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A)

B)
C)
D)

1.After being laid off from work, a client becomes increasingly withdrawn and fatigued,
spends entire days in bed, is unkempt, and is eating and sleeping poorly. The nurse would
recognize that the client is in which stage of grieving, according to Kubler-Ross?
Anger
Bargaining
Denial
Depression

A)
B)
C)
D)

2.The client says to the nurse, I really want to see my first grandchild born before I die. Is
that too much to ask? The nurse would recognize that the client is in which stage of
grieving, according to Kubler-Ross?
Acceptance
Anger
Bargaining
Depression

A)
B)
C)
D)

3.A client comes to the physician's office for an annual checkup. During the interview, the
nurse learns that the client's husband died unexpectedly of a heart attack 2 months ago.
The most appropriate response by the nurse would be,
At least you and your husband enjoyed life right until the end.
It's better to go quickly like your husband did instead of suffering.
The loss of your husband must be very painful for you.
You'll feel better after you get over the shock of your husband's death.

C)
D)

4.A client is talking with the nurse about the death of her son 3 years ago. Which of the
following would indicate successful completion of the mourning process?
All of the son's belongings are still in his room just as he left them before he died.
Although they were close, the client reports she has never cried or had any negative
feelings over her son's death.
The client reminisces about the pleasures and disappointments of her son.
The client speaks of her son as though he was still living, weeping as she does so.

A)
B)
C)
D)

5.A woman has just delivered a stillborn baby boy. Which of the following would be the
most appropriate nursing response?
Can I do anything for you?
If something was wrong, it's better this way.
Your son is in heaven with God now.
Would you like to hold your son?

A)

6.A client is scheduled for a mastectomy for breast cancer. She is quiet, shows little
emotion, and states that she has no questions. The nurse's assessment would need to focus
on
The client's plans for reconstructive surgery

A)
B)

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B)
C)
D)

The meaning of the mastectomy to the client


Whether the client truly understands the surgery
Why the client seems depressed

A)
B)
C)
D)

7.A client with terminal cancer has been told he has 3 or 4 months to live. Which of the
following would indicate to the nurse that further interventions are needed?
The client says he wants to live life to the fullest.
The client hopes for a peaceful and dignified death.
The client is reviewing his life and talking about death.
The client says he is well and is making future plans.

A)
B)
C)
D)

8.The nurse is working with the family of a client who is near death. The client is
unresponsive, his extremities are cool, and respirations are shallow. Which of the
following actions by the nurse is most appropriate at this time?
Ask the family to leave the room.
Encourage family members to talk to the client.
Explain that the client is not aware of their presence.
Leave the family alone with the client.

A)
B)
C)
D)

9.A young client tells the nurse that her husband died 3 months ago, and she is feeling
alone and vulnerable. Which statement by the client would indicate that her coping skills
are adequate?
I can't understand why this happened to me.
I'm mentally healthy. I can solve my own problems.
I will find a support group.
What can I do? My husband abandoned me.

A)
B)
C)
D)

10.A couple came to the emergency department with their 5-month-old son. He was
pronounced dead of sudden infant death syndrome (SIDS). In the next day or two, it will
be important for this couple to
Accept that they could do nothing to prevent this death
Delay the grieving process until they are ready to cope
Minimize their discussion of the death with others
Plan funeral arrangements for their son

11.A young couple just dissolved their relationship after a 9 month engagement. The one of
the individuals is seeking short-term counseling to assist in grieving this loss. Which type
of loss best describes what this patient is experiencing?
A)
Safety loss
B)
Loss of security and sense of belonging
C)
Loss of self-esteem

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D)

Loss related to self-actualization

A)
B)
C)
D)

12.A married couple has just received the news that the husband has terminal cancer. The
wife tells the nurse, Maybe if we get another opinion and start treatment right way there
is a chance of survival. The nurse documents that the wife is expressing signs of which
of Kubler-Rosss stages of grief?
Denial
Anger
Bargaining
Depression

A)
B)
C)
D)
E)

13.According to Engel, individuals progress through 5 stages when grieving. In which order
does Engel describe the grief experience?
Developing awareness
Shock and disbelief
Resolution
Restitution
Recovery

A)
B)
C)
D)

14.Friends of a teenage male recently killed in a car accident are discussing their sense of
loss. Which of the following comments best indicates that the friends are trying to make
sense of the loss cognitively?
Why did he have to die so young?
He shouldnt have been driving so recklessly.
If we had only stayed longer he would not have been on that road.
It took the ambulance too long to get there.

A)
B)
C)
D)

15.The nurse is working with a woman who lost her partner nearly 3 weeks prior. The
woman has recently become less emotional and expressed that few things in her life have
meaning right now. Which response by the nurse is most appropriate at this time?
I am concerned. You are starting to show signs of ineffective grieving.
You must feel some anger. It is alright to let that out.
Lets look at the things in your life that you still enjoy.
You are just starting to accept that this loss is real.

16.The nurse is working with a patient who lost her youngest child 2 months ago. When the
nurse approaches, the patient, the patient yells, I dont want to talk to you. You have no
idea what its like to lose a child! The nurse bases her response to the patient on the
understanding of which of the following?
A)
Hostility is a common behavioral response to grief
B)
It is too soon after the loss to empathize with the patient

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C)
D)

Personality traits such as aggressiveness are exaggerated during the grief process
The nurse may have non-verbally indicated a judgmental attitude toward the patient

A)
B)
C)
D)

17.The nurse is conducting a history and physical exam on a patient who is grieving the
unwanted loss of a marriage by divorce. Which of the following physical symptoms of
grief would the nurse most likely expect to detect in the history
Headaches
Insomnia
Weight loss
GI upset

A)
B)
C)
D)
E)

18.The nurse is caring for a hospice patient whose death is imminent. In preparing the family
for the death of their loved one, then nurse prepares to assist the family in which of the
following, regardless of the familys cultural preferences? (Select all that apply)
Dealing with the shock of losing a loved one
Burial plans after death had occurred
Efforts to stay connected to the patient after death
Use of support from family and friends
Anger at the loss of a loved one

A)
B)
C)
D)

19.The most effective way for the nurse to provide culturally competent care to individuals
who are grieving is which of the following?
Understand the practices associated with a patients culture
Suggest developing a new ritual to make mourning meaningful
Ask the patient what rituals are personally meaningful
Contact a spiritual leader from the patients culture to become involved

A)
B)
C)
D)

20.A nurse has been caring for a gunshot victim who has just died. Various family and
friends are present. One of the visitors privately discloses to the nurse the she and the
patient were having an illicit affair. Which of the following is the best action by the nurse
after learning of this relationship?
Give the name of a clergy to the visitor and suggest she contact him for support
Encourage the visitor to ask for support from the friends who are present
Ignore the information about the affair and tend to the family
Privately offer support to the visitor who was having the affair with the patient

21.Which of the following data recorded in a patients assessment is most likely to prevent
the patient from experiencing complicated grief?
A)
Tendency to suppress emotions
B)
History of depression
C)
Places trusts familiar others

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D)

Dependent on others to meet needs

A)
B)
C)
D)

22.The nurse is meeting a patient for the first time that has just spontaneously lost her
unborn child. After establishing rapport, the priority nursing intervention should focus on
which of the following?
Assessing the patients support system
Exploring what this loss means for the patient
Discuss helpful ways to cope with the loss
Assess what knowledge the patient desires about the situation

A)
B)
C)
D)

23.Which of the following is NOT essential to include in the framework for facilitating the
patients grief process?
Genetic risk
Perception of loss
Support system
Coping skills

A)
B)
C)
D)

24.The nurse is establishing outcomes for a grieving patient. Which of the following is an
appropriate outcome?
Develop a plan for coping with the loss
Demonstrate self-reliance during the grief process
Suppress emotions related to the loss
Verbalize that loss will not adversely affect the quality of life

A)
B)
C)
D)

25.Which of the following terms is used to describe the process by which a person
experiences the grief?
Anticipatory grieving
Disenfranchised grief
Bereavement
Mourning

A)
B)
C)
D)

26.Kubler-Ross developed a model of five stages to explain what people experience as they
grieve and mourn. Which of the following is Phase V of Kubler-Ross's stages of
grieving?
Denial
Bargaining
Acceptance
Anger
27.The nurse approaches a patient who looks very sad and is sitting alone crying. The best

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A)
B)
C)
D)

A)
B)
C)
D)

A)
B)
C)
D)

A)
B)
C)
D)

response by the nurse in this situation is:


Im sorry you are sad. Is there anything I can do to help you feel better?
Please dont cry. It will get better.
You look very sad. What is happening?
What is bothering you?
28.A woman has just been served divorce papers from her husband. She has no financial
resources and little social support. She states, Hes not really leaving. Hell be back.
The most appropriate response by the nurse would be which of the following:
Has he done this before?
Ill call social services and get you signed up for financial assistance.
You have to face reality. Here are the papers.
How is this affecting you right now?
29.An elderly woman who lives alone is beginning to have difficulty maintaining her
household and performing daily tasks. The nurse asks her to identify someone who can
help her. The woman replies, I dont need help. Ive been managing for years.
Which of the following responses helps the patient shift from denial to consciously
coping with her situation?
You dont think you need any help? But your family is worried about you.
It must be hard to lose your independence. Ill ask a social worker to see what can
be arranged.
You said you have been having trouble at home. Who would you call if you needed
anybody?
If you dont ask for some help then the only option is to move to an assisted living
facility.
30.A patient who has been grieving the loss of his wife 2 weeks ago says to the nurse, The
best part of my day is when I am back at work. Is that wrong? The nurse educates that
work and other daily activities serve which purpose?
You cannot work effectively this soon. You should finish grieving first.
Working reminds you of your loss. It may be too early to go back.
Working is your way of avoiding grief which will make it harder for you to move
on.
Working is letting you take an emotional break from grieving. Theres nothing
wrong with that.

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Answer Key
1.D
2.C
3.C
4.C
5.D
6.B
7.D
8.B
9.C
10.D
11.B
12.C
13.A, B, C, D, E
14.A
15.D
16.A
17.B
18.A, C, E
19.C
20.D
21.C
22.B
23.A
24.A
25.C
26.C
27.C
28.D
29.C
30.D

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