ohn is a 70-year-old male whose wife died from COPD two months ago. They were very close, married for 52 years, and had no children. He comes by the nursing unit to bring you all candy and a thank you note for all the times you cared for her the past year. He tells you he is struggling to want to eat since she always was the cook, and is just not ready to go out to dinner with his buddies, even though they keep asking him. Your assessment is that John is: - ✔✔Experiencing normal grief after his wife died two months ago You are caring for a number of patients and family members who are facing loss or death. In speaking with them about grief, you correctly convey that grief: - ✔✔Begins before a loss or death, as people consider a pending loss Which of the following family members is at greatest risk for complicated grief? - ✔✔The daughter who has a long history of substance use and has just recently returned home to be at her dying mother's bedside. You are talking with the staff on your unit about the emotional challenges of working with dying patients and their families. Which of the following is an appropriate response to the grief the staff has been experiencing recently? - ✔✔Consult with the hospital chaplain or spiritual care counselor for staff support. You are making a bereavement visit to the 35-year-old daughter and primary caregiver of a female patient who died three months ago. The daughter reports she is experiencing mild breathlessness, loss of appetite, and difficulty concentrating. You should recognize that the daughter is experiencing: - ✔✔A normal grief reaction A year after the loss of her son to suicide, Mrs. Phelps expresses to you that she is still terrified that her surviving son will also commit suicide. Mrs. Phelps reports continuing to have nightmares in which this happens. What type of grief is Mrs. Phelps experiencing? - ✔✔Exaggerated grief The hospice interdisciplinary team is creating a bereavement plan for the family of Mr. A, a 50-year-old patient with advanced HIV/AIDS. The patient defines his family as consisting of his partner, his parents, four siblings, as well as his two closest friends. In creating the plan, each member of the interdisciplinary team understands that bereavement interventions must: - ✔✔Take into account each survivor's cultural practices in mourning and grief reactions. You are assessing Mrs. Smith's husband's well-being during Mrs. Smith's recent hospitalization. He tells you he has had trouble with heart failure this past year and then says, "All that matters is my wife. I don't have time to go to my doctor even though my prescriptions have run out. Don't you realize how many medications I have to give my wife around the clock? I can't deal with any more medications. I will have time to take care of myself later on." Your best response is: - ✔✔"I am concerned about you too. Keep in mind you can't take care of Mrs. Smith if you get sick; you need to get your prescriptions filled." You and your nurse colleagues on your unit have all been talking about how hard it is in the ICU to see so many patients who have stated they didn't want any more aggressive treatment be admitted to the ICU. You found one of your colleagues was crying in the bathroom stating, "I can't stand this anymore - I just admitted another patient who told me last time he never wanted to come back here." Your best intervention is to: - ✔✔Listen to her and suggest you both talk with the ICU manager about the unit needing the chaplain or psychiatric nurse liaison for emotional support. You are caring for a 55-year-old female patient with metastatic breast cancer. During a home visit, you find the patient's 22-year-old daughter weeping at the kitchen table. The daughter explains that she just realized that her mother will not be alive when she gets married or has children of her own. Recognizing anticipatory grief in the young woman, the best first intervention is: - ✔✔Provide active listening and therapeutic presence. You are caring for a 65-year-old male patient who has just died. In planning for follow-up bereavement care, which person is at risk for disenfranchised grief? - ✔✔The ex-wife of the patient who lives nearby Mr. C, whose wife of 14 years died five months ago, returns to your unit to thank you all for your great care. He states, "I still can't get through a week without crying sometimes. I know I should be at least starting to move on a bit." Your best response would be: - ✔✔"This is very hard; can you tell me a bit about what moving on means to you?" You are talking with the wife of a patient who died recently. Which statement can you make that would be most helpful? - ✔✔"It must be hard to accept that this has happened." Mr. C's family tells you they are very worried about his granddaughter who is 13 years old. She has lived with her mother and grandparents since she was three and seems to be having a hard time accepting