilt
c. Hostility
d. Grief

ANS: B

Parents often harbor extreme guilt in an out of sequence death.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 738

OBJ:4TOP:Out of sequence death

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

14.What is the termination of tube feedings to a dying patient considered?

a. Active euthanasia
b. Holistic care
c. Passive euthanasia
d. Terminal care

ANS: C

Permitting the death of a patient by withholding treatments is referred to as passive euthanasia.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 750

OBJ:7TOPassive euthanasia

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

15.How is a durable power of attorney helpful to an incapacitated patient?

a. It directs treatment in accordance with the patients wishes.
b. It directs an agent to make health care decisions.
c. It gives power to an agent to make decisions regarding health, property, and other assets.
d. It can only be executed by an attorney.

ANS: B

The durable power of attorney gives an agent the power to make health care decisions. It can be executed by anyone and does not extend beyond health care issues. A living will directs treatment according to the patients wishes.

PTS: 1 DIF: Cognitive Level: Application REF: Page 751

OBJ:7TOPurable power of attorney

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

16.When a nurse informs a patients spouse that the patient has died, the spouse states, You must be mistaken. Which of Kbler-Rosss stages of dying is the spouse demonstrating?

a. Anger
b. Denial
c. Depression
d. Bargaining

ANS: B

When experiencing denial, the individual acts as though nothing has happened and may refuse to believe or understand that loss has occurred.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 740, Box 24-3

OBJ:3TOP:Stages of dying

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

17.A patient whose spouse died 1 year earlier complains of feeling overwhelmingly lonely and has withdrawn from interpersonal interactions. The patient is demonstrating what stage of dying according to Kbler-Rosss stages of dying theory?

a. Anger
b. Denial
c. Depression
d. Bargaining

ANS: C

When experiencing depression, the individual feels overwhelmingly lonely and withdraws from interpersonal interaction.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 740, Box 24-3

OBJ:3TOP:Stages of dying

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

18.A nurse is caring for the dying mother of a 7-year-old child. What is important for the nurse to understand regarding the child?

a. The child associates death with aggression.
b. The child believes his or her own death cannot be avoided.
c. The child lacks understanding of the concept of death.
d. The child understands death as the inevitable end of life.

ANS: A

A child from 5 to 9 years old understands that death is final, believes ones own death can be avoided, associates death with aggression or violence, and believes wishes or unrelated actions can be responsible for death. A child between the ages of 9 to 12 years understands that death is the inevitable end of life.

PTS: 1 DIF: Cognitive Level: Application REF: Page 740, Table 24-1

OBJ:4TOP:Understanding of death

KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

MULTIPLE RESPONSE

19.The home health nurse assesses that the goal of grief resolution has been accomplished when the nurse observes that a widow has performed which activities? (Select all that apply.)

a. Adjusted to an environment without the spouse
b. Put financial affairs in order
c. Made plans for a lengthy trip
d. Sought new relationships
e. Acquired a job

ANS: A, D

Environmental adjustment and seeking new relationships are clear evidence of grief resolution. A trip, arranging financial affairs, or finding employment may be a form of denial or activities that may be dictated by the situation and is not necessarily resolution of grief.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 759

OBJ:13TOP:Grief resolution

KEY: Nursing Process Step: Evaluation MSC: NCLEX: Psychosocial Integrity

20.Which of the five aspects of human functioning must a nurse address when dealing with a grieving person? (Select all that apply.)

a. Physical
b. Emotional
c. Intellectual
d. Financial
e. Spiritual

ANS: A, B, C, E

The five areas of human function are physical, emotional, intellectual, sociocultural, and spiritual.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 741

OBJ: 5 TOP: Aspects of human function KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

COMPLETION

21.The nurse explains to a grieving husband that the process of the resolution of the hurt and the reestablishment of his life is called the __________ ___________.

ANS:

grief process

grieving process

The grief process includes the resolution of the hurt and the reestablishment of life activities following bereavement.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 735

OBJ:13TOP:Grief process

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

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