Chapter 7 Loss, Grief, and End-of-Life Care

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Chapter 7  Loss, Grief, and End-of-Life Care

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

 

A 74-year-old widow is being seen in the mental health clinic. She has never fully regained the level of activity she had prior to her husband’s death. She continues to have symptoms of depression and has not been able to work or volunteer. In addition, she complains of “anxiety attacks” that occur nearly every night. What type of grief reaction is this client exhibiting?
A)
She is experiencing a normal grief reaction and does not need any intervention at this time.
B)
She is experiencing a prolonged reaction but within normal limits of the grieving process.
C)
She is having a prolonged reaction to her husband’s death, but since she is surrounded by family members who support her, she does not need any interventions at this time.
D)
She is experiencing an unresolved, or dysfunctional, grieving reaction. She needs to have a comprehensive mental health assessment.
Ans:
D

Feedback:

In the case of dysfunctional grief, it is important to treat as soon as possible. Unresolved grieving can lead to other psychological, as well as physical, problems if left untreated. Even in the case of extensive family support, medications are often needed to assist the individual to recover completely from this type of grief reaction.

2.
A client with terminal cancer is discussing health care alternatives with the nurse. The nurse would be correct in giving which of the following explanations of advance care planning?
A)
A plan for care in the event that the individual is rendered unconscious while hospitalized
B)
A plan for parent disposition that is drawn up by the children when parent(s) reach the age of 75
C)
A plan drawn up by the primary nurse that delineates the steps to be taken by nurses on opposite shifts in the event of the client’s death
D)
A plan that involves a thoughtful, facilitated discussion encompassing a lifetime of values, beliefs, and goals to complete an advance directive
Ans:
D

Feedback:

Advance care planning is a thoughtful, facilitated discussion encompassing a lifetime of values, beliefs, and goals and involves completing an advance directive, such as a Living Will, Health Care Directive, or Health Care Proxy. Advance care planning allows the individual to participate fully in decisions regarding end-of-life care or care during catastrophic illness.

3.
A client has just been diagnosed with terminal brain cancer and given approximately two months to live. He wishes to visit his mother soon to “say goodbye.” The nurse acknowledges this reaction as which of the following?
A)
Anticipatory
B)
Bereavement
C)
Mourning
D)
Loss
Ans:
A

Feedback:

Anticipatory grief refers to the reactions that occur when an individual, family, significant other, or friends are expecting a loss or death to occur. Bereavement is the process of grief that includes feelings of sadness, insomnia, poor appetite, deprivation, and desolation. Mourning describes an individual’s outward expression of grief regarding the loss of a loved object or person. Loss is a change in the status of a significant object or situation.

4.
A nurse is caring for a client with terminal cancer. The client states, “If I promise to change my bad habits, the cancer will go away.” The nurse knows that this statement is an example of which of Kubler-Ross’ stages of grief?
A)
Denial
B)
Anger
C)
Bargaining
D)
Acceptance
Ans:
C

Feedback:

This scenario is an example of bargaining to prolong one’s life. Denial serves as a temporary escape from reality. In the anger stage, the client appears difficult, demanding, and ungrateful. In the acceptance stage, the client has achieved an inner and outer peace due to a personal victory over fear.

5.
A client’s quality of life is decreasing as a result of uncontrolled diabetes. Which of the following types of loss is the client experiencing?
A)
Anticipatory
B)
Unexpected
C)
Gradual
D)
Sudden
Ans:
C

Feedback:

Loss of function due to a medical condition usually causes a gradual loss over time. It would not be considered sudden, unexpected, or anticipatory at this point.

 

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