Chapter 42 Death and Loss

Chapter 42  Death and Loss

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The hospice nurse is caring for a terminally ill patient. The patient’s son is distraught because the patient will probably die within the next few days and there is nothing he can do about it. What is the most appropriate nursing diagnosis for the patient’s son at this time?
a.
Chronic sorrow r/t impending death of mother
b.
Impaired religiosity r/t difficulty adhering to religious beliefs
c.
Powerlessness r/t progression of mother’s terminal illness
d.
Complicated grieving r/t desired avoidance of mourning

ANS: C
The patient’s son is experiencing powerlessness because he is unable to change the outcome of his mother’s imminent death. The son makes no mention of religious beliefs, so impaired religiosity is not appropriate. Complicated grieving is applicable to individuals who have recently experienced a loss.

DIF: Applying REF: pp. 1120-1121 TOP: Diagnosis
MSC: NCLEX Client Needs Category: Psychosocial Integrity: Grief and Loss
NOT: Concepts: Coping

2. The nurse is caring for a terminally ill patient whose children have come home to be with their mother during her last few days. They spend time looking through picture albums, watching old home movies, and remembering fun times spent together. Which term best describes the activity of the patient’s children?
a.
Anticipatory grieving
b.
Bereavement
c.
Caregiver role strain
d.
Death anxiety

ANS: A
The patient and her children are experiencing anticipatory grief as they prepare for the expected death of the patient. The patient and her children are preparing themselves for what is to come.

DIF: Applying REF: pp. 1113-1114 TOP: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity: Grief and Loss
NOT: Concepts: Family Dynamics

3. The nurse is caring for a female patient who died a few minutes previously. The patient’s family comes in to the room and immediately starts to wash the body in preparation for burial. What is the most appropriate action of the nurse at this time?
a.
Inform the patient’s family that the body must be transported to the morgue.
b.
Instruct the patient’s family that hospital staff will provide post-mortem care.
c.
Obtain needed signatures for organ donation and autopsy.
d.
Offer to provide any needed supplies and provide privacy for the family.

ANS: D
The most appropriate action of the nurse at this time is to allow the family to wash the patient’s body in accordance with their wishes and cultural values. Signatures may be obtained from the next of kin when washing is complete. The patient’s body may be transported to the morgue or funeral home after washing is completed.

DIF: Applying REF: pp. 1127-1128 TOP: Implementation
MSC: NCLEX Client Needs Category: Psychosocial Integrity: End of Life Care
NOT: Concepts: Family Dynamics

4. The nurse is caring for an emergency room patient who died as a result of a mishap with a loaded gun. The patient’s body will be transported to the coroner’s office for an autopsy. Which items will the nursing staff remove from the body before it leaves the hospital?
a.
Endotracheal tube
b.
Foley catheter and IV line
c.
Dentures
d.
Necklace and watch

ANS: D
Medical devices and tubes are not removed from the body if an autopsy is to be performed. The patient’s necklace and watch may be removed and given to the patient’s family members before the body is transported to the coroner’s office for autopsy. Dentures should be left in the patient’s mouth.

DIF: Understanding REF: p. 1127 TOP: Implementation
MSC: NCLEX Client Needs Category: Psychosocial Integrity: End of Life Care
NOT: Concepts: Health Care Law

5. The nurse is caring for a patient who suffered a miscarriage at 24 weeks of pregnancy. The patient is devastated by the loss but her husband minimizes her grief by stating, “Quit crying. It’s not like you lost a real baby.” What term best describes the anguish felt by the patient?
a.
Disenfranchised grief
b.
Ineffective denial
c.
Moral distress
d.
Interrupted family processes

ANS: A
The patient is experiencing disenfranchised grief because she cannot share the pain of her loss with her husband. The husband is not willing to support his wife as she mourns the loss of her pregnancy or recognize the grief that she is going through.

DIF: Applying REF: p. 1118 TOP: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity: Grief and Loss
NOT: Concepts: Coping