Grief, Loss review

A nurse is reinforcing teaching with a group of clients about common findings that can indicate cancer, the nurse should instruct the client to monitor for which of the following findings? SATA (C.A.U.T.I.O.N)

-Change in bowel or bladder habits -A sore that does not heal -Unusual bleeding or discharge -Thickening or lump in the breast or elsewhere -Indigestion or difficulty swallowing -Obvious change in a wart or mole -Nagging cough or hoarseness

You are the nurse providing post-mortem care, which of the following interventions should the nurse include? SATA

-Determine whether family will have autopsy -Cover body with clean sheets and place arms outside sheets -Give client's personal belongings to the family

A nurse is providing a post-mortem care for a client, identify the sequence of post- mortem care: SEQUENCE

-Make sure the provider certifies patient's death -Verify organ donation status -Remove medical equipment from pt -Cleanse body with body fluid precautions -Attach identification tags to the body

A patient being care for in the hospital had an opportunity to formulate a living will and durable power of attorney for health care, these are examples of what type of document?

Advance directives

A nurse enters a client's room and finds the client pulseless, the nurse knows the client's family has requested DNR status form provider but the provider has not written the order, what is the first thing to do?

Call emergency response team

A hospice nurse is caring for a client who is approaching death and has fecal incontinence which of the following actions should he nurse take?

Change incontinence brief

When a nurse informs a patient's spouse that the patient died the spouse states "you must be mistaken," what type of grieving process is this?

Denial

A client is receiving chemotherapy for malignant lymphoma, how do chemotherapeutic agent works?

Interferes with the cells ability to replicate

A 33 year-old patient has recently been diagnosed with stage 3 cervical cancer, what does the nurse understand about the patient's cancer?

It has extensive local and regional spread

A nurse is collecting data from a client whose child was killed 2 years ago, which of the following actions indicates that the client is experiencing maladaptive grieving?

Leaving the child's room exactly as it was before

A nurse is caring for an older adult client who expresses feelings of grief in his earlier life, which of the following actions should then ruse take to help the client with his feelings?

Listen attentively when the client talks about the past

Lost is a natural part of life, what is the lost that is left when one leaves home for college?

Maturational loss

A nurse is contributing to a plan of care for an older adult client who has a WBC of 2,000 (elevated) after 3 rounds of chemotherapy, which of the following interventions should the nurse incorporate in the plan of care?

Serve cooked fruits with meals

A nurse is reinforcing teaching for a client who is to begin external radiation for lower leg tumor. The nurse instructs the client to monitor for which of the following adverse effects?

Shedding of skin

A nurse is caring for a client following a recent sudden death of his partner, the client says I feel paralyzed and I cannot seem to cope with work or family responsibility anymore? What type of loss is that?

Situational loss

Which of the following loss best describes a client who has life event in which is a loss of employment had occurred?

Situational loss

After teaching a client about advance directives, a nurse assesses the clients understanding, which statement indicates that the client correctly understands teaching?

Specifies what they want done when they can't make decisions anymore

Which of the 5 aspects of human functions must a nurse address when dealing with grieving person? SATA

-physical -emotional -spiritual -intellectual

A young man is undergoing a bone marrow transplant as a treatment for leukemia. His brother has been identified as a bone marrow donor, what kind of transplant is this?

Allogeneic transplant

A 42 year-old patient has palpated a small lump on her left breast during her monthly breast examination she has scheduled an appointment with her healthcare provider, which type of diagnostic test would the provider recommend?

Biopsy

A nurse is evaluating an older adult client who is receiving an end of life care and has Cheynes-stokes respiration, which of the following type of respirations indicate this respiration?

Breathing shallow with periods of dyspnea

A nurse is collecting data from a middle age client whose partner died 7 months ago which of the following finding indicate that the client is experience maladaptive grieving?

Client unable to return to work

A nurse in a dialysis center is caring for a client who has a new diagnosis of end stage renal disease at the first dialysis treatment client tells the nurse I decided to come today but I am not willing and liking to have this done, what kind of grieving is that?

Denial

A nurse is caring for a client several days following acute radiation exposure at a client workplace, which of the following findings should the nurse identify as an indication of bone marrow suppression?

Fever

A client with leukemia receives a course of chemotherapy the nurse read the lab results and notes that the client neutrophils count is 600 normal is between 3000-7000. Which home care would the nurse suggest to not bring to her room?

Fresh cut flowers

A nurse is assisting with the plan of care of a patient who is neutropenic as a result of radiation, which of the following is the most important intervention?

Hand hygiene

An older adult is about to have an elective procedure and inform the nurse that she wants a DNR, which of the following responses should the nurse make?

Inform the doctor that you wish to have DNR status

A client has been receiving external radiation and chemo for oropharyngeal carcinoma his mucosa has ulceration and stomatitis. Which intervention is appropriate for the pt?

Instruct the client to use a soft toothbrush with saline

A nurse is contributing to the plan of care of a patient who has bone marrow suppression. Due to chemotherapy treatment, which of the following intervention should the nurse include in the plan of care?

Monitor oral mucosa daily

A patient had a biopsy of a lump in her R breast that reveal a benign tumor, what do you know about benign tumor?

Not recurrence and not progressive

What is the termination of tube feeding to a dying patient considered?

Passive euthanasia (passive care)

A client is hospitalized for the insertion of an internal cervical radiation implant, after the procedure the nurse sees the radiation implant on the bed, what is the first action for nurse to do immediately?

Pick up with long handled forceps and put in metal container

A 58-year old patient who had colon cancer is receiving chemo and combined radiation therapy and developed diarrhea , the patient asked then nurse why is he having diarrhea. What nursing statement would be your response?

Radiation is very irritating to the lining of your GI track, which has caused diarrhea

A nurse is caring for a client receiving chemotherapy, on review of the morning lab result the nurse reads that the WBC is extremely low, what are the things that you need to remove from the patients environment?

Remove fresh orange from client's breakfast tray

A nurse is assisting with developing of plan of care with a client who is experiencing hematologic toxicity as a result of chemo, which following actions should the nurse instruct the patient?

Restricting fresh fruits and vegetables in diet

A nurse is caring or a client who had just been diagnosed with angina pectoris, the client tells the nurse that he is afraid of dying from a heart attack, which of the following is an appropriate nursing intervention?

Tell me more about your feelings

How do you handle a chemotherapy tablet?

Use gloves

A nurse is contributing to the development of a pamphlet for breast cancer awareness, which of the following information provided by the nurse needs to be corrected?

Use the palm of your hands to feel for lumps w/ patting motion

A nurse is receiving a laboratory data of a client who has an acute leukemia and received aggressive chemotherapy treatment 10 days ago, which of the following abnormalities should the nurse expect?

WBC, RBC and platelets decrease

As the nurse admits a patient in an end stage kidney disease to the hospital, the patient tells the nurse if my heart or breathing stops I do not want to be resuscitated, what is the best action for the nurse?

ask the pt if they discussed this with their MD

According to Kubler-Ross, the stages of grief during which the person wishes for more time to avoid the loss and may express feelings that the loss is occurring as a punishment for past actions is called?

bargaining

A patient is admitted to a unit for an autologous bone marrow transplant, where is the bone marrow coming from?

comes from the patient itself

A client hospitalized for chemotherapy has a hemoglobin of 6.1 mg/dL what medication would the nurse prepare to administer?

epoetin alfa (epogen)

A client received an internal radiation therapy, which of the following people may be permitted to visit?

friend with history of glaucoma

After death the body must be prepared to be transferred to morgue or funeral home the person responsible for care and preparation of the body at the funeral home is?

mortician

A nurse assist with developing plan of care of a client who will be hospitalized for insertion internal radiation implant. What precaution should be put in place?

place a radiation sign on the door of clients room

A patient age 39 has been receiving chemotherapy for treatment of her breast cancer, she has WBC of 1600 a person has leukopenia has a special need, for which nursing intervention would you put in place?

protection against infection

A patient age 62 has been receiving external radiation and chemotherapy for oropharyngeal carcinoma and his oral mucosa diluted and edematous it has ulceration over his bucks and tongue, how do you feed the patient?

provide small frequent feedings

The physical needs of the dying patient should be at utmost importance to the nurse giving care, which patient description should require intervention?

pt is soiled and needs clothing change

A nurse is assisting with teaching a community group about the early detection of colon rectal cancer. Which of the following screenings should the nurse recommend to adults who are 50 yrs old?

sigmoidoscopy

You are the nurse caring for a client who is about to go under exploratory surgery to destroy the tumor and search for metastasis, the client states that she is not hopeful, what is the best nursing intervention?

sit quietly with the client and follow her cues