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Chapter 030

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Potter & Perry: Fundamentals of Nursing, 7th Edition Test Bank Chapter 30: The Experience of Loss, Death, and Grief MULTIPLE CHOICE 1. A client has a terminal illness and is discussing future treatments with the nurse. The nurse notes that he has not been eating and his response to the nurse’s information is, “What does it matter?” The most appropriate nursing diagnosis for this client is: 1. Denial 2. Hopelessness 3. Social isolation 4. Spiritual distress ANS: 2 A defining characteristic for th
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  Potter & Perry: Fundamentals of Nursing, 7 th  Edition Test Bank Chapter 3: The E!perien e of #oss, $eath, and %rief '#T(P#E C)*(CE 1.A client has a terminal illness and is discussing future treatments with the nurse. The nurse notes that he has not been eating and his response to the nurse’s information is, “What does it matter?” The most appropriate nursing diagnosis for this client is:1.  Denial  .  Hopelessness !. Social isolation . Spiritual distress A#$:A defining characteristic for the nursing diagnosis of hopelessness  ma% include the client stating, “What does it matter?” when offered choices or information concerning themsel&es. Also, the client’s beha&ior of not eating is an indicator of hopelessness . The client’s beha&ior and &erbali'ation do not indicate denial  . This is not an e(ample of  social isolation . The client is not a&oiding or restricted from seeing others. Spiritual distress  is not the most appropriate nursing diagnosis for this client. The focus needs to beon the client’s lac) of hope.*T$:1+-:A/-: 0234:5omprehensionT2*:#ursing *rocess: /&aluation6$5:#57/89 test plan designation: $afe, /ffecti&e 5are /n&ironment.2ne of the benefits of anticipator% grie&ing to a client or famil% is that it can:1.3e done in pri&ate.3e discussed with others!.*romote separation of the ill client from the famil% .elp a person progress to a healthier emotional stateA#$: 6osb% items and deri&ed items ; <, = b% 6osb%, nc., an affiliate of /lse&ier nc.  Test 3an) The benefit of anticipator% grief is that it allows time for the process of grief >i.e., to sa% goodb%e and complete life affairs@. Anticipator% grief allows time to grie&e in pri&ate, to discuss the anticipated loss with others, and to “let go” of the lo&ed one. Anticipator% grief can help a person progress to a healthier emotional state of acceptance and dealing with loss. t is not most beneficial for grie&ing to ta)e place onl% in pri&ate. t is important for grief to be ac)nowledged b% others, and to be able to recei&e the support of others in the grie&ing process. Anticipator% grie&ing can be discussed with others in most circumstances. owe&er, there ma% be times when anticipator% grief is disenfranchised grief as well, meaning it cannot be openl% ac)nowledged, sociall% sanctioned, or publicl%shared, such as a partner d%ing of A+$. The benefit of anticipator% grie&ing is not so much that it can be discussed in most circumstances, as this discussion can also occur with normal grief when the actual loss has occurred. Anticipator% grief is the process of disengaging or “letting go” that occurs before an actual loss or death has occurred. The  benefit is not the separation of the ill client from the famil% as much as it is the process of  being able to sa% goodb%e and to put life affairs in order, and as a result, it can help a client or famil% to progress to a higher emotional state.*T$:1+-:A/-: !234:5omprehensionT2*:#ursing *rocess: mplementation6$5:#57/89 test plan designation: $afe, /ffecti&e 5are /n&ironment!.A newl% graduated nurse is best prepared for the assignment of his first d%ing patient if he:1.5ompleted a course dealing with death and d%ing.s able to control his own personal emotions about death!.as pre&iousl% e(perienced the death of a dear lo&ed one .as de&eloped a personal understanding of his own feelings about deathA#$: When caring for clients e(periencing grief, it is important for the nurse to assess his or her own emotional wellbeing and to understand his or her own feelings about death. The nurse who is aware of his or her own feelings will be less li)el% to place personal situations and &alues before those of the client. Although coursewor) on death and d%ing ma% add to the nurse’s )nowledge base, it does not best prepare the nurse for caring for a d%ing client. The nurse needs to ha&e an awareness of his or her own feelings about deathfirst, as death can raise man% emotions. 3eing able to control one’s own emotions is importantB howe&er, it is unli)el% the nurse would be able to do so if he or she has not first de&eloped a personal understanding of his or her own feelings about death. /(periencing the death of a lo&ed one is not a prereCuisite to caring for a d%ing client. /(periencing death ma% help an indi&idual mature in dealing with loss, or it ma% in&o)e man% negati&e emotions if there is complicated grief present. The nurse is best prepared  b% first de&eloping an understanding of his or her own feelings about death.*T$:1+-:5/-: =234:Anal%sisT2*:#ursing *rocess: mplementation6$5:#57/89 test plan designation: $afe, /ffecti&e 5are /n&ironment 6osb% items and deri&ed items ; <, = b% 6osb%, nc., an affiliate of /lse&ier nc. !  Test 3an)  .The famil% of a client with a terminal illness will be able to help pro&ide some  ps%chological support to their famil% member. To assist the famil% to meet this outcome, the nurse plans to include in the teaching plan:1.+emonstration of bathing techniCues.Application of o(%gen deli&er% de&ices!.ecognition of the client’s needs and fears .nformation on when to contact the hospice nurseA#$:!A d%ing client’s famil% is better prepared to pro&ide ps%chological support if the nurse discusses with them wa%s to support the d%ing person and listen to needs and fears. +emonstration of bathing techniCues ma% help the famil% meet the d%ing client’s ph%sicalneeds, not in pro&iding ps%chological support. Application of o(%gen de&ices ma% help the famil% pro&ide ph%sical needs for the client, not in pro&iding ps%chological support for the client. nformation on when to contact the hospice nurse is important )nowledge for the famil% to ha&e and ma% help them feel the% are being supported in caring for the d%ing client. owe&er, contact information does not help the famil% pro&ide  ps%chological support to the d%ing client.*T$:1+-:A/-: 0 234:5omprehensionT2*:#ursing *rocess: mplementation6$5:#57/89 test plan designation: $afe, /ffecti&e 5are /n&ironment=.A client that was recentl% diagnosed with a terminal illness as)s his nurse about organ donation. The nurse should:1.a&e the client first discuss the subDect with the famil%.$uggest the client dela% ma)ing a decision at this time!.Assist the client to obtain the necessar% information to ma)e this decision .5ontact the client’s ph%sician so consent can be obtained from the famil%A#$:! #o topic that a d%ing client wishes to discuss should be a&oided. The nurse should respond to Cuestions openl% and honestl%. As client ad&ocate, the nurse should assist the client to obtain the necessar% information to ma)e this decision. The nurse should pro&idethe client with information in order to ma)e such a decision. Although the nurse ma% suggest that the client discuss this option after ha&ing obtained information, it is up to theclient to discuss the subDect with the famil%. The nurse should respect the client and  pro&ide the necessar% information for him or her to ma)e a decision rather than dismissing the client’s Cuestion. t is not necessar% to contact the ph%sician or the famil% for consent for organ donation if the client is capable of ma)ing this decision.*T$:1+-:A/-: < 0234:5omprehensionT2*:#ursing *rocess: mplementation6$5:#57/89 test plan designation: $afe, /ffecti&e 5are /n&ironment 6osb% items and deri&ed items ; <, = b% 6osb%, nc., an affiliate of /lse&ier nc. !!  Test 3an) .A client, who is recei&ing chemotherap% on a medical unit due to a recent diagnosis of terminal cancer of the li&er, has an indepth con&ersation with the nurse. The client sa%s, “This cannot be happening to me.” The nurse identifies that this stage is associated with, according to EFbleross:1.An(iet%.+enial!.5onfrontation .+epressionA#$:According to EFbleross, the client is in the denial stage of d%ing. The client ma% act as though nothing has happened, ma% refuse to belie&e or understand that a loss has occurred, and ma% seem stunned, as though it is “unreal” or difficult to belie&e. There is no stage of an(iet% in the fi&e stages of d%ing of EFbleross. There is no stage of confrontation in the fi&e stages of d%ing of EFbleross. +uring depression the indi&idualma% feel o&erwhelmingl% lonel% and withdraw from interpersonal interaction.*T$:1+-:A/-:  234:5omprehensionT2*:#ursing *rocess: mplementation6$5:#57/89 test plan designation: $afe, /ffecti&e 5are /n&ironment0.A client who is 5hinese American has Dust died on the unit. The nurse is prepared to  pro&ide afterdeath care to the client and anticipates the probable preferences of a famil% from this cultural bac)ground will include:1.*astoral care.*reparation for organ donation!.Time for the famil% to bathe the client .*reparation for Cuic) remo&al out of the hospitalA#$:!$ome families of 5hinese Americans will prefer to bathe the client themsel&es. The% often belie&e the bod% should remain intactB organ donation and autops% are uncommon. 5hinese Americans do not prefer pastoral care for afterdeath care of a famil% member. 2rgan donation is uncommon for 5hinese Americans. 5hinese Americans ma% desire time to bathe the client. Guic) remo&al from the hospital is not preferred.*T$:1+-:A/-: 234:5omprehensionT2*:#ursing *rocess: mplementation6$5:#57/89 test plan designation: $afe, /ffecti&e 5are /n&ironmentH.The nurse is pro&iding care to a d%ing client. Which of the following is the primar% concern? The nurse should:1.*romote optimism in the client and be a source of encouragement.*romote dignit% and selfesteem in as man% inter&entions as is appropriate 6osb% items and deri&ed items ; <, = b% 6osb%, nc., an affiliate of /lse&ier nc. !

Chapter 026

Jul 23, 2017

Chapter 025

Jul 23, 2017
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