CHPN Grief and Bereavement Care 2 — Questions and Answers
Question 1: Which researchers proposed the 'continuing bonds' theory of grief, challenging the idea that bereaved individuals must 'let go' of the deceased?
- Kübler-Ross and Ross
- Klass, Silverman, and Nickman (Correct answer)
- Worden and Parkes
- Rando and Stroebe
Correct answer: Klass, Silverman, and Nickman
Klass, Silverman, and Nickman proposed the continuing bonds theory in 1996, suggesting that maintaining an ongoing connection with the deceased is normal and healthy rather than something to overcome.
Question 2: What does Stroebe and Schut's 'dual process model' of grief describe?
- The two phases of acute and chronic grief progression over time
- Oscillation between loss-orientation (confronting grief) and restoration-orientation (adapting to life changes) (Correct answer)
- The parallel processing of physical and emotional aspects of loss simultaneously
- The dual caregiver and mourner roles experienced by family members
Correct answer: Oscillation between loss-orientation (confronting grief) and restoration-orientation (adapting to life changes)
Stroebe and Schut's dual process model describes how bereaved individuals naturally oscillate between loss-orientation (processing pain of the loss) and restoration-orientation (coping with secondary stressors and rebuilding life).
Question 3: Which of the following is NOT considered a normal grief reaction?
- Difficulty concentrating and short-term memory problems
- Transient hallucinations of seeing or hearing the deceased
- Persistent psychosis lasting more than 6 months after the death (Correct answer)
- Fatigue, sleep disturbances, and changes in appetite
Correct answer: Persistent psychosis lasting more than 6 months after the death
Persistent psychosis lasting more than 6 months is not a normal grief reaction and warrants psychiatric evaluation, whereas brief hallucinations, cognitive difficulties, and fatigue are common normal grief manifestations.
Question 4: A bereaved family member reports feeling angry at the deceased for 'leaving them.' What is the most appropriate nursing response?
- Redirect the family member to focus on positive memories of the deceased
- Normalize the anger as a common grief response and provide a safe, non-judgmental space to express feelings (Correct answer)
- Refer the family member to a psychiatrist immediately for anger management
- Advise the family member to avoid expressing negative feelings out of respect for the deceased
Correct answer: Normalize the anger as a common grief response and provide a safe, non-judgmental space to express feelings
Anger toward the deceased is a normal grief response; the nurse should normalize these feelings and create a safe environment for expression rather than redirecting or pathologizing the emotion.
Question 5: Kübler-Ross's five stages of grief include all of the following EXCEPT:
- Denial
- Anger
- Guilt (Correct answer)
- Acceptance
Correct answer: Guilt
Kübler-Ross's five stages are denial, anger, bargaining, depression, and acceptance; guilt is not one of the five stages, though it is a common grief experience.
Question 6: Which intervention is most appropriate for a bereaved family member showing signs of complicated grief?
- Encourage the family member to 'move on' and resume normal life within 6 months
- Referral to a mental health professional specializing in grief therapy such as Complicated Grief Treatment (Correct answer)
- Provide only written bereavement educational materials and pamphlets
- Discontinue all contact since the patient has died and the hospice episode is closed
Correct answer: Referral to a mental health professional specializing in grief therapy such as Complicated Grief Treatment
Complicated grief requires specialized intervention beyond standard bereavement support; referral to a mental health professional with expertise in grief therapy is the most appropriate action.
Question 7: Which statement best describes the difference between 'grief' and 'bereavement'?
- Grief refers to the death event itself; bereavement refers to the emotional response that follows
- Bereavement is the state of having experienced a loss; grief is the emotional, cognitive, and behavioral response to that loss (Correct answer)
- Grief is always pathological in nature; bereavement describes the normal adjustment process
- Bereavement occurs before death during caregiving; grief only begins after the patient has died
Correct answer: Bereavement is the state of having experienced a loss; grief is the emotional, cognitive, and behavioral response to that loss
Bereavement is the objective state of having experienced a loss through death, while grief encompasses the subjective emotional, cognitive, physical, and behavioral responses to that bereavement.
CHPN Grief and Bereavement Care 2
Which researchers proposed the 'continuing bonds' theory of grief, challenging the idea that bereaved individuals must 'let go' of the deceased?