Chapter 36 Loss and Grief Fundamentals of Nursing 11th Edition (Potter & Perry) 50 NCLEX-Style Exam Questions with Detailed Rationale

1. A nurse is caring for a terminally ill patient who says, “I’m not ready to die.” Which stage of grief is the patient most likely experiencing, according to Kübler-Ross? A) Denial B) Anger C) Bargaining D) Depression Answer: A Rationale: The denial stage involves difficulty accepting the reality of death. ________________________________________ 2. A family caregiver reports that their loved one has been withdrawn and quiet since receiving a terminal diagnosis. What is the nurse’s best interpretation? A) The patient is depressed and needs medication. B) The patient is progressing through normal grief. C) The patient is in the anger stage of grief. D) The patient may be hearing impaired. Answer: B Rationale: Withdrawal is a normal reaction and part of anticipatory grief in the dying process. ________________________________________ 3. A patient with terminal cancer states, “If I can just live to see my granddaughter graduate, I’ll be at peace.” This statement best reflects which stage of grief? A) Acceptance B) Depression C) Bargaining D) Denial Answer: C Rationale: Bargaining often involves negotiations or promises to delay death or loss. ________________________________________ 4. Which of the following statements by the nurse demonstrates appropriate support for a grieving family? A) “You need to stay strong for your children.” B) “Try not to cry in front of the patient.” C) “Tell me what this loss means to you.” D) “You should focus on the positive memories.” Answer: C Rationale: Open-ended questions allow the family to express feelings and find meaning in the loss. ________________________________________ 5. In providing palliative care, the nurse should prioritize which of the following? A) Curative treatment and disease control B) Emotional, spiritual, and physical comfort C) Avoiding conversation about death D) Encouraging complete independence Answer: B Rationale: Palliative care focuses on quality of life and holistic comfort. ________________________________________ 6. Which statement by a patient’s spouse indicates complicated grief? A) “I still cry sometimes, but I’m managing.” B) “It’s been a year, and I feel like I died too.” C) “We talk about him often and remember the good times.” D) “She’s at peace now.” Answer: B Rationale: Persistent, intense grief after a year may suggest complicated grief requiring intervention. ________________________________________ 7. A nurse is planning care for a dying patient. Which intervention best aligns with promoting a dignified death? A) Limiting family visitation B) Minimizing spiritual discussions C) Respecting patient preferences and wishes D) Avoiding opioid use Answer: C Rationale: Dignity is preserved when care is personalized and patient-centered. ________________________________________ 8. Which of the following is a priority nursing intervention during the dying process? A) Encouraging the patient to ambulate B) Administering curative medications C) Managing pain and dyspnea D) Performing all ADLs for the patient Answer: C Rationale: Comfort is a top priority in end-of-life care. ________________________________________ 9. A nurse caring for a patient at end of life notices noisy breathing or the “death rattle.” What is the appropriate intervention? A) Increase fluid intake B) Suction continuously C) Reposition and provide anticholinergic medications D) Call a code Answer: C Rationale: Repositioning and medications reduce secretions and improve comfort.