# NUR 155 Exam 4 Review Guide – Foundations of Nursing | Galen
College | 2026/2027
## SECTION 1: GRIEF, LOSS, AND END-OF-LIFE CARE (Questions 1-30)
**1. A nurse is caring for a patient whose spouse died 10 months ago. The patient reports persistent
crying, inability to return to work, and symptoms of depression. This is best described as:**
A) Normal grief
B) Anticipatory grief
C) Complicated grief
D) Disenfranchised grief
**Answer: C**
**Rationale:** Complicated grief is prolonged, intense, or debilitating grief lasting greater than 6
months that can affect a person's well-being and physical health, causing anxiety, depression, and
difficulty with daily functioning .
**2. A patient's family member is crying and expressing anger after learning of a terminal diagnosis.
The nurse recognizes this as which stage of grief?**
A) Denial
B) Anger
C) Bargaining
D) Acceptance
**Answer: B**
**Rationale:** The five stages of grief according to Kübler-Ross are Denial, Anger, Bargaining,
Depression, and Acceptance .
**3. A patient is grieving the loss of a pet, but family members tell the patient, "It was just a dog, get
over it." The nurse recognizes this as:**
,A) Complicated grief
B) Disenfranchised grief
C) Anticipatory grief
D) Normal grief
**Answer: B**
**Rationale:** Disenfranchised grief refers to loss that is not validated or recognized by others, such
as the loss of a pet, a miscarriage, or the death of an ex-spouse .
**4. What is the outward social expression of loss, such as crying or screaming, called?**
A) Bereavement
B) Mourning
C) Grief
D) Acceptance
**Answer: B**
**Rationale:** Mourning is the outward social expression of loss, while bereavement is the period of
time after loss .
**5. Which legal document states a patient's wishes regarding end-of-life medical treatment?**
A) Do Not Resuscitate (DNR) order
B) Living will
C) Healthcare proxy
D) Durable power of attorney
**Answer: B**
**Rationale:** A living will is a legal document that states a patient's wishes for medical treatment at
the end of life .
**6. What is the primary goal of hospice care?**
A) To cure the underlying disease
B) To provide aggressive treatment
, C) To focus on comfort and quality of life
D) To prolong life at all costs
**Answer: C**
**Rationale:** Hospice care is provided for terminally ill patients focusing on comfort, with a
prognosis of 6 months or less .
**7. What is the goal of palliative care?**
A) To cure the underlying disease
B) To focus on relief of symptoms, not curing disease
C) To provide care only at the end of life
D) To prolong life at all costs
**Answer: B**
**Rationale:** Palliative care focuses on symptom relief and improving quality of life, regardless of
whether the patient is at the end of life .
**8. A physical sign of impending death includes:**
A) Increased urine output
B) Decreased urine output
C) Increased appetite
D) Increased activity level
**Answer: B**
**Rationale:** Decreased urine output is a physical sign of impending death .
**9. Grieving before an expected loss is called:**
A) Complicated grief
B) Disenfranchised grief
C) Anticipatory grief
D) Normal grief
**Answer: C**
College | 2026/2027
## SECTION 1: GRIEF, LOSS, AND END-OF-LIFE CARE (Questions 1-30)
**1. A nurse is caring for a patient whose spouse died 10 months ago. The patient reports persistent
crying, inability to return to work, and symptoms of depression. This is best described as:**
A) Normal grief
B) Anticipatory grief
C) Complicated grief
D) Disenfranchised grief
**Answer: C**
**Rationale:** Complicated grief is prolonged, intense, or debilitating grief lasting greater than 6
months that can affect a person's well-being and physical health, causing anxiety, depression, and
difficulty with daily functioning .
**2. A patient's family member is crying and expressing anger after learning of a terminal diagnosis.
The nurse recognizes this as which stage of grief?**
A) Denial
B) Anger
C) Bargaining
D) Acceptance
**Answer: B**
**Rationale:** The five stages of grief according to Kübler-Ross are Denial, Anger, Bargaining,
Depression, and Acceptance .
**3. A patient is grieving the loss of a pet, but family members tell the patient, "It was just a dog, get
over it." The nurse recognizes this as:**
,A) Complicated grief
B) Disenfranchised grief
C) Anticipatory grief
D) Normal grief
**Answer: B**
**Rationale:** Disenfranchised grief refers to loss that is not validated or recognized by others, such
as the loss of a pet, a miscarriage, or the death of an ex-spouse .
**4. What is the outward social expression of loss, such as crying or screaming, called?**
A) Bereavement
B) Mourning
C) Grief
D) Acceptance
**Answer: B**
**Rationale:** Mourning is the outward social expression of loss, while bereavement is the period of
time after loss .
**5. Which legal document states a patient's wishes regarding end-of-life medical treatment?**
A) Do Not Resuscitate (DNR) order
B) Living will
C) Healthcare proxy
D) Durable power of attorney
**Answer: B**
**Rationale:** A living will is a legal document that states a patient's wishes for medical treatment at
the end of life .
**6. What is the primary goal of hospice care?**
A) To cure the underlying disease
B) To provide aggressive treatment
, C) To focus on comfort and quality of life
D) To prolong life at all costs
**Answer: C**
**Rationale:** Hospice care is provided for terminally ill patients focusing on comfort, with a
prognosis of 6 months or less .
**7. What is the goal of palliative care?**
A) To cure the underlying disease
B) To focus on relief of symptoms, not curing disease
C) To provide care only at the end of life
D) To prolong life at all costs
**Answer: B**
**Rationale:** Palliative care focuses on symptom relief and improving quality of life, regardless of
whether the patient is at the end of life .
**8. A physical sign of impending death includes:**
A) Increased urine output
B) Decreased urine output
C) Increased appetite
D) Increased activity level
**Answer: B**
**Rationale:** Decreased urine output is a physical sign of impending death .
**9. Grieving before an expected loss is called:**
A) Complicated grief
B) Disenfranchised grief
C) Anticipatory grief
D) Normal grief
**Answer: C**
