Med Surg 2 Test 9 Chapter 10

The family of a terminally ill client is deciding between home care and a hospice facility. When comparing options, which factor of home care needs regular assessment? A)Pain control B)Caregiver strain C)A comfortable environment D)Transportation to appointments

B)Caregiver strain

The nurse is caring for a client who is interested in learning about hospice care. Which of the eligibility criteria would the nurse stress? A)Serious, progressive illness B)Choice of palliative care over cure focused C)Limited life expectancy D)Physician-certified illness

B)Choice of palliative care over cure focused

When considering care for the dying, which awareness, by the nurse, provides the best rationale for general nursing care? A)Comfort measures are essential during this period. B)Death is the final stage of growth and development. C)Care for grieving family members is important. D)Technology extends death and dying.

B)Death is the final stage of growth and development.

Which of the following nursing interventions will a nurse perform to transfer heat and improve circulation in a dying client? A)Change the position frequently. B)Gently massage the arms and legs. C)Administer warm intravenous fluids. D)Administer intramuscular injections.

B)Gently massage the arms and legs

Which of the following nursing interventions should a nurse perform to promote the dignity and self-esteem of a dying client? A)Communicate hopefulness. B)Keep the client clean and well groomed. C)Share emotional pain. D)Help the client live according to his or her wishes.

B)Keep the client clean and well groomed

Which statement, made by the nurse, can be most helpful when caring for a client in the third stage of Kübler-Ross's emotional reactions to dying? A)"Let's review the laboratory results and compare them with the diagnostic tests." B)"I understand that it would be wonderful to see your daughter's graduation." C)"What makes you most angry about getting the disease?" D)"I like your idea of living for today and enjoying those around you."

B)"I understand that it would be wonderful to see your daughter's graduation."

The nurse is caring for a client at the end of life. The client is ordered a regular dosage of narcotics and short-acting narcotics for breakthrough pain. When administering the narcotics, the nurse is correct to realize which of the following? A)Death is imminent. B)Side effects must be treated. C)Dosages are restricted. D)Patient may become sedated.

B)Side effects must be treated.

The nurse is caring for a client who has diminished lung function due to emphysema. The terminally ill client is short of breath on exertion and states he has difficulty sleeping in bed. The client states, "I am so afraid of getting any worse." Which statement, by the nurse, assists the client in sustaining hope? A)"Do not worry, I will be here for you to help you with your needs." B)"I will talk with the physician to determine the next step in your care." C)"Your grandchild is almost here, and you will enjoy seeing it." D)"I hear you say that you are not sleeping well."

B)"I will talk with the physician to determine the next step in your care."

The family of a dying client is noticing that their loved one is short of breath, restless in bed, and appears to be trying to tell them something. Which nursing intervention is appropriate at this time? A)Offer the bedpan to urinate. B)Call the physician to obtain an anxiolytic. C)Get the client out of bed to the chair. D)Offer the client sips to drink.

B)Call the physician to obtain an anxiolytic.

The nurse is caring for a dying client in a hospice setting. The family is unsure whether to go home for rest or spend the night with the client. Which body system would the nurse assess to provide the first data on decline? A)Central nervous system B)Cardiovascular system C)Respiratory system D)Gastrointestinal system

B)Cardiovascular system

The hospice nurse is visiting the client in the home. The client is comfortable with talking to the nurse. Which of the following statements, made by the client, demonstrates that the spiritual needs are being met? A)"I believe that there is a better place." B)"I am comfortable and feel no pain." C)"Family is the most important thing to me." D)"There have been many positives in my life, and I am grateful."

A)"I believe that there is a better place."

Which of the following is an appropriate intervention for the client with pulmonary edema? A)Administer the prescribed sedative to decrease anxiety. B)Suction as needed to clear the lungs. C)Position the client supine. D)Use chest percussion.

A)Administer the prescribed sedative to decrease anxiety.

All nurses care for clients who are grieving. It is important for the nurse to understand the grieving process for which reason? A)Allows for the nurse to facilitate the grieving process B)Allows for the nurse to take the client through in the appropriate order C)Allows for the nurse to understand when the grieving process should be concluded D)Allows the nurse to express his or her feelings

A)Allows for the nurse to facilitate the grieving process

Which of the following is an appropriate intervention to promote sleep in the dying client? A)Cluster necessary activities. B)Awaken client every three hours. C)Allow a steady stream of visitors. D)Provide maximal environmental stimulation to the client.

A)Cluster necessary activities

Which of the following nursing interventions should be implemented for the dying client who is incontinent of urine, with associated skin breakdown, and exhibits a decreased level of consciousness? A)Insertion of an indwelling catheter B)Use of absorbent pads C)Offering a bedpan every 4 hours D)Assisting the client to the commode every 2 hours

A)Insertion of an indwelling catheter

Which of the following is the nurse's primary concern when providing end-of-life care for a client and the family? Select all that apply. A)Maintaining client comfort B)Arranging plans for after death C)Supporting family members D)Providing personal care E)Completing a head-to-toe assessment F)Encouraging fluids

A)Maintaining client comfort, C)Supporting family members D)Providing personal care

A client has learned of a terminal illness and impending death. The client asks the nurse to explain the concepts and care that are provided under the definition of palliative care. Which of the following would the nurse include in the explanation for this client? Select all that apply. A)Provides pain relief B)Includes chemotherapy C)Integrates spirituality D)Hastens death E)Offers a team approach to care F)Enhances quality of life

A)Provides pain relief, C)Integrates spirituality, E)Offers a team approach to care F)Enhances quality of life

Which cardiovascular findings indicate to the nurse that the condition of the dying client is worsening? A)Pulse 104 beats/minute in the morning, 62 beats/minute in the afternoon with mottled feet and ankles B)Pulse 72 beats/minute, irregular; patient confused and agitated C)Pulse 100 beats/minute, blood pressure 100/60 mm Hg, pale with poor skin turgor D)Pulse 60 beats/minute, blood pressure 90/42 mm Hg, difficult to arouse

A)Pulse 104 beats/minute in the morning, 62 beats/minute in the afternoon with mottled feet and ankles

A terminally ill client is admitted to a hospice facility. The client has an advanced directive indicating that no heroic measures be used to prolong life. What is the most appropriate nursing action when death appears imminent? A)Sit quietly and stroke the client's hand. B)Notify the client's clergy of the potential for death. C)Call the funeral home to notify of imminent death. D)Move the client to a private room.

A)Sit quietly and stroke the client's hand.

In which scenario would the nurse, caring for the palliative care client, encourage the treatment of chemotherapy? A)When the chemotherapy can assist in managing distressing clinical symptoms B)When the client and family requests to have more chemotherapy C)When the client feels chemotherapy will cure the disease D)When the chemotherapy helps the psychological state of the client

A)When the chemotherapy can assist in managing distressing clinical symptoms

A nurse is caring for a terminally ill client inquiring about physician-assisted suicide. Which statement, made by the nurse, would correctly advocate for the practice? A)The physician administers a lethal dose of medication via IV. B)The physician provides the means for the clients to take their life. C)The physician provides the means and waits to pronounce them dead. D)The physician provides counseling and has a third party physician assist in the suicide.

B)The physician provides the means for the clients to take their life.

Which action, following the death of a loved one, would the nurse witness the Chinese American family members doing? A)Praying beside the body B)Washing the body C)Calling the spirits D)Perfuming the body

B)Washing the body

What major complication is associated with oral intake in the client with a decreased level of consciousness? A)Distended abdomen B)Nausea C)Aspiration D)Pocketing of food

C)Aspiration

The nurse is caring for a 90-year-old male who has never completed an advanced directive. The man has a son but has not seen him in several years. A neighbor has assisted him with meals and housecleaning for many years. The neighbor states that the client expressed only wanting to have comfort measures. The estranged son wants his father to be treated aggressively. Which would be the nurse's initial step? A)Follow the son's directive. B)Follow the neighbor's directive. C)Assess the client's ability to state wishes. D)Notify the physician of the discrepancy.

C)Assess the client's ability to state wishes.

The nurse is caring for a pediatric client who is dying. The best way to provide care and comfort to dying clients and their families is to first do which of the following? A)A workshop on caring for the dying client B)Use evidence-based practice in daily care regimen. C)Explore own feelings on mortality and death and dying. D)Participate in a support group to learn clients' feeling on care.

C)Explore own feelings on mortality and death and dying.

Which of the following is an example of near-death awareness? A)Feeling warm and peaceful B)Floating above one's body C)Premonition regarding date and time of death D)Moving rapidly toward a bright light

C)Premonition regarding date and time of death

The nurse is caring for a client who is in the dying process. The nurse is reviewing orders to confirm that all is being done to meet client needs. Which additional nursing intervention may be helpful? A)Lay client in the supine position. B)Apply glycerin products for moisture. C)Reposition client every 2 hours. D)Remove extra blankets and covers.

C)Reposition client every 2 hours.

As the moment of death approaches, which of the following does the nurse encourage the family to do? A)Have the family sit in front of the client so they can be seen. B)Rub the client's hand and arm to comfort the client. C)Speak to the client in a calm and soothing voice. D)Lie next to the client and hold the client.

C)Speak to the client in a calm and soothing voice.

A nurse is caring for a dying patient. The family asks the nurse why there is a rattling in their loved one's chest. Which response is most appropriate? A)The client picked up a virus and has respiratory symptoms. B)The client has been lying in bed and secretions pool in the lung bases. C)There is an accumulation of fluid in the pulmonary circulation and secretions throughout the respiratory tract. D)Thick sputum accumulates as the client dehydrates from having little oral intake.

C)There is an accumulation of fluid in the pulmonary circulation and secretions throughout the respiratory tract.

Which of the following should the nurse report so that the team can consider alternative nutritional and fluid administration routes for a dying client? A)Altered gastrointestinal function B)Drop in blood pressure and rapid heart rate C)Weight loss and inadequate food intake D)Irregular eating habits

C)Weight loss and inadequate food intake

Which of the following interventions should the nurse perform to prevent drying of the oral mucous membranes and lips in a dying client? A)Place the client in a cool temperature. B)Provide water to the client at regular intervals. C)Provide the client with absorbent pads. D)Provide oral care, ice chips, and petroleum jelly.

D) Provide oral care, ice chips, and petroleum jelly.

A nurse is caring for a terminally ill client who is receiving chemotherapy and radiation for an aggressive lung cancer. The treatment success is limited in shrinking the tumor, and the treatments are making the client very ill. The client states, "I feel that I would like to stop treatments. I would like to enjoy the time that I have remaining with my family." Which emotional reaction does the nurse recognize that the client is experiencing? A)Denial B)Bargaining C)Anger D)Acceptance

D)Acceptance

Which of the following is a nursing intervention for promoting self-care in the dying client? A)Apply glycerin to the lips. B)Promote active range-of-motion exercises every hour. C)Avoid oral hygiene to minimize risk of aspiration. D)Assist with personal hygiene.

D)Assist with personal hygiene.

The family of a dying client being cared for at home is requesting information on how best to prepare food. Which suggestion by the nurse may stimulate appetite? A)Eating alone so the client can eat at his own pace and not be hurried B)Providing several choices on the plate so that the client has what may appeal to him C)Offering high caloric foods to build fat and muscle D)Preparing cool or cold foods that may be better tolerated

D)Preparing cool or cold foods that may be better tolerated

The nurse is caring for a client who just learned of his terminal diagnosis. After the physician leaves, the nurse remains to answer further questions so that the client can make an informed decision about further treatment. By providing all available information, the nurse is promoting which ethical principle? A)The principle of justice B)The principle of nonmaleficence C)The principle of fidelity D)The principle of autonomy

D)The principle of autonomy