NCLEX · General

A bereaved spouse says: 'It's been 14 months since my wife died and I still cry every day — something must be wrong with me.' What is the most appropriate nursing response?

Correct answer

'Grief has no set timeline. While intense acute grief typically evolves over the first year, it is normal to continue experiencing sadness and missing someone you loved deeply. The question is whether grief is impairing your ability to function in daily life'

  1. A 'You're right, 14 months is too long — you should seek medication'
  2. B 'Grief has no set timeline. While intense acute grief typically evolves over the first year, it is normal to continue experiencing sadness and missing someone you loved deeply. The question is whether grief is impairing your ability to function in daily life'
  3. C 'By now you should be over it'
  4. D 'You need psychiatric evaluation immediately'

Why this is the answer

COMPLICATED GRIEF vs NORMAL GRIEF: NORMAL GRIEF: Varies enormously between individuals; no set timeline; acute phase most intense first year; grief does not end — it transforms; sadness and missing the deceased indefinitely is NORMAL; COMPLICATED GRIEF (Prolonged Grief Disorder — DSM-5 2022): Persisting intense yearning; rumination about the deceased; emotional pain; difficulty accepting the death; feeling meaningless; social withdrawal — ALL still significantly present beyond 12 months (6 months for children); NURSING ASSESSMENT FOCUS: Is the person able to function (work, relationships, self-care)? Are they eating and sleeping? Are they experiencing suicidal ideation? Do they have social support?; THERAPEUTIC RESPONSE: Validate that grief is not a schedule; normalise ongoing sadness; assess for functioning and red flags; provide information about grief support resources; THE WRONG RESPONSES: Giving a timeline to 'be over it'; immediately pathologising normal grief; reassuring without assessment; INTERVENTION: Complicated grief may benefit from specialised Complicated Grief Treatment (CGT) — evidence-based therapy.
Source: NCLEX-RN Psychosocial — Grief, Normal vs Prolonged Grief Disorder

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