Chapter 18: Loss and End-of-Life Issues

 

Chapter 18: Loss and End-of-Life Issues

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse documents that a newly widowed older adult patient is likely experiencing physical grief responses when she:

a.	becomes hypotensive.
b.	has difficulty getting up from the chair.
c.	reports having tightness in the chest.
d.	develops a red rash over her upper chest and back.

 

 

ANS:  C

Physical symptoms are commonly associated with acute grief responses. Tearfulness, crying, loss of appetite, feelings of hollowness in the stomach, decreased energy, fatigue, lethargy, and sleep difficulties are common symptoms of grief. Other physical sensations may include tension, weight loss or gain, sighing, feeling something stuck in one’s throat, tightness in one’s chest or throat, heart palpitations, restlessness, shortness of breath, and dry mouth.

 

DIF:    Remembering (Knowledge)             REF:   Page 326        OBJ:   18-3

TOP:   Nursing Process: Assessment           MSC:  Psychosocial Integrity

 

2. The nurse is confident that an older adult is successfully completing the tasks associated with mourning his wife’s death when he:

a.	shares that, “No amount of wishing will bring her back.”
b.	openly cries in the presence of family and friends.
c.	takes cooking classes at the local community college.
d.	takes a female acquaintance to the movies.

 

 

ANS:  D

The last task in the process of mourning is the withdrawal of emotional energy and the reinvestment in another relationship; this entails withdrawing emotional attachment to the lost person and continuing on with life.

 

DIF:    Remembering (Knowledge)             REF:   Page 328        OBJ:   18-5

TOP:   Nursing Process: Assessment           MSC:  Psychosocial Integrity

 

3. Although the family of a newly widowed older adult patient lives several hours away, they are interested in providing appropriate support. The nurse suggests it would be most helpful if they would:

a.	telephone daily and arrange for a neighbor to help with the shopping.
b.	assume responsibility for paying the bills and upkeep of the home.
c.	encourage the patient to move into a smaller home and learn to drive.
d.	include the patient in their yearly vacation plans

 

 

ANS:  A

Loneliness and problems associated with the tasks of daily living are two of the most common and difficult adjustments for older bereaved spouses. Calling daily will help alleviate the loneliness. Taking over responsibilities may take away the only thing the patient “has left.” Learning to drive may be important, but the family should not encourage the patient to make a major life decision like moving now. Taking the patient on vacation is a nice idea, but this occurs yearly versus calling daily.

 

DIF:    Applying (Application)                    REF:   N/A                OBJ:   18-3

TOP:   Teaching-Learning                          MSC:  Psychosocial Integrity

 

4. A man who recently lost his wife of 50 years shares with the nurse that he’ll “never get over missing her.” The nurse is most therapeutic when responding:

a.	“We are here to help you anyway we can.”
b.	“Focus on the beautiful memories you have of her and your life together.”
c.	“Time will help you adjust to your loss.”
d.	“You’ll never get over your loss but you can learn to live with it.”

 

 

ANS:  D

The third step in the process of mourning is the adjustment to an environment in which the deceased is missing. Older spouses have reported that they feel as though they will never “get over” their loss; instead, they have learned to live with it. It is nice to let the patient know you are here for him or her, but this does not give any useful information to help the patient. Telling the patient to focus on memories is dismissive. The nurse should not use clichés like “time will help.”

 

DIF:    Applying (Application)                    REF:   N/A                OBJ:   18-5

TOP:   Caring            MSC:  Psychosocial Integrity