End of Life Care Study

1. The nurse is preparing to care for a dying client and several family members are at the client's bedside. Which therapeutic techniques should the nurse use when communicating with the family? Select all that apply. a. Discourage reminiscing b. Make the decisions for the family c. Encourage expression of feelings, concerns, and feels d. Explain everything that is happening to all family members e. Touch & hold the client's or family member's hand if appropriate f. Be honest and let the client and family know that they will not be abandoned by the nurse

C. Encourage expression of feelings, concerns, and feels F. Be honest and let the client and family know that they will not be abandoned by the nurse

15. A client has a terminal illness, and her spouse is distraught about the unrelenting pain she experiences. Which should the nurse implement as the most effective measures to alleviate the spouse's distress? Select all that apply. a. Convey respect for the couple's wishes. b. Engage the spouse in providing comfort c. Enable the couple in discussing their loss d. Maintain a presence to answer questions e. Encourage the spouse and client to hold hands f. Discourage the spouse and client from talking about the terminal illness

b. engage the spouse in providing comfort e. encourage the spouse and client to hold hands

19. The nurse is caring for an older client who is terminally ill. Which signs indicate to the nurse that death may be imminent? a. Flushed and warm skin b. Eupnea and normal body temperature c. Irregular, noisy breathing and cold, clammy skin d. Presence of swallowing reflex and active bowel sounds

c. Irregular, noisy breathing and cold, clammy skin

10. The nurse is caring for a client at the end of life. The client is withdrawn and agitated and is experiencing visual hallucinations. Which actions should the nurse take to provide end-of-life psychological care? Select all that apply. a. Provide privacy to the client and family. b. Speak in a soft tone, but not directly to the client c. Encourage the family to talk with and reassure the client d. Encourage visits by appropriate spiritual services as desired e. Encourage family and visitors to avoid taking in the presence of the client to provide a calming environment

A. provide privacy to the client and family C. Encourage the family to talk with and reassure the client D. Encourage visits by appropriate spiritual services as desired

12. The nurse is caring for a client who has just died. Which end-of-life information needs to be documented in the client's medical record? Select all that apply. a. time and date of death b. time of body transfer and destination c. family members present at the time of death d. medical tubes, devices, or lines left in the body e. name of PHCP certifying death

A. time and date of death B. time of body transfer and destination D. Medical tubes, devices, or lines left in the body E. Name of PHCP certifying death

14. A licensed practical nurse (LPN) is providing instructions to an unlicensed assistive personnel (UAP) who is preparing to care for a deceased client whose eyes will be donated. The nurse intervenes if the UAP performs which action? a. Closes the client's eyes b. Elevates the head of the bed c. Places a dry sterile dressing over the open eyes d. places wet saline gauze pads and an ice pack on the eyes

C. places a dry sterile dressing over the open eyes

8. The nurse is caring for an 8-year-old child in the late stage of a terminal illness. The child is semiconscious. The nurse notices that the child has a dry mouth and the family believes the child is thirsty. The family is attempting to give the child a large glass of apple juice. Which actions should the nurse take? Select all that apply. a. give the child the glass of apple juice b. perform frequent oral care with mouth swabs c. provide the child with mouthwash to help with mouth odor d. inform the family that oral intake increases as death approaches e. encourage the family to participate in oral care as much as desired f. give the child small sips of water or ice chips if alert and requested by the child.

B. perform frequent oral care with mouth swabs E. encourage the family to participate in oral care as much as desired F. give the child small sips of water or ice chips if alert and requested by the child.

6. A client who was struck by a car while jogging is brought to the emergency department by emergency medical services. The client is unconscious, and a ruptured spleen is suspected. Emergency measures are instituted but are unsuccessful. The client's fiancé is with the client and tells the nurse that the client is an organ donor. In anticipation that the client's eyes will be donated, which should the nurse implement? a. Ask the fiancé to obtain the client's will from the lawyer b. Call the national eye bank to confirm that the client is a donor c. Close the deceased client's eyes and place gauze and a small ice pack on the eyes d. Position the deceased client supine and place dry sterile dressings over the eyes.

C. close the deceased client's eyes and place gauze and a small ice pack on the eyes.

13. The nurse is working with a new nurse employee in a hospice agency. The nurse recognizes the new employee needs further assistance in facilitating effective communication between a client and the family if the new nurse employee performs which action? a. The new nurse employee encourages the client and family to openly identify and discuss feelings b. The new nurse employee assists the client and family in carrying out spiritually meaningful practices c. The new nurse employee makes decisions for the client and family in order to relieve them of unnecessary demands d. The new nurse employee maintains a calm attitude and one of acceptance when the family or client expresses anger

C. the new nurse employee makes decision for the client and family in order to relieve them of unnecessary demands

The nurse is caring for a client at the end of life. Which skin changes would the nurse expect to note? SATA A. dry skin B. warm skin C. wax-like texture D. mottling of arms, legs, hands, and feet E. cyanosis of the nose, nail beds, and knees

C.wax-like texture D. mottling of arms, legs, hands, and feet E. cyanosis of the nose, nail beds, and knees

The nurse is caring for a client with terminal cancer who is close to death. In reviewing the plan of care, the nurse determines that which action is a priority? a. Keep the client well sedated so the client is totally unaware of what is actually happening b. Maintain the client's dignity and self-esteem, and make the client as comfortable as possible c. Make sure that the family has privacy and is kept informed of what is happening at all times d. Carry out the PHCP's prescriptions so that all prescribed treatments are carried out in time.

b. Maintain the client's dignity and self-esteem, and make the client as comfortable as possible

2. The nurse is caring for a client at the end of life. Which gastrointestinal findings indicate that death is approaching? Select all that apply. a. Nausea b. Incontinence c. Profuse diarrhea d. Accumulation of gas e. Abdominal distention

a. nausea b. incontinence d.Accumulation of gas e.Abdominal distention

18. A client's spouse becomes distraught when thinking about his wife's terminal prognosis. Which action should the nurse implement to promote hope for the spouse? a. Promote acceptance that their loss is real b. Encourage formation of achievable goals c. Encourage establishing new relationships d. Instruct the spouse to express positive goals

b. Encourage formation of achievable goals

11. The nurse is caring for a client at the end of life. Which late cardiovascular and respiratory findings should the nurse expect to note while collecting data? Select all that apply. a. Friction rub b. Irregular heart rate c. Deceased pulse rate d. Decreased blood pressure e. Irregular breathing patterns

b. Irregular heart rate c. Deceased pulse rate d. Decreased blood pressure e. Irregular breathing patterns

17. The nurse is participating in a care plan session for a client with a terminal illness. Which nursing actions should be included? Select all that apply. a. Follow standard care plans for end-of-life care b. Respond to requests from client and family promptly c. Support the client's decision-making in order to promote client control d. Discuss sensitive topics quickly and efficiently to avoid upsetting the client and family e. Provide information about what to expect during the dying process to the client and family

b. Respond to requests from client and family promptly c. Support the client's decision-making in order to promote client control e. Provide information about what to expect during the dying process to the client and family

5. The nurse is preparing to care for a dying client and several family members are at the client's bedside. Which therapeutic techniques should the nurse use when communicating with the family? Select all that apply. a. Discourage reminiscing b. Make the decisions for the family. c. Encourage expression of feelings, concerns, and fear d. Explain everything that is happening to all family members e. Extend touch, and hold client or family member's hand if appropriate f. Be honest and truthful, and let the client and family know that you will not abandon them.

c. encourage expression of feelings, concerns, and fear e. extend touch, and hold client or family member's hand if appropriate f. be honest and truthful, and let the client and family know that you will not abandon them

7. A client and her husband are being discharged from the hospital after delivering a stillborn infant. They ask about the possibility of attending a bereavement support group in the community. The nurse realizes this action corresponds to which aspect of grieving? a. Anger b. Denial c. Normal grieving d. Prolonged sadness

c. normal grieving

16. A 39-year-old man learned today that his 36-year-old wife has an incurable cancer and is expected to live not more than a few weeks. The nurse identifies which responses by the husband as indicative of effective individual coping? Select all that apply. a. He states that he will not allow his wife to come home to die b. He refuses to visit his wife in the hospital or discuss her illness c. He immediately arranges for their three teenage children to live with relatives in another state. d. He expresses his anger at God and the PHCP for allowing this to happen e. He tells the nurse he has prayed that God will allow his wife to live long enough to watch their children's HS graduation f. He has asked his wife and children to assist him in making funeral arrangements, such as casket selection and cemetery burial sites.

d. He expresses his anger at God and the PHCP for allowing this to happen e. He tells the nurse he has prayed that God will allow his wife to live long enough to watch their children's HS graduation f. He has asked his wife and children to assist him in making funeral arrangements, such as casket selection and cemetery burial sites.

3. A client has died, and the nurse asks a family member about the funeral arrangements. The family member refuses to discuss the issue. Which is the appropriate nursing action? a. Show acceptance of feelings b. Provide information needed for decision making c. Suggest a referral to a mental health professional d. Remain with the family member without discussing funeral arrangements

d. remain with he family member without discussing funeral arrangements.