# Review an older adult's bereavement timeline and determine when supportive grief care should expand to formal assessment and referral. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=535419&lang=en > language: en > subject: Grief and Loss > category: PSI ## Question Review an older adult's bereavement timeline and determine when supportive grief care should expand to formal assessment and referral. | Time | Data | | --- | --- | | 2 weeks after the death | The client cries during the visit, sleeps poorly, accepts meals from neighbors, and talks with an adult child each evening. | | 3 months | The client reports good and bad days, attends one support-group meeting, and is completing basic self-care with reminders. | | 8 months | The client has stopped answering family calls, misses meals and medications, no longer leaves home, and says, 'There is no point in planning anything without my spouse.' | Q1. How should the nurse interpret the overall trajectory? Increasing functional impairment and hopelessness that require prompt assessment Normal grief that should never be discussed clinically Recovery because eight months have passed Q2. What is the nurse's priority response at the latest visit? Tell the client that grief should be over by now Schedule only a routine annual examination Ask directly about suicide and self-harm, assess immediate safety and basic needs, and notify the clinician Q3. Which follow-up plan best supports the client? Avoid mentioning the spouse so the client will not become sad Require participation in a single religious program Wait for the client to recover without additional contact Offer grief counseling, mental-health evaluation, support groups, and chosen family or community supports while monitoring function and safety ## Explanation Grief varies, and sadness, sleep disruption, appetite change, and difficulty concentrating can occur after a loss. The nurse should not impose a timetable or label normal emotion as illness. The trajectory becomes concerning when distress remains intense, daily function deteriorates, social isolation increases, and the client expresses hopelessness or an inability to imagine a future. The nurse should directly assess suicide and self-harm risk, communicate the change to the clinician, and connect the client with grief counseling, mental-health care, support groups, or other chosen resources. Direct safety questions do not replace compassionate listening; both are needed. ## In-depth explanation Correct Answer The trend changes from expected variable grief to persistent functional decline and hopelessness requiring direct safety assessment and referral. Why It Fits Missed meals, medication errors, withdrawal from all supports, worsening function, and statements that life has no point are not adequately addressed by reassurance alone. Clinical Picture Early grief includes some contact and self-care, but later observations show progressive isolation and inability to manage daily needs. Memory Link Do not time grief; track safety and function. NCLEX Rule When grief is accompanied by marked functional impairment or hopelessness, assess immediate safety and facilitate clinical and bereavement support. Why the Alternatives Fail Telling the client to move on, avoiding the spouse's name, or waiting indefinitely can invalidate the loss and miss escalating risk. Sources 1National Institute on Aging Coping With Grief and Loss 22026 NCLEX-RN Test Plan ## Clinical scenario Primary care follow-up An older adult is followed after the death of a spouse. The nurse compares sleep, nutrition, social connection, daily function, and statements about the future across visits. ## Key concepts - **Bereavement** — The state of having experienced the death of someone significant. - **Functional impairment** — Difficulty carrying out daily activities such as eating, taking medication, attending appointments, or maintaining the home. - **Grief support** — Compassionate listening, social connection, counseling, support groups, and clinical care selected to match the person's needs and preferences. ## Related questions - [For each nursing response to a grieving adolescent, identify whether it is supportive now …](https://mymerci.kr/pages/nclex_q.php?qn_id=547009&lang=en) - [A nurse in a primary care clinic sees a 50-year-old client whose spouse died suddenly 2 mo…](https://mymerci.kr/pages/nclex_q.php?qn_id=617294&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=535419&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=535419&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=535419&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=535419&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=535419&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._