,NUR253/NUR 253 Exam 4 | Mental Health Nursing
Concepts | Galen College | 26/27 (PDF)
1. The nurse is providing support to the family of a client who died 2 hours ago. A family member
states, "I can't believe this is real. I just saw him yesterday, and he was fine." The nurse recognizes this
response as an example of which stage of grief?
A) Denial
B) Anger
C) Bargaining
D) Depression
Correct Answer: Denial
Rationale: Denial is the initial stage of grief, characterized by shock and disbelief that the loss has
occurred. The family member's statement reflects an inability to accept the reality of the death. Anger
involves blaming others, bargaining involves attempting to negotiate for more time, and depression
involves deep sadness and withdrawal.
2. The nurse is caring for a client whose spouse of 50 years died 6 months ago. The client states, "I still
expect to see her when I come home. I don't know how to go on without her." Which response by the
nurse is most therapeutic?
A) "It's been 6 months now; you should be starting to feel better."
B) "You are experiencing a normal grief reaction; tell me more about what you are feeling."
C) "You need to focus on the good memories you shared together."
D) "Have you considered joining a grief support group to help you move on?"
Correct Answer: You are experiencing a normal grief reaction; tell me more about what you are
feeling.
Rationale: This response validates the client's feelings and normalizes the grief process while
encouraging further expression of emotions. Option A minimizes the client's grief by setting an
arbitrary timeline. Option C offers false reassurance and dismisses the client's current pain. Option D
suggests a solution before fully exploring the client's feelings.
,3. The nurse is assessing a client who was recently diagnosed with a terminal illness. The client states,
"If I can just live long enough to see my grandchild born, I will accept whatever happens." The nurse
recognizes this statement as an example of which stage of grief?
A) Denial
B) Anger
C) Bargaining
D) Acceptance
Correct Answer: Bargaining
Rationale: Bargaining is characterized by attempts to negotiate for more time or a different outcome,
often with a higher power. The client's statement reflects a hope to postpone the inevitable in
exchange for acceptance. Denial involves refusal to accept the diagnosis. Anger involves resentment
or blame. Acceptance involves coming to terms with the reality of the situation.
4. The nurse is caring for a client who is actively dying. The client's family members are present and
appear anxious. Which nursing intervention is most appropriate to support the family?
A) Encourage the family to leave the room to give the client privacy
B) Provide the family with information about the dying process and what to expect
C) Ask the family to make decisions about funeral arrangements immediately
D) Reassure the family that everything will be fine
Correct Answer: Provide the family with information about the dying process and what to expect
Rationale: Providing information about the dying process helps reduce anxiety and fear of the
unknown, enabling the family to feel more prepared and supported. Encouraging the family to leave
may increase their distress. Asking about funeral arrangements is premature and insensitive. False
reassurance is not therapeutic.
5. The nurse is caring for a client who is experiencing terminal agitation. Which medication should the
nurse anticipate administering to manage this symptom?
, A) Haloperidol
B) Methylphenidate
C) Fluoxetine
D) Naloxone
Correct Answer: Haloperidol
Rationale: Haloperidol is an antipsychotic commonly used to manage terminal agitation, delirium, and
restlessness in end-of-life care. Methylphenidate is a stimulant used for depression or fatigue.
Fluoxetine is an antidepressant that takes weeks to be effective. Naloxone is an opioid antagonist
used for opioid overdose.
6. The nurse is providing education to a client's family about comfort feeding in advanced dementia.
Which statement by the family indicates understanding?
A) "We will continue to push feeding even if our family member refuses."
B) "We understand that tube feeding is recommended to prevent aspiration."
C) "We will offer food and fluids as long as our family member is able to swallow safely."
D) "We will stop all food and fluids to prevent suffering."
Correct Answer: We will offer food and fluids as long as our family member is able to swallow safely.
Rationale: In advanced dementia, comfort feeding involves offering food and fluids by mouth as
tolerated, without forcing intake or using tube feeding, which does not improve outcomes and may
cause discomfort. Pushing feeding or using tube feeding is not recommended in comfort care.
7. The nurse is assessing a client with dementia who becomes increasingly agitated and confused in
the late afternoon. The nurse documents this phenomenon as:
A) Delirium
B) Sundowning
C) Hallucination
D) Wandering
Concepts | Galen College | 26/27 (PDF)
1. The nurse is providing support to the family of a client who died 2 hours ago. A family member
states, "I can't believe this is real. I just saw him yesterday, and he was fine." The nurse recognizes this
response as an example of which stage of grief?
A) Denial
B) Anger
C) Bargaining
D) Depression
Correct Answer: Denial
Rationale: Denial is the initial stage of grief, characterized by shock and disbelief that the loss has
occurred. The family member's statement reflects an inability to accept the reality of the death. Anger
involves blaming others, bargaining involves attempting to negotiate for more time, and depression
involves deep sadness and withdrawal.
2. The nurse is caring for a client whose spouse of 50 years died 6 months ago. The client states, "I still
expect to see her when I come home. I don't know how to go on without her." Which response by the
nurse is most therapeutic?
A) "It's been 6 months now; you should be starting to feel better."
B) "You are experiencing a normal grief reaction; tell me more about what you are feeling."
C) "You need to focus on the good memories you shared together."
D) "Have you considered joining a grief support group to help you move on?"
Correct Answer: You are experiencing a normal grief reaction; tell me more about what you are
feeling.
Rationale: This response validates the client's feelings and normalizes the grief process while
encouraging further expression of emotions. Option A minimizes the client's grief by setting an
arbitrary timeline. Option C offers false reassurance and dismisses the client's current pain. Option D
suggests a solution before fully exploring the client's feelings.
,3. The nurse is assessing a client who was recently diagnosed with a terminal illness. The client states,
"If I can just live long enough to see my grandchild born, I will accept whatever happens." The nurse
recognizes this statement as an example of which stage of grief?
A) Denial
B) Anger
C) Bargaining
D) Acceptance
Correct Answer: Bargaining
Rationale: Bargaining is characterized by attempts to negotiate for more time or a different outcome,
often with a higher power. The client's statement reflects a hope to postpone the inevitable in
exchange for acceptance. Denial involves refusal to accept the diagnosis. Anger involves resentment
or blame. Acceptance involves coming to terms with the reality of the situation.
4. The nurse is caring for a client who is actively dying. The client's family members are present and
appear anxious. Which nursing intervention is most appropriate to support the family?
A) Encourage the family to leave the room to give the client privacy
B) Provide the family with information about the dying process and what to expect
C) Ask the family to make decisions about funeral arrangements immediately
D) Reassure the family that everything will be fine
Correct Answer: Provide the family with information about the dying process and what to expect
Rationale: Providing information about the dying process helps reduce anxiety and fear of the
unknown, enabling the family to feel more prepared and supported. Encouraging the family to leave
may increase their distress. Asking about funeral arrangements is premature and insensitive. False
reassurance is not therapeutic.
5. The nurse is caring for a client who is experiencing terminal agitation. Which medication should the
nurse anticipate administering to manage this symptom?
, A) Haloperidol
B) Methylphenidate
C) Fluoxetine
D) Naloxone
Correct Answer: Haloperidol
Rationale: Haloperidol is an antipsychotic commonly used to manage terminal agitation, delirium, and
restlessness in end-of-life care. Methylphenidate is a stimulant used for depression or fatigue.
Fluoxetine is an antidepressant that takes weeks to be effective. Naloxone is an opioid antagonist
used for opioid overdose.
6. The nurse is providing education to a client's family about comfort feeding in advanced dementia.
Which statement by the family indicates understanding?
A) "We will continue to push feeding even if our family member refuses."
B) "We understand that tube feeding is recommended to prevent aspiration."
C) "We will offer food and fluids as long as our family member is able to swallow safely."
D) "We will stop all food and fluids to prevent suffering."
Correct Answer: We will offer food and fluids as long as our family member is able to swallow safely.
Rationale: In advanced dementia, comfort feeding involves offering food and fluids by mouth as
tolerated, without forcing intake or using tube feeding, which does not improve outcomes and may
cause discomfort. Pushing feeding or using tube feeding is not recommended in comfort care.
7. The nurse is assessing a client with dementia who becomes increasingly agitated and confused in
the late afternoon. The nurse documents this phenomenon as:
A) Delirium
B) Sundowning
C) Hallucination
D) Wandering
