Chapter 10 Loss, Grief, and Dying

Chapter 10  Loss, Grief, and Dying

Complete Chapter Questions And Answers
 

Sample Questions

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. The nurse understands that when the terminal patient states, “No, I don’t need anything. What would you get me anyway?” he or she is most likely in the stage of grief called
A.
Denial.
B.
Acceptance.
C.
Anger.
D.
Bargaining.

____ 2. A nurse has just witnessed a terminally ill patient telling the physician that he does not wish to have his life prolonged as stated in his living will. The nurse expects that the physician will
A.
Explain to the patient why he should be more hopeful.
B.
Write a Do-Not-Resuscitate (DNR) order.
C.
Speak to the patient’s family before writing a DNR order.
D.
Ignore the patient’s request.

____ 3. A patient dying from colon cancer tells the nurse that he is sure that he can beat the cancer if he changes his eating habits. The nurse understands that the patient is likely in the stage defined by Kübler-Ross that is called
A.
Acceptance.
B.
Anger.
C.
Denial.
D.
Bargaining.

____ 4. When questioned by a patient about the difference between palliative care and the services provided by hospice, the nurse explains that palliative treatment
A.
Is aggressive, but administered to cure the disease.
B.
Is geared toward the patient, family, and their wishes.
C.
May be aggressive and is directed at eliminating discomfort.
D.
Indicates the patient has fewer than 6 months to live.

____ 5. The nurse realizes that a terminally ill patient is ready to talk about dying when he or she states,
A.
“I’m feeling a little stronger each day.”
B.
“Do you think you could just sit with me for a while?”
C.
“I’ve decided to begin taking chemotherapy again.”
D.
“What do you think death feels like?”

Chapter 10. Loss, Grief, and Dying
Answer Section

MULTIPLE CHOICE

1. ANS: C

Feedback
A
Denial involves disbelief that he or she has a terminal illness.
B
Acceptance indicates resolution of conflicting feelings toward death.
C
Answering the nurse’s question and following with “What would you get me anyway?” suggests that the patient is angry. Chapter Objective: Explain the traditional five stages of grief.
D
Bargaining is the stage in which a terminally ill patient offers something in exchange for death.

PTS: 1 REF: Chapter: 10 | Page: 196 OBJ: Chapter Objective: 10-4
KEY: Content Area: Psychosocial Integrity | Integrated Process: Nursing Process/Assessment | Client Need: Psychosocial Integrity/Coping Mechanisms | Cognitive Level: Analysis

2. ANS: C

Feedback
A
The physician will most likely speak further to the patient and family about his request, not giving false hope.
B
The physician will probably wait to write a DNR order until speaking to the family.
C
A DNR order will most likely be discussed with the family prior to writing the order. Chapter Objective: Describe the function of each of the following documents: durable power of attorney, living will, do-not-resuscitate order.
D
In response to a patient’s request, the physician will speak to the family and probably write a DNR order.

PTS: 1 REF: Chapter: 10 | Page: 194 OBJ: Chapter Objective: 10-3
KEY: Content Area: Coordinated Care | Integrated Process: Nursing Process/Planning | Client Need: Safe and Effective Care Environment/Coordinated Care/Advance Directives | Cognitive Level: Application

3. ANS: D

Feedback
A
Acceptance of death would be demonstrated by such things as finalizing a will, telling family everything will be fine, and so forth.
B
The anger stage is characterized by statements that describe frustration and are emotionally charged.
C
When in denial, the patient is attempting to avoid death.
D
A patient stating he will change his eating habits to beat colon cancer is an example of bargaining or bartering. Chapter Objective: Explain the traditional five stages of grief.

PTS: 1 REF: Chapter: 10 | Page: 196 OBJ: Chapter Objective: 10-4
KEY: Content Area: Psychosocial Integrity | Integrated Process: Nursing Process/Assessment | Client Need: Psychosocial Integrity/Coping Mechanisms | Cognitive Level: Analysis

4. ANS: C

Feedback
A
Curing a disease is curative care.
B
Hospice is geared toward the patient and family.
C
Palliative care may be aggressive toward comfort, not toward curing the illness. Chapter Objective: Explain the difference between curative care, palliative care, and hospice care.
D
Patients placed on palliative care generally have more than 6 months to live.

PTS: 1 REF: Chapter: 10 | Page: 190 OBJ: Chapter Objective: 10-2
KEY: Content Area: Psychosocial Integrity | Integrated Process: Teaching and Learning | Client Need: Psychosocial Integrity/End-of-Life Concepts | Cognitive Level: Application

5. ANS: D

Feedback
A
The statement doesn’t acknowledge death.
B
Usually a nurse’s presence is comforting to someone dying or dealing with a difficult situation, but the request doesn’t indicate a need to talk.
C
The decision made to continue treatment may not indicate a need to talk about dying.
D
When a nurse is questioned by a patient about death, the nurse would correctly identify that the patient is ready to discuss it. Chapter Objective: Identify comments the patient might make indicating that he or she desires to discuss a terminal condition.

PTS: 1 REF: Chapter: 10 | Page: 204 OBJ: Chapter Objective: 10-7
KEY: Content Area: Psychosocial Integrity | Integrated Process: Communication and Documentation | Client Need: Psychosocial Integrity/End-of-Life Concepts | Cognitive Level: Analysis