MEDICAL SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMONE
Chapter 5
1. The hospice nurse is working with the family of a 30-year-old client who is dying. The
client voices concerns about how her death will be perceived by her 7-year-old child.
What advice from the nurse would be most beneficial?
1. Advise the client that children that age emotionally distance themselves from the
death.
2. Explain to the client that children of this age recognize death is permanent.
3. Encourage the client to begin to prepare the child by explaining that death is
permanent, as the child fears separation, and might lack comprehension of
permanentseparation.
4. Advise the client that children at this age fear death.
Answer: 2
Rationale: Age is a great determinant of beliefs about death. Children at this age
understand the finality of death. At the age of 7, children do not have the emotional
,MEDICAL SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMONE
maturity to distance themselves from death. The ability to understand separation has been
mastered by the age of 7. The fear of death is typically seen in children this young.
Nursing Process Step: Implementation
Client Needs Category: Psychological Integrity
Client Needs Subcategory:
Cognitive Level: Application
2. A client has reported to the physician’s office with complaints of an inability to sleep at
night. During the data collection, the client reports her estranged husband died a little
over a year ago. She states “I am not sure why this is so difficult, I really couldn’t stand
him near the end.” Which response by the nurse is most appropriate?
1. “You seem angry.”
2. “You should contact a therapist.”
,MEDICAL SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMONE
3. “Sometimes a rocky relationship with someone at the time of their death can
impactyour ability to grieve.”
4. “You are just entering the grief process, things will get better.”
Answer: 3
Rationale: Unresolved conflict at the time of death can impact the ability of survivors to
successfully grieve the deceased. The client’s demeanor does not seem angry. It is
inappropriate for the nurse to refer the client to a therapist. Referrals must be initiated by
the physician. The death occurred more than a year ago. The client’s continued inability
to sleep indicates impaired grieving.
Nursing Process Step: Implementation
Client Needs Category: Psychological Integrity
Client Needs Subcategory:
Cognitive Level: Analysis
3. After suffering a massive cerebral hemorrhage, a client of American Indian descent is
not expected to survive. The family arrives at the hospital. In conversation with the
family, they report they observe most of their religious and cultural traditions. Which of
the following interventions by the nursing staff would be most appropriate?
1. Offer the family a private room to sit together.
2. Discourage the family from sitting with their loved one prior to death.
3. Discuss the possibility of transferring the client home for the death.
4. Encourage the family to assist in the care of the dying client.
Answer: 1
Rationale: Traditional American Indians prefer to mourn in private. They often will
mourn away from the dying client. While the American Indian culture might not
encourage the family to be with the dying individual, it is not appropriate for the nurse to
discourage the family from having time with the client at this critical point. The severity
of the client’s condition does not allow for transfer at this time. Traditional American
Indian rituals associated with death do not encompass assistance with the care.
, MEDICAL SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMONE
Nursing Process Step: Planning
Client Needs Category: Safe, Effective Care Environment
Client Needs Subcategory: Management of Care
Cognitive Level: Application
4. A competent elderly client has a living will. The living will expressed the desire to
avoid resuscitation and heroic life support measures. The family members are not
supportive of this directive. Which of the following actions by the nursing staff is most
appropriate?
1. Contact the Social Services department.
CARE, 4TH EDITION PRISCILLA LEMONE
Chapter 5
1. The hospice nurse is working with the family of a 30-year-old client who is dying. The
client voices concerns about how her death will be perceived by her 7-year-old child.
What advice from the nurse would be most beneficial?
1. Advise the client that children that age emotionally distance themselves from the
death.
2. Explain to the client that children of this age recognize death is permanent.
3. Encourage the client to begin to prepare the child by explaining that death is
permanent, as the child fears separation, and might lack comprehension of
permanentseparation.
4. Advise the client that children at this age fear death.
Answer: 2
Rationale: Age is a great determinant of beliefs about death. Children at this age
understand the finality of death. At the age of 7, children do not have the emotional
,MEDICAL SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMONE
maturity to distance themselves from death. The ability to understand separation has been
mastered by the age of 7. The fear of death is typically seen in children this young.
Nursing Process Step: Implementation
Client Needs Category: Psychological Integrity
Client Needs Subcategory:
Cognitive Level: Application
2. A client has reported to the physician’s office with complaints of an inability to sleep at
night. During the data collection, the client reports her estranged husband died a little
over a year ago. She states “I am not sure why this is so difficult, I really couldn’t stand
him near the end.” Which response by the nurse is most appropriate?
1. “You seem angry.”
2. “You should contact a therapist.”
,MEDICAL SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMONE
3. “Sometimes a rocky relationship with someone at the time of their death can
impactyour ability to grieve.”
4. “You are just entering the grief process, things will get better.”
Answer: 3
Rationale: Unresolved conflict at the time of death can impact the ability of survivors to
successfully grieve the deceased. The client’s demeanor does not seem angry. It is
inappropriate for the nurse to refer the client to a therapist. Referrals must be initiated by
the physician. The death occurred more than a year ago. The client’s continued inability
to sleep indicates impaired grieving.
Nursing Process Step: Implementation
Client Needs Category: Psychological Integrity
Client Needs Subcategory:
Cognitive Level: Analysis
3. After suffering a massive cerebral hemorrhage, a client of American Indian descent is
not expected to survive. The family arrives at the hospital. In conversation with the
family, they report they observe most of their religious and cultural traditions. Which of
the following interventions by the nursing staff would be most appropriate?
1. Offer the family a private room to sit together.
2. Discourage the family from sitting with their loved one prior to death.
3. Discuss the possibility of transferring the client home for the death.
4. Encourage the family to assist in the care of the dying client.
Answer: 1
Rationale: Traditional American Indians prefer to mourn in private. They often will
mourn away from the dying client. While the American Indian culture might not
encourage the family to be with the dying individual, it is not appropriate for the nurse to
discourage the family from having time with the client at this critical point. The severity
of the client’s condition does not allow for transfer at this time. Traditional American
Indian rituals associated with death do not encompass assistance with the care.
, MEDICAL SURGICAL NURSING CRITICAL THINKING IN CLIENT
CARE, 4TH EDITION PRISCILLA LEMONE
Nursing Process Step: Planning
Client Needs Category: Safe, Effective Care Environment
Client Needs Subcategory: Management of Care
Cognitive Level: Application
4. A competent elderly client has a living will. The living will expressed the desire to
avoid resuscitation and heroic life support measures. The family members are not
supportive of this directive. Which of the following actions by the nursing staff is most
appropriate?
1. Contact the Social Services department.
