Q&A | Mental Health
1. The nurse is providing support to the family of a recently deceased client.
A family member states, "My father took me fishing all the time. He can't
physically take me anymore, but he will be watching over me. I really miss
him." The nurse recognizes the family member is experiencing:
A) Mourning
B) Anticipatory grief
C) Disenfranchised grief
D) Bereavement
Correct Answer: Mourning
Rationale: Mourning is the outward expression of grief and sorrow following a
loss, often influenced by cultural and personal factors. The statement reflects
the family member processing their loss while acknowledging a continuing
emotional connection, which is characteristic of mourning. Anticipatory grief
occurs before a loss, disenfranchised grief is not socially recognized, and
bereavement is the state of having experienced the loss.
2. The nurse educator is providing an in-service to nursing staff on a unit that
has recently experienced an increase in client deaths. The nurse educator
knows that a priority recommendation for nurses who are struggling to cope
with all the loss is:
A) Creating a sustainable practice of self-care and balance
B) Working additional shifts to provide support for each other
C) Volunteering on days off to stay busy and make a positive difference
D) Temporarily transferring to another unit with fewer terminal diagnoses
Correct Answer: Creating a sustainable practice of self-care and balance
,Rationale: Implementing sustainable self-care practices is crucial for nurses
dealing with compassion fatigue and grief. Working more shifts or
volunteering can lead to burnout, and transferring units may not address the
underlying emotional needs.
3. The nurse is caring for a client whose spouse of 52 years suddenly died.
Which statement by the nurse is most therapeutic?
A) "Your loved one is no longer in pain; you should be happy for that."
B) "You can be grateful for the time you had together."
C) "Your loved one was very special and will not be replaceable."
D) "I know how you feel; I have had many family members pass away."
Correct Answer: "Your loved one was very special and will not be
replaceable."
Rationale: This statement validates the uniqueness of the loss and
acknowledges the client's grief without minimizing it. Options A and B offer
false reassurance, and option D implies the nurse understands the client's
exact experience, which is not therapeutic.
4. The nurse is caring for a client who is dying and in severe pain. Which of
the following interventions should the nurse consider as the priority?
A) Teach the client the end stages of grief.
B) Enhance the client's quality of life.
C) Encourage the client to speak to a grief counselor.
D) Support the client's family in grieving.
Correct Answer: Enhance the client's quality of life.
,Rationale: At the end of life, the priority is to enhance the client's quality of
life by managing pain and other distressing symptoms. This is the essence of
palliative care. Teaching about grief stages, counseling, and family support
are important but secondary to symptom management.
5. The nurse is caring for a terminally ill client. Which statement by the nurse
best demonstrates the art of presence?
A) "Would you like to talk about what this experience is like for you?"
B) "I am going to sit here and read a book, just pretend I am not here."
C) "I am going to the other room so you can be alone and reflect on your life;
please call out if you need me."
D) "Are you feeling guilty about leaving your wife and kids behind?"
Correct Answer: "Would you like to talk about what this experience is like for
you?"
Rationale: The art of presence involves being emotionally and physically
available to the client without being intrusive. This open-ended question
invites the client to share their experience if they wish. Option B is passive,
option C is detached, and option D is a leading, judgmental question.
6. A home health nurse is caring for a client who is dying from acquired
immune deficiency syndrome (AIDS). The client is incompetent and asks the
nurse to help with assisted suicide. The nurse tells the client they will not
assist with the request. Which ethical principle is the nurse demonstrating?
A) Autonomy
B) Nonmaleficence
C) Individual liberty
D) Beneficence
Correct Answer: Nonmaleficence
, Rationale: Nonmaleficence is the ethical principle of "do no harm". The nurse
is refusing to participate in assisted suicide because it would cause harm to
the client. While autonomy respects the client's right to make decisions, it
does not override the nurse's obligation to avoid harm.
7. A nurse is caring for a client in hospice who is in the dying process. The
family wants to put in a feeding tube because the client is refusing to eat.
Which statement by the nurse is appropriate therapeutic communication?
A) "It's natural for clients to refuse food at this stage and can be difficult for
family members."
B) "You do understand this can be a painful procedure."
C) "You do not need to worry about that at this stage of the dying process."
D) "It is not unusual for family members to feel guilty."
Correct Answer: "It's natural for clients to refuse food at this stage and can
be difficult for family members."
Rationale: This response normalizes the family's feelings and provides
education about the dying process. It validates their concern without
dismissing it. Option B focuses on the procedure's pain, which may increase
anxiety.
8. The nurse is caring for a client who is dying. The client tells the nurse, "I
have worked hard all my life and now this, it's not fair!" The nurse recognizes
this statement as reflecting which stage of grief according to Kübler-Ross?
A) Denial
B) Anger
C) Bargaining
D) Depression