ElNEC Quizzes Module 4 WGU C475.

Mrs. F., a 78-year-old Italian woman, is caring for her husband who has end-stage COPD and is experiencing anorexia and cachexia. She tells you that she is so upset that he won't eat her pasta anymore, which was "always his favorite." She cannot understand why he doesn't like it anymore. Which of the following is your best response?

"Food is such an important way that we show we care; it must be so hard for you that he doesn't feel like eating."

Which of the following patients' statements suggest that the patient is experiencing an existential crisis?

"I am so afraid that God has abandoned me in my time of need."

You are asking a nursing student to describe the assessment of a patient for dyspnea as part of end-of-life care. Which statement by the student indicates understanding of the best method to assess for dyspnea?

"I will ask my patient about his breathing."

You have been assigned to care for a woman who was recently admitted for advanced cancer, and who reports ongoing fatigue. Her husband offers observations about his wife's fatigue. Which statement by the husband indicates the most correct understanding of his wife's fatigue?

"She's been in pain. If we control that maybe, she'll have more energy."

Mrs. Smith has end-stage COPD and is admitted with severe dyspnea and is started on morphine sulfate. Which of the following statements by her husband demonstrates he understands the use of morphine in patients with COPD?

"The morphine is being used to treat her shortness of breath."

You are teaching the son of a 65-year-old male patient with cancer about his father's anorexia. Which statement by the son reassures you that the son understands your teaching and ways to help his father?

"We can offer Dad small, frequent feedings rather than large, overwhelming meals."

You are doing a spiritual assessment on Mrs. H. Which of the following questions are the most important to understanding her spirituality?

"What gives your life meaning?"

Mr. Tate tells you that he is very worried about dying. He knows his disease is terminal and he only has a few months to live. He tells you he has done "some bad things" in his younger days and thinks God is going to make him suffer with pain now because of his past. After listening to his story, what is your best response?

"Would you like me to contact our chaplain? He's very good at helping people who have concerns like yours?"

You are caring for the following four patients. Which patient is at the highest risk for developing constipation?

A 48-year-old with metastatic cancer of the breast on high doses of opioids for pain.

Which of the following patients are you most concerned may have an undiagnosed depression?

A 71-year-old grandmother with pancreatic cancer who reports trouble sleeping, fatigue, and doesn't care to see her grandchildren on the weekends anymore.

Geraldine is an 80-year-old woman with Parkinson's disease. She is still functioning at home and is able to safely care for herself. Ever since her diagnosis she has been extremely anxious about her disease and how debilitated she might get as it progresses. Which of the following interventions is most appropriate to help treat her anxiety?

Active listening and presence as she talks about her fears and concerns

John's lung cancer is causing him severe shortness of breath. Which pharmacologic intervention would be of most benefit for his dyspnea?

An opioid like morphine sulfate

Which of the following statements about dyspnea in patients at end of life is true?

Dyspnea may be relieved by a cool fan blowing on the patient.

You are caring for a patient in end-stage renal disease. The patient has no apparent family or support systems. The patient is taking prescribed opioid analgesics for pain management yet continues to complain of feeling tired. The patient states, "I wish it would all end." Which action should you take first?

Evaluate the patient further for depression.

Symptom management in older adults with serious illness is complicated because:

Many have multiple comorbidities.

Mr. Jones is struggling with fatigue from his advanced heart failure. Which of the following referrals would you recommend to help him with this debilitating symptom?

Occupational therapy

You are developing a plan of care for a patient with cancer-related pain who is taking sustained-release morphine sulfate 30 mg twice a day, along with 15 mg of immediate release morphine sulfate every three hours as needed for breakthrough pain. Which goal is important to include in the patient's plan of care?

Patient will have a bowel movement at least once every three days.

You are caring for an elderly woman who has severe osteoporosis and is suffering with bone pain from several spinal fractures. She is in bed most of the day, on a low dose opioid for the most recent fracture, and is not eating or drinking much. Which of the following nursing interventions to prevent constipation is best?

Recommend a physician order for a scheduled laxative and stool softener.

You are caring for a patient who is in the advanced stages of AIDS. The patient is reporting severe fatigue. Which finding is commonly associated with the symptom of fatigue?

Sedating medications

You are caring for a 77-year-old patient at the end of life who has not had a bowel movement in five days. Which sign should you assess the patient for to determine if a fecal impaction is present?

Sudden onset of liquid stool