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Chapter 34 End of Life Issues | Kaplan and Sadock

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Chapter 34 End of Life Issues

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Chapter 34: End of Life Issues
MULTIPLE CHOICE

1. Which physical disturbance is commonly assessed in patients experiencing acute grief?

a. Hypersomnia

b. Increased appetite

c. Tightness in the chest

d. Cardiovascular problems


ANS: C

Chest discomfort is common with the bereaved person. Anorexia is more common. There is no
research to support the connection with cardiovascular involvement. Insomnia is more frequent
than sleepiness.

2. When differentiating between bereavement symptoms and depression, the nurse will base the
formulation on knowledge that in bereavement:

a. Suicide thoughts are common.

b. Symptoms remit and exacerbate.

c. Guilt feelings are overwhelming.

d. Psychomotor retardation is obvious.


ANS: B

Acute exacerbations are common especially around holidays and significant milestones. The
remaining options are more common with depression.




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,3. A grief support group is held at the local community center to assist persons who are dealing
with issues of loss. Which remark by one of the members would the nurse interpret as indicating
unresolved feelings of guilt?

a. I know that my husband had a good life.

b. It seems I miss my son more as time goes on.

c. I am still wishing I had gotten help to him sooner.

d. The Christmas season is always a sad time for me.


ANS: C

Unresolved guilt reflects that the person should have done more. Expressing peace with a
situation indicates closure on the husbands life. Missing indicates continued grieving but not
guilt. Reflection on difficult times is not guilt.

4. A young woman had just learned of the accidental death of her husband. She begins to cry and
states, Its not fair! How could he do this to me? This remark is assessed as:

a. A plea for help

b. An explosive episode

c. An expression of anger

d. Fear of making decisions alone


ANS: C

The remark indicates anger that her husband died on purpose. She is not asking for help nor is
there data to support an explosive response. She is not stating fear.

5. Family and friends rush to offer support to a friend who has lost her teenage son. Which of
these persons, through an intended act of kindness, may contribute to prolonging the womans
grief?

a. The physician who prescribed antianxiety agents




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, b. The nurse who offered to spend the night at her home

c. The next-door teenager who provided care for the sons pet

d. The accountant who assisted with stabilizing their financial affairs


ANS: A

Frequent use of anxiolytic medications can mask grief. The other options are usual offers of
assistance.

6. When a hospitalized patient dies, his wife stares blankly at the nurse and states, It cant be. The
nurse assesses this as indicating:

a. Despair and protest

b. Shock and disbelief

c. Anger and hostility

d. Disorganization and confusion


ANS: B

Shock and disbelief are often the first responses to a death, followed by protest and despair. The
wifes statement does not indicate confusion or anger.

7. When asked, the nurse explains that grief work refers to:

a. Establishing new methods of coping with stress

b. Evaluating progress made toward accepting the loss

c. The means by which one moves through the grief process

d. Actively seeking assistance to cope with the loss experiences


ANS: C

Grief work is moving through the stages of grief. The remaining options can be components of
grief work.




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