DGB Final Exam

" A Dying Person's Bill of Rights", is based on which ethical principle? A. Autonomy B. Nonmaleficence C. Beneficence D. Justice

A

"I know it seems strange, but I feel guilty being pregnant after the death of my son last year," said a woman during her routine obstetrical examination. The nurse spends extra time with this woman, helping her to better bond with her unborn child. This demonstrates which caring technique? A. Facilitating mourning B. Providing curative therapy C. Promoting spirituality D. Eradicating grief

A

"I know it seems strange, but I feel guilty being pregnant after the death of my son last year," said a woman during her routine obstetrical examination. The nurse spends extra time with this woman, helping her to better bond with her unborn child. This demonstrates which nursing technique? A. Facilitating mourning B. Providing curative therapy C. Promoting spirituality D. Eradicating grief

A

A client confides to the therapist that he is upset because his mother remarried 2 months following the death of his father. The therapist should advise the client to do which of the following? A. Express his concerns to his mother B. Accept the mother's marriage without causing added stress to their relationship C. Give her (the therapist) permission to speak to the mom on his behalf D. Avoid revealing his feelings to his mother

A

According to the article on Mrs. Bush, the family's decision for comfort care was a verbal understanding between the doctor and patient. A. True B. False

A

After the anticipated death of a chronically ill patient, a hospice nurse is found crying in the staff lounge. The best response the care team can make to their crying colleague, is which of the following? A. "It is normal to feel this way. Give yourself some time to mourn." B. "Your other patients still need you, so hurry back to them." C. "You're being a bad role model to the unit's nursing students." D. "Why don't you take a sedative to cope?"

A

Families are a system. In a healthy system, all the parts must work together in order for the system to function well. The literature states that which of the following best describes how a family should grieve? A. Families do not grieve; only individuals grieve B. Families do not expect to grieve together C. Families do not expect to provide support and comfort to each other D. The family system should always participate in a bereavement support group

A

Funerals mark the beginning of the grief process because they: A. assist individuals to face the reality of death. B. help people to let go of denial. C. provide the only opportunity for loved ones to grieve publicly. D. help individuals bring closure to a painful experience.

A

Grandmother brings a child to the clinic for a health examination because the child who has been toilet trained for 2 years, has recently started bed wetting again. While gathering a health history from the grandparent, the interviewer asks about which factor as the most likely cause of the child's regression? A. Recent parent death B. Time out for not sharing toys C. Dietary changes D. Lack of outside playtime

A

Resolution is a final component of surviving the death of a loved one. Which one of the following statements is a false expectation of resolution? A. Resolution means an end to grieving for the individual B. Resolution means managing life's situation as time goes on C. Resolution may include resuming old activties and assuming new activities and new roles. D. Resolution may include developing a changed perception of one's self and of the world.

A

The deceased was an 81-year old man who had Alzheimer's disease for 6 years before he died. His wife of 50 years had been his primary caretaker. Which statement is true about loss related to cognitive decline (Alzheimer's dementia)? A. Loss in dementia is pervasive and all encompasing with many losses occuring gradually B. Alzheimer's loss does not affect the social aspect of the person's life with their caregiver spouse C. With Alzheimer's there is a loss of the past and the present with little loss of role function D. Caregivers feel immediate relief when the person with Alzheimer's dies

A

Which statement of "nearing death awareness" is incorrect? A. Nearing death awareness is the same as near death experiences. B. Nearing death awareness is experienced by people of diverse cultures and ages. C. Nearing death awareness is sometimes confused with delerium. D. Nearing death awareness experiences usually make reference to people who have predeceased the dying person.

A

You have just been assigned to take care of a very sick, but alert patient, who does not have an advance directive. What is the best way to facilitate a discussion about advance directives with this patient/family? A. Ask the patient if they have thought about the kind of care they want when they can no longer speak for her/himself. B. Tell the patient they need to make a decision now before it is too late. C. Tell the patient that they must take this opportunity to develop an advance directive because death is imminent. D. Advise the patient that everyone receiving Medicare must have an advance directive.

A

Your client's family is concerned because your client has not been thinking clearly, and has been unable to concentrate or pay attention since the sudden death of her partner a few weeks ago. You explain that because the death was recent the client's behavior is normal and that the client may also show which of the following normal grief behaviors? A. Long term memory loss B. Anger at God C. Use of alcohol or drugs to dull the pain D. Hyperactive, manic behavior

A

Which of the following statement(s) is/are true regarding veterans, and persons with HIV/AIDS or cancer. (Select all that apply). A. It is likely that these three groups of people have deteriorating physiological conditions (co-morbidities) B. Only HIV/AIDS and cancer patients are at risk for situational low self esteem C. All may be at risk for social isolation and stigmatization D. Persons in each of these categories are most likely grieving multiple losses E. Strong support groups do not exist for these three classifications of people

A, C, D

Mrs. Harrison's father died a couple of weeks ago. Mr. Harrison is experiencing headaches and fatigue, and keeps shouting at his wife to turn down the television, although he has not done so in the past. Mrs. Harrison is having trouble sleeping, has no appetite, and says she feels like she is choking all the time. What is the correct assessment of this situation? A. Mrs. Harrison is grieving and Mr. Harrison is angry. B. Both Mr. and Mr. Harrison likely are grieving C. Mrs. Harrison is ill and Mr. Harrison is grieving D. Both Mr. and Mrs. Harrison likely are in denial

B

A couple is informed that their fetus will be stillborn (born dead). Which intervention by the care team will best help the couple through this stressful situation? A. Leaving the couple alone to grieve their situation B. Providing careful explanations and time to process their situation C. Briefly discussing the situation before providing funeral guidance D. Immediately contacting a social worker to assist the couple

B

A family is grieving the loss of their five-year old son, who was an only child. When dealing with families who are grieving, care providers should remember that which of the following is the most important factor in successful grief resolution? A. The couple actively debates who is responsible for the child's death B. The ability of the couple to engage in open and honest communication C. The couple has decided to enshrine the child's room D. The couple is planing to have a baby to replace the child they lost

B

A very religious family is concerned because their daughter's six-week old baby passed away from Sudden Infant Death Syndrome (SIDS). The daughter has not been thinking clearly, is at times quite forgetful, and cries very easily. You explain that because the death was recent and the relationship was significant, their daughter's behavior is normal and that the she may also show which of the following normal grief behaviors? A. Long term memory loss B. Anger at God C. Use of alcohol or drugs to dull the pain D. Hyperactive, manic behavior

B

Grief can partially be defined as: a normal part of life. A. a pathological condition. B. a normal part of life. C. an experience only related to death. D. an emotion too difficult for most people to endure.

B

In providing anticipatory guidance to adult family members about the impending death of a loved one, the care team should do which of the following to assist the family? A. Warn them to brace themselves because the worst is yet to come Monday, September 23, 2019 4:09:41 PM EDT B. Inform them about normal grief reactions and what they can expect in the days ahead C. Insist that they do not dwell on the impending death D. Suggest that the family seek out a funeral home that can be on call

B

Members of a cultural group can be of assistance to grieving members from their own cultural group because: A. there is likely a professional facilitator in that group. B. they share similar life experiences with other group members. C. they are most likely to focus on solving specific problems. D. they share a herd mentality.

B

The social worker is performing a self-assessment prior to beginning work in a hospice setting. Which factor places the social worker at risk for an heightened emotional response to a client's death? A. The social worker lacks home care experience B. The social worker experienced loss/death of a loved one recently C. The frequency of death experienced in the hospice setting D. Experience with clients who have advanced stages of uncurable diseases

B

Which of the following are normal reactions to a significant loss? A. Memory loss, digestive upset, crying, insomnia, and psychotic breakdown B. Memory loss, digestive upset, crying, insomnia, and inability to concenrate C. Memory loss, digestive upset, insomnia, depression, and halucinations D. Memory loss, digestive upset, insomnia, depression, and thoughts of hurting oneself

B

Which of the following are therapeutic rituals that persons can use to help manage their grief? 1. Funerals 2. Graduation ceremonies 3. Candle lighting ceremonies 4. Wedding ceremonies A. 1 and 4 B. 1 and 3 C. 2, 3 and 4 D. 1, 2, and 3

B

Which of the following leads to conflict in grieving families? A. Not knowing what behaviors to expect from each other B. Expectations that every family member will grieve in the same way C. Family members avoiding each other D. Siblings respecting their sick dad's advance directive

B

You are a new member of the palliative care team. In order for you to provide culturally sensitive care to persons at the end of life, one of your earliest orientation tasks should be to: A. evaluate the cultural beliefs of co-workers. B. identify your own cultural beliefs and values. C. learn to predict how various races deal with end-of-life issues. D. studying state laws concerning end-of-life care for various cultural and ethnic groups.. The correct answer

B

You are the staff person assigned to admit a young woman with uterine cancer to the unit. You sense she is anxious about something. Which question should you ask that will assist you with prioritizing the woman's needs and concerns? A. "You seem uncomfortable, are you having pain?" B. "What is the most important thing I can do for you right now?" C. "You seem sad today, can you tell me more?" D. "Do you wish to rest now?"

B

You note that your friend who recently began treatment for breast cancer has become quiet and withdrawn. She states that she does not believe the treatments will make any difference, does not ask about her progress, and has missed two chemotherapy sessions. Based on the above assessment data and after getting more information from your friend, you understand that she is experiencing which of the following conditions? A. Anxiety B. Hopelessness C. Spiritual distress D. Complicated grieving

B

Your friend's 6-year old son is very sad because his dog died 2 weeks ago when it was hit by a car. His mother tells you that since the incident her son is sometimes withdrawn and gets very upset if he hears a dog barking or sees a dog. Which of the following is the best intervention to encourage the child to express his feelings? A. Request a visit from the family religious leader (Pastor, Rabbi, Imam) B. Tell the mom to use play techniques involving dolls, puppets or art C. Insist to your friend that she should get the child a new dog right away D. Suggest to the mom that they refrain from talking about dogs for several months, allowing the child to get over his loss (the dog)

B

A client who was diagnosed with terminal liver cancer is still able to comb her hair, wash her upper body and brush her teeth, (activities of daily living or ADLs).The palliative care team observes that the client's family completes all of the ADLs for their loved one. Which of the following rationales for self-care is most important for the team to communicate to the family? A. Strengthening of the client's muscles may promote healing of the cancer B. The client needs time alone to reason through the diagnosis C. The client's sense of loss can be lessened by retaining control in certain areas of life D. Increased activity required for self-care will enhance the client's mood

C

A loss that occurs when a person can no longer feel, see, hear, or know another person , or object is what type of loss? A. A maturational loss B. A situational loss C. An actual loss D. A perceived loss

C

A sophomore student comes to the student health center because she is having problems concentrating in her classes. She is falling behind in her assignments and is afraid she may fail this semester. During your assessment you find out that her best friend was killed in a car accident 6 months ago. Your most appropriate intervention would be which of the following? A. Give her some information on loss and grief and suggest that she writes her feelings in a journal for a week and then come back for a follow up visit B. Let her know that she should seek counseling for her grief because at six months she should be feeling better by now C. Let her talk and inform her that at six months she is just beginning to feel the impact of the loss. Stress the normalcy of her feelings D. Give the student some literature on grief and loss and tell the student she should make an appointment to come back or go to the emergency room if her feelings do not improve.

C

A unique form of stress, also referred to as secondary trauma that affects people in the health professions is recognized as: A. workplace overload. B. psychological overload. C. compassion fatigue. D. intra-psychic conflict.

C

As a member of the palliative care team, you know that which of the following statements is a guiding principle for providing end-of-life-care? A. Pain and symptom management are the issues that must be addressed first regardless of other problems the patient may be having. B. The patient's provider should complete a physical assessment, conduct a minimental assessment, advocate for the best care on behalf of the patient, and monitor for pain. C. For starters, the patient's care coordinator should ask the patient and family about their preferences for treatment and care, and believe the patient's report of distress. D. Usually the first thing the team does when administering care to a patient at the end-of-life is to call the chaplain, or ask the family to contact the patient's religious leader."

C

Dyspnea or breathlessness can be caused by chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), and/or anxiety. This subjective symptom can be one of the most distressing symptoms for patients and their families. Dyspnea relief can be achieved by which of the following interventions? (Select all that apply). 1. Using a fan to circulate the air in the person's room 2. Restricting the number of visitors in a person's room 3. Making sure the person is lying very still on a flat bed 4. Administering oxygen as prescribed 5. Restricting the use of Inhalers and nebulizers 6. Using complementary therapy (ie. progressive relaxation) A. 1,3,4,5 B. 2,3,5,6 C. 1,2,4,6 D. 3,4,5,6

C

In order to to assist families through the grieving process, care providers should be aware that: 1. loss occurs on a continuum from simple to complex. 2. mourning is the public manifestation of grief. 3. grief only occurs following a death. 4. grieving means letting go of all memories of the loved one. 5. anger, fear, and guilt are a part of normal grieving. A. 3, 4, 5 B. 2, 3, 4 C. 1, 2, 5 D. 2, 4, 5

C

Many persons nearing death experience significant pain. Pain is: A. an objective sensation that requires care-giver validation. B. a feeling that can only be accurately quantified using a pain scale. C. a subjective phenomenon that can affect a person's total being. D. managed the same way for all persons at the end-of-life.

C

Morphine is a drug commonly used for pain management. This medication also causes respiratory depression which may cause death. The term used to describe this phenomenon is referred to as: A. a two for one. B. drug synergy. C. double effect. D. physician assisted suicide.

C

Mrs. Bush suffered from chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF.) She received "comfort care" at her family's home. What type of care/treatment did she receive? A. Treatment to cure the COPD and CHF disease B. Treatment to prolong her life C. Treatment to manage the symptoms of COPD and CHF D. Treatment to hasten her death

C

Mrs. Bush, a former smoker had chronic obstructive pulmonary disease (COPD). Smoking may be a contributing factor to COPD. How may years did Mrs. Bush smoke? A. 12 B. 18 C. 25 D. 29

C

One of the most common reasons that dying persons reject the use of opioids and other strong medications for pain management at the end-of-life is because: A. the medications are very expensive. B. taking medication at the end-of-life is considered a sign of weakness. C. they fear becoming addicted to the medications. D. they think that all pain medication will hasten their death.

C

The best verbal response to an individual who has had a death in the family is: "I am sorry for your loss." A. "I know how you feel." B. "She/he lived a long life." C. "I am sorry for your loss." D. "At least you have another child/sibling/parent."

C

The palliative care team's primary obligation to a patient in severe pain includes which of the following? A.. Planning postmortem care with the patient B. Teaching the patient the stages of grief C. Enhancing the patient's quality of life D. Providing grief counseling to the patient's family

C

Which is considered an inappropriate behavior for a bereaved person who had a loving relationship with the decedent (the person who died)? A. Writing a poem about the deceased person B. Attending the wake and/or funeral of the deceased C. Shredding a scrapbook of photos and memories of the deceased D. Tracing a family tree of the deceased

C

Which of the following is crucial to providing quality end-of-life care? A. Maintaining cost-effective analgesic regimens B. Restricting care to symptom management algorithms C. Communicating effectively with clients and families D. Employing volunteers to ensure clients are not alone

C

A man and his wife had been married for 62 years. They died within hours of each other; the man first and then later in the same day his wife. Scientists think that deaths among aging couples may occur in this or a similar manner because: A. when one person of the marriage passes away, the survivor does not have adequate finances to live a quality life. B. although elderly people have stronger immune systems than young people, they have smaller support groups. C. elderly married couples have had many life experiences together so one does not want to live without the other. D. age alters how the body's immune system responds to grief and bereavement.

D

Which statement below made by persons who are dying might indicate that they are experiencing "nearing death awareness"? Ann a chronic alcoholic has who is dying from cirrhosis of the liver and suffering from terrible bouts of pain, says, " I wonder if this is how Mary felt when she was dying of cirrhosis?" A. Joe with terminal cancer that has spread to various parts of his body says, "I hope this chemotherapy works, because this is my last chance to live a little longer." B. Ann a chronic alcoholic has who is dying from cirrhosis of the liver and suffering from terrible bouts of pain, says, " I wonder if this is how Mary felt when she was dying of cirrhosis?" C. Sam, age 90 is dying from complications related to Alzheimer's disease. He is often not understood when he speaks. He has been saying all morning to anyone who walks past his bed, "Tell my mama not to go. I need to get my clothes on. I don't want her to leave me!" D. Jane age 35 suffers from head trauma caused by a head on collision between her car and a truck. She appears to be sleeping with her eyes and mouth partially open. She occasionally grimmaces, makes a few verbal noises that sound like she is trying to talk, and then goes back to sleep. Her behavior is like this around the clock. She has been in a nursing home for 2 years.

C

You are observing a bereavement support group. Which person in the group is most at risk for complicated grief? A. A woman whose next door neighbor was murdered B. A man who recently lost his wife of 56 years C. A woman happy to be pregnant who sustained a third trimester miscarriage D. A man whose wife died from complications of Alzheimer's disease

C

You are visiting your aunt who was diagnosed with an incurable disease 6 months ago. You observe that today she is more agitated than usual. You wonder if she wants to discuss her impending death? What is the best approach to let her know you are interested in discussing it with her? A. Let her bring up the subject when she is ready B. Refrain from saying anything because most dying patients do not like to talk anyway C. You could say something like, "I feel sad about what is happening to you." D. Try to distract her by saying, "What a beautiful day it is outside." The correct answer is C. Let her know you are interested by bringing up the

C

A Dying Person's Bill of Rights", is based on which ethical principle? A. Nonmaleficence B. Beneficence C. Justice D. Autonomy

D

A child grieves the loss of his teddy bear that was burned up in a house fire. For the child this type of loss is: A. a maturational loss. B. a situational loss. C. a perceived loss. D. an actual loss.

D

A child's understanding of death is impacted by which of the following? A. Age and developmental stage B. Knowledge of family members and caretakers responses to loss. C. All children understand death quite readily D. A and B only

D

A family member reports that their terminally ill father is experiencing constipation secondary to his opiod pain medication. What is the best way to relieve the patient's constipation? Instruct the family member to: A. massage the patient's abdomen. B. discontinue the pain medication. C. administer enemas twice daily until the father has a bowel movement. D. administer the father's stimulant laxative and increase his fluid intake.

D

A woman experiences the loss of a fetus very early in her pregnancy. Her friends do not mention the loss, and someone suggests to her that she can always try again to have another baby. The woman feels confusion over her sadness and stops talking about it with others. What type of grief response is she most likely experiencing? A. Delayed B. Anticipated C. Exaggerated D. Disenfranchised

D

An individual's best response to his/her grief is to: A. hold back his/her emotions. B. show how strong he/she can be. C. exemplify stoicism so as not to attract unwanted attention. D. respond the way they feel like responding.

D

Which of the following is/are concern(s) that grieving children may have after the death of a loved one? A. Who will take care of me? B. Will it happen to me? C. Did I cause the death? D. All of the above E. A and C

D

Which of the situations below is least likely to be a risk factor for complicated grief? A. Sudden or traumatic death B. Death of a child C. Multiple losses in a short period of time D. Death of an older person with co-morbid (more than one) diseases

D

You are visiting the mother of a recently murdered child. The mother keeps the child's room just like it was when he died a few weeks ago. Family members are encouraging her to redecorate the room and adjust to her loss. You recognize that the mother is exhibiting what type of grief? A. Disenfranchised B. Complicated C. Cummulative D. Normal

D