,NUR253/NUR 253 Exam 4 | Mental Health | Galen
College | Q & A | 2026/2027 Edition (PDF)
**1. A hospice nurse is caring for a terminally ill client who states, "I can't believe this is happening to
me. There must be some mistake." According to Kübler-Ross, which stage of grief is the client
exhibiting?**
A) Anger
B) Bargaining
C) Denial
D) Depression
Correct Answer: Denial
Rationale: Denial is the first stage of Kübler-Ross's grief model, characterized by shock and disbelief. The
client's statement reflects an inability to accept the reality of the situation. Denial serves as a temporary
defense mechanism that allows the client to process the overwhelming news at their own pace. The
hospice nurse should allow the client to express their feelings without pushing them to move to another
stage.
**2. The nurse is providing education to a client who is in the bargaining stage of grief. Which statement
by the client is most consistent with this stage?**
A) "I can't believe this is happening to me."
B) "If I just do everything right, maybe I'll be okay."
C) "Why me? This isn't fair."
D) "I'm ready to let go."
Correct Answer: "If I just do everything right, maybe I'll be okay."
Rationale: Bargaining is characterized by attempts to negotiate for more time or a better outcome, often
with a higher power. The statement reflects a desire to control the situation through good behavior. This
is a common coping mechanism in the dying process, and the nurse should listen empathetically without
reinforcing false hope.
,**3. A client whose spouse died 8 months ago tells the nurse, "I still feel so empty inside. I don't know
how to go on without them." Which response by the nurse is most therapeutic?**
A) "You should be feeling better by now. It's been 8 months."
B) "Tell me more about what life has been like for you since your spouse died."
C) "Have you considered joining a support group?"
D) "Why do you think you are still feeling this way?"
Correct Answer: "Tell me more about what life has been like for you since your spouse died."
Rationale: This open-ended response encourages the client to express their feelings and explore their
grief experience without judgment. It validates the client's emotions and facilitates therapeutic
communication. Telling the client how they "should" feel is dismissive, and asking "why" can be
perceived as accusatory.
**4. A client whose partner died suddenly is having difficulty accepting the loss and is unable to function
at work. The nurse suspects the client may be experiencing:**
A) Anticipatory grief
B) Disenfranchised grief
C) Complicated grief
D) Normal grief
Correct Answer: Complicated grief
Rationale: Complicated grief (also called prolonged grief disorder) occurs when the grieving process is
prolonged and interferes with daily functioning. It is characterized by intense, persistent grief that does
not improve over time. Normal grief typically resolves within 6-12 months. The client's inability to
function at work indicates the grief has become complicated.
**5. A hospice nurse is caring for a terminally ill client who is in the acceptance stage of dying. Which
nursing intervention is most appropriate?**
A) Encourage the client to fight the illness
, B) Provide a calm, supportive presence
C) Suggest the client seek a second opinion
D) Encourage the client to talk about their anger
Correct Answer: Provide a calm, supportive presence
Rationale: In the acceptance stage, the client may be at peace with their impending death. The nurse
should provide a calm, supportive presence and allow the client to express their feelings. Encouraging
the client to fight the illness or seek a second opinion may not be appropriate. The goal is to provide
comfort and dignity.
**6. A client who is grieving the loss of a child asks the nurse, "Why did this happen to me?" Which
response by the nurse is most therapeutic?**
A) "Everything happens for a reason."
B) "I don't know, but I'm here to support you."
C) "You should not question God's plan."
D) "Try to focus on the positive things in your life."
Correct Answer: "I don't know, but I'm here to support you."
Rationale: This response acknowledges the client's pain and offers support without providing false
reassurance or platitudes. It validates the client's feelings and allows them to express their grief. False
reassurance and clichés are non-therapeutic and can invalidate the client's experience.
**7. The nurse is caring for a client who is experiencing disenfranchised grief after the loss of a same-sex
partner. Which nursing intervention is most appropriate?**
A) Tell the client that their grief is not valid
B) Validate the client's grief and provide support
C) Discourage the client from talking about their loss
D) Tell the client that they should not grieve
College | Q & A | 2026/2027 Edition (PDF)
**1. A hospice nurse is caring for a terminally ill client who states, "I can't believe this is happening to
me. There must be some mistake." According to Kübler-Ross, which stage of grief is the client
exhibiting?**
A) Anger
B) Bargaining
C) Denial
D) Depression
Correct Answer: Denial
Rationale: Denial is the first stage of Kübler-Ross's grief model, characterized by shock and disbelief. The
client's statement reflects an inability to accept the reality of the situation. Denial serves as a temporary
defense mechanism that allows the client to process the overwhelming news at their own pace. The
hospice nurse should allow the client to express their feelings without pushing them to move to another
stage.
**2. The nurse is providing education to a client who is in the bargaining stage of grief. Which statement
by the client is most consistent with this stage?**
A) "I can't believe this is happening to me."
B) "If I just do everything right, maybe I'll be okay."
C) "Why me? This isn't fair."
D) "I'm ready to let go."
Correct Answer: "If I just do everything right, maybe I'll be okay."
Rationale: Bargaining is characterized by attempts to negotiate for more time or a better outcome, often
with a higher power. The statement reflects a desire to control the situation through good behavior. This
is a common coping mechanism in the dying process, and the nurse should listen empathetically without
reinforcing false hope.
,**3. A client whose spouse died 8 months ago tells the nurse, "I still feel so empty inside. I don't know
how to go on without them." Which response by the nurse is most therapeutic?**
A) "You should be feeling better by now. It's been 8 months."
B) "Tell me more about what life has been like for you since your spouse died."
C) "Have you considered joining a support group?"
D) "Why do you think you are still feeling this way?"
Correct Answer: "Tell me more about what life has been like for you since your spouse died."
Rationale: This open-ended response encourages the client to express their feelings and explore their
grief experience without judgment. It validates the client's emotions and facilitates therapeutic
communication. Telling the client how they "should" feel is dismissive, and asking "why" can be
perceived as accusatory.
**4. A client whose partner died suddenly is having difficulty accepting the loss and is unable to function
at work. The nurse suspects the client may be experiencing:**
A) Anticipatory grief
B) Disenfranchised grief
C) Complicated grief
D) Normal grief
Correct Answer: Complicated grief
Rationale: Complicated grief (also called prolonged grief disorder) occurs when the grieving process is
prolonged and interferes with daily functioning. It is characterized by intense, persistent grief that does
not improve over time. Normal grief typically resolves within 6-12 months. The client's inability to
function at work indicates the grief has become complicated.
**5. A hospice nurse is caring for a terminally ill client who is in the acceptance stage of dying. Which
nursing intervention is most appropriate?**
A) Encourage the client to fight the illness
, B) Provide a calm, supportive presence
C) Suggest the client seek a second opinion
D) Encourage the client to talk about their anger
Correct Answer: Provide a calm, supportive presence
Rationale: In the acceptance stage, the client may be at peace with their impending death. The nurse
should provide a calm, supportive presence and allow the client to express their feelings. Encouraging
the client to fight the illness or seek a second opinion may not be appropriate. The goal is to provide
comfort and dignity.
**6. A client who is grieving the loss of a child asks the nurse, "Why did this happen to me?" Which
response by the nurse is most therapeutic?**
A) "Everything happens for a reason."
B) "I don't know, but I'm here to support you."
C) "You should not question God's plan."
D) "Try to focus on the positive things in your life."
Correct Answer: "I don't know, but I'm here to support you."
Rationale: This response acknowledges the client's pain and offers support without providing false
reassurance or platitudes. It validates the client's feelings and allows them to express their grief. False
reassurance and clichés are non-therapeutic and can invalidate the client's experience.
**7. The nurse is caring for a client who is experiencing disenfranchised grief after the loss of a same-sex
partner. Which nursing intervention is most appropriate?**
A) Tell the client that their grief is not valid
B) Validate the client's grief and provide support
C) Discourage the client from talking about their loss
D) Tell the client that they should not grieve
