Potter and Perry Chapter 36 The Experience of Loss with
complete solution
A nurse encounters a family that experienced the death of their adult child last
year. The parents are talking about the upcoming anniversary of their child's
death. The nurse spends time with them discussing their child's life and death.
The nurse's action best demonstrates which nursing principle?
a. Pain management technique
b. Facilitating normal mourning
c. Grief evaluation
d. Palliative care
ANS: B
Anniversary reactions can reopen grief processes. A nurse should openly acknowledge
the loss and talk about the common renewal of grief feeling around the anniversary of
the individual's death. This facilitates normal mourning. The nurse is not attempting to
alleviate a physical pain. The actions are of open communication, not evaluation.
Palliative care refers to comfort measures for symptom relief.
A cancer patient asks the nurse what the criteria are for hospice care. What
should the nurse answer?
a. Having a terminal illness, such as cancer
b. Needing assistance with pain management
c. Expected to live less than 6 to 12 more months
d. Completion of an advance directive
ANS: C
The criterion for hospice care is being expected to live less than 6 to 12 more months.
Patients with a terminal illness are not eligible until that point. Palliative care provides
assistance with pain management when a patient is not eligible for hospice care. An
advance directive can be
completed by any person, even those who are healthy.
A terminally ill patient is experiencing constipation secondary to pain medication.
What is the best way for the nurse to improve the patient's constipation problem?
a. Massage the patient's abdomen.
b. Contact the provider to discontinue pain medication.
c. Administer enemas twice daily for 7 days.
d. Use a stimulant laxative and increase fluid intake.
ANS: D
Opioid medication is known to slow gastrointestinal transit time, which places the patient
at high risk for constipation. Stimulant laxatives are indicated for opioid-induced
constipation. Added water to the diet will allow water to be pulled into the GI tract,
softening up stool. Massaging the patient's abdomen may cause further discomfort.
Discontinuing pain medication is inappropriate for a terminally ill patient. Enema
administration is not the first
step in the treatment of opioid-induced constipation.
A severely depressed patient cannot state any positive attributes to his or her life.
The nurse patiently sits with this patient and assists the patient to identify several
,activities the patient is actually looking forward to in life. The nurse is helping the
patient to demonstrate which spiritual concept?
a. Time management
b. Hope
c. Charity
d. Faith
ANS: B
The concept of hope is vital to nursing; it enables a person to anticipate positive
experiences. Being patient and friendly and creating positive relationships are key
concepts in all areas of nursing, but especially with depressed patients. The nurse's
actions do not address time management, charity, or faith.
In preparation for the eventual death of a female hospice patient of the Muslim
faith, the nurse organizes a meeting of all hospice caregivers. A plan of care to be
followed when this patient dies is prepared. This plan of care would include
a. Male health care workers care for the body after death has occurred.
b. Body preparation for autopsy.
c. Body preparation for cremation.
d. Female health care workers care for the body after death has occurred.
ANS: D
Islamic culture calls for modesty and same-sex caregivers whenever possible. Muslim
faith discourages cremation and autopsy to preserve the sanctity of the soul of the
deceased.
Family members gather in the emergency department after learning that a family
member was involved in a motor vehicle accident. After learning of the family
member's unexpected death, the surviving family members begin to cry and
scream in despair. The nurse recognizes this as the Bowlby Attachment Theory
stage of
a. Numbing.
b. Disorganization and despair.
c. Bargaining.
d. Yearning and searching.
ANS: D
Yearning and searching characterize the second bereavement phase in the Bowlby
Attachment Theory. Emotional outbursts are common in this phase. During the numbing
phase, the family may feel a sense of unreality. During disorganization and despair, the
reason why the loss occurred is constantly questioned. Bargaining is part of the Kübler-
Ross stages, not of the Bowlby Attachment Theory.
After the anticipated demise of a chronically ill patient, the unit nurse is found
crying in the staff lounge. The best response to her crying colleague would be
a. "It is normal to feel this way. Give yourself some time to mourn."
b. "Your other patients still need you, so hurry back to them."
c. "You're being a bad role model to the unit's nursing students."
d. "Why don't you take a sedative to cope?"
ANS: A
Nurses often witness suffering on a daily basis. Nurses, as humans, also experience
grief and loss when they have been intensely involved in the patient's suffering and
, death. Offer comfort and understanding to colleagues, and maintain a stable patient
care environment. It is inappropriate to create guilt by telling a grieving nurse to hurry
back to her patients or by indicating that she is a bad role model. Suggesting that a
colleague take sedative during a shift is dangerous for the safety of patients in her care.
A family is grieving after learning of a family member's accidental death. The
transplant coordinator requests to talk with the family about possible organ and
tissue donation. The nurse recognizes that
a. All religions allow for organ donation.
b. Life support must be removed before organ and tissue retrieval occurs.
c. The best time for organ and tissue donation is immediately after the autopsy.
d. The transplant coordinator is working in accordance with federal law.
ANS: D
It is a federal law to require facilities to develop policies about organ donation. The
transplant coordinator has additional education on providing answers about organ
donation. Not all religions allow for organ donation. A patient may be on life support
during organ removal to
preserve organ tissues. Autopsy compromises organ integrity; removal should occur
prior.
An Orthodox Jewish Rabbi has been pronounced dead. The nursing assistant
respectfully asks family members to leave the room and go home as postmortem
care is provided. Which of the following statements from the supervising nurse
reflects correct knowledge of Jewish culture?
a. "I wish they would go home because we have work to do here."
b. "Family members stay with the body until burial the next day."
c. "I should have called a male colleague to handle the body."
d. "I thought they would quietly leave after praying and touching the Rabbi's
head."
ANS: B
Jewish culture calls for family members or religious officials to stay with the decedent's
body until the time of burial. A male provider is unnecessary. Requesting or expecting
the family to go home is not providing culturally sensitive care.
The palliative team's primary obligation to a patient in severe pain includes which
of the following?
a. Supporting the patient's nurse in her grief
b. Providing postmortem care for the patient
c. Teaching the patient the stages of grief
d. Enhancing the patient's quality of life
ANS: D
The primary goal of palliative care is to help patients and families achieve the best
quality of life. Providing support for the patient's nurse is not the primary obligation when
the patient is experiencing severe pain. Not all collaborative team members would be
able to provide
postmortem care, as is the case for nutritionists, social workers, and pharmacists.
Teaching about stages of grief should not be the focus when severe pain is present.
A man is hospitalized after surgery that amputated both lower extremities owing
to injuries sustained during military service. The nurse should recognize his need
complete solution
A nurse encounters a family that experienced the death of their adult child last
year. The parents are talking about the upcoming anniversary of their child's
death. The nurse spends time with them discussing their child's life and death.
The nurse's action best demonstrates which nursing principle?
a. Pain management technique
b. Facilitating normal mourning
c. Grief evaluation
d. Palliative care
ANS: B
Anniversary reactions can reopen grief processes. A nurse should openly acknowledge
the loss and talk about the common renewal of grief feeling around the anniversary of
the individual's death. This facilitates normal mourning. The nurse is not attempting to
alleviate a physical pain. The actions are of open communication, not evaluation.
Palliative care refers to comfort measures for symptom relief.
A cancer patient asks the nurse what the criteria are for hospice care. What
should the nurse answer?
a. Having a terminal illness, such as cancer
b. Needing assistance with pain management
c. Expected to live less than 6 to 12 more months
d. Completion of an advance directive
ANS: C
The criterion for hospice care is being expected to live less than 6 to 12 more months.
Patients with a terminal illness are not eligible until that point. Palliative care provides
assistance with pain management when a patient is not eligible for hospice care. An
advance directive can be
completed by any person, even those who are healthy.
A terminally ill patient is experiencing constipation secondary to pain medication.
What is the best way for the nurse to improve the patient's constipation problem?
a. Massage the patient's abdomen.
b. Contact the provider to discontinue pain medication.
c. Administer enemas twice daily for 7 days.
d. Use a stimulant laxative and increase fluid intake.
ANS: D
Opioid medication is known to slow gastrointestinal transit time, which places the patient
at high risk for constipation. Stimulant laxatives are indicated for opioid-induced
constipation. Added water to the diet will allow water to be pulled into the GI tract,
softening up stool. Massaging the patient's abdomen may cause further discomfort.
Discontinuing pain medication is inappropriate for a terminally ill patient. Enema
administration is not the first
step in the treatment of opioid-induced constipation.
A severely depressed patient cannot state any positive attributes to his or her life.
The nurse patiently sits with this patient and assists the patient to identify several
,activities the patient is actually looking forward to in life. The nurse is helping the
patient to demonstrate which spiritual concept?
a. Time management
b. Hope
c. Charity
d. Faith
ANS: B
The concept of hope is vital to nursing; it enables a person to anticipate positive
experiences. Being patient and friendly and creating positive relationships are key
concepts in all areas of nursing, but especially with depressed patients. The nurse's
actions do not address time management, charity, or faith.
In preparation for the eventual death of a female hospice patient of the Muslim
faith, the nurse organizes a meeting of all hospice caregivers. A plan of care to be
followed when this patient dies is prepared. This plan of care would include
a. Male health care workers care for the body after death has occurred.
b. Body preparation for autopsy.
c. Body preparation for cremation.
d. Female health care workers care for the body after death has occurred.
ANS: D
Islamic culture calls for modesty and same-sex caregivers whenever possible. Muslim
faith discourages cremation and autopsy to preserve the sanctity of the soul of the
deceased.
Family members gather in the emergency department after learning that a family
member was involved in a motor vehicle accident. After learning of the family
member's unexpected death, the surviving family members begin to cry and
scream in despair. The nurse recognizes this as the Bowlby Attachment Theory
stage of
a. Numbing.
b. Disorganization and despair.
c. Bargaining.
d. Yearning and searching.
ANS: D
Yearning and searching characterize the second bereavement phase in the Bowlby
Attachment Theory. Emotional outbursts are common in this phase. During the numbing
phase, the family may feel a sense of unreality. During disorganization and despair, the
reason why the loss occurred is constantly questioned. Bargaining is part of the Kübler-
Ross stages, not of the Bowlby Attachment Theory.
After the anticipated demise of a chronically ill patient, the unit nurse is found
crying in the staff lounge. The best response to her crying colleague would be
a. "It is normal to feel this way. Give yourself some time to mourn."
b. "Your other patients still need you, so hurry back to them."
c. "You're being a bad role model to the unit's nursing students."
d. "Why don't you take a sedative to cope?"
ANS: A
Nurses often witness suffering on a daily basis. Nurses, as humans, also experience
grief and loss when they have been intensely involved in the patient's suffering and
, death. Offer comfort and understanding to colleagues, and maintain a stable patient
care environment. It is inappropriate to create guilt by telling a grieving nurse to hurry
back to her patients or by indicating that she is a bad role model. Suggesting that a
colleague take sedative during a shift is dangerous for the safety of patients in her care.
A family is grieving after learning of a family member's accidental death. The
transplant coordinator requests to talk with the family about possible organ and
tissue donation. The nurse recognizes that
a. All religions allow for organ donation.
b. Life support must be removed before organ and tissue retrieval occurs.
c. The best time for organ and tissue donation is immediately after the autopsy.
d. The transplant coordinator is working in accordance with federal law.
ANS: D
It is a federal law to require facilities to develop policies about organ donation. The
transplant coordinator has additional education on providing answers about organ
donation. Not all religions allow for organ donation. A patient may be on life support
during organ removal to
preserve organ tissues. Autopsy compromises organ integrity; removal should occur
prior.
An Orthodox Jewish Rabbi has been pronounced dead. The nursing assistant
respectfully asks family members to leave the room and go home as postmortem
care is provided. Which of the following statements from the supervising nurse
reflects correct knowledge of Jewish culture?
a. "I wish they would go home because we have work to do here."
b. "Family members stay with the body until burial the next day."
c. "I should have called a male colleague to handle the body."
d. "I thought they would quietly leave after praying and touching the Rabbi's
head."
ANS: B
Jewish culture calls for family members or religious officials to stay with the decedent's
body until the time of burial. A male provider is unnecessary. Requesting or expecting
the family to go home is not providing culturally sensitive care.
The palliative team's primary obligation to a patient in severe pain includes which
of the following?
a. Supporting the patient's nurse in her grief
b. Providing postmortem care for the patient
c. Teaching the patient the stages of grief
d. Enhancing the patient's quality of life
ANS: D
The primary goal of palliative care is to help patients and families achieve the best
quality of life. Providing support for the patient's nurse is not the primary obligation when
the patient is experiencing severe pain. Not all collaborative team members would be
able to provide
postmortem care, as is the case for nutritionists, social workers, and pharmacists.
Teaching about stages of grief should not be the focus when severe pain is present.
A man is hospitalized after surgery that amputated both lower extremities owing
to injuries sustained during military service. The nurse should recognize his need
