PrepU assignment 11 Funds
A nurse is preparing a presentation for a family support group for cancer. The nurse is planning to describe grieving and the various terms associated with this concept. Which term would the nurse use to describe the entire range of responses to the loss of a valued object, person, belief, or relationship?
Grief
A client has been receiving dialysis for years and now states, "I have been thinking about this for a long time. I no longer wish to continue dialysis. I just want to die." The most appropriate statement by the nurse is:
"Can you tell me about why you've made this decision?"
The caregiver of a client who is terminally ill is becoming short tempered with the client and states, "I just can't take this anymore." Which nursing response is most appropriate?
"Have you considered respite care so that you can rest for a few days?"
The nurse is providing care to a group of terminally ill clients. The client who is most likely experiencing the bargaining stage of grief is the one who states:
"I just want to see my son have a family of his own."
The nurse is trying to help the client cope with the dying process. Which nursing statement is most appropriate?
"It must be very difficult for you."
The psychiatrist is evaluating a client who has recently learned she has a terminal illness. Which statement indicates to the psychiatrist that the client is in the Kübler-Ross stage of bargaining?
"Just let me go on vacation with my wife; then I'll be satisfied."
Which phrase can do much to instill hope in the dying client?
"Let me tell you about your illness."
The nurse is caring for a client who has just died after a long diagnosis of dementia. Which nursing assessment is the priority for documentation?
"No breathing and no pulse at 0840."
The nurse is caring for a client who recently found out he has a terminal illness. The nurse notes that the client is hostile and yelling. Which statement by the nurse shows that she has understanding of the Kübler-Ross emotional responses to impending death?
"Sometimes a person returns to a previous stage."
When preparing for palliative care with the dying client, the nurse should provide the family with which explanation?
"The goal of palliative care is to give clients the best quality of life by the aggressive management of symptoms."
Which situation is most likely to warrant an autopsy?
A client's death involves an allegation of a medical error.
The nurse should explain to the client's family member that a comfort-measures-only order is being implemented to obtain which expected outcome?
A comfortable, dignified death for the client
The nurse is providing care to a group of terminally ill clients. The client who is most likely experiencing the anger stage of grief is the one who states
"Why did this have to happen to me?"
When providing end-of-life care for clients, what will the nurse most often need to prioritize?
pain control and emotional support
A nurse is assessing a client's grief response. Which concept would be most important for the nurse to keep in mind during the assessment to determine whether the client's response is normal or altered?
severity of the symptoms and the pattern of change over time
A nurse is caring for a client whose husband died over 4 years ago. The nurse suspects that the client has abnormal grief. Which assessment finding would support this?
talking about her husband as if he were still alive
Following surgery, the surgeon informed the client's spouse that invasive cancer was found during the procedure and the client may only have days to live. The client's spouse has told the physician and the nurse that they do not want the client to know the severity of the diagnosis. How will the nurse respond?
understanding that this directive would violate the client's rights
Which assessment finding would best support a nursing diagnosis of Dysfunctional Grieving?
A man is unable to return to work after his sister's death 18 months ago.
Upon interviewing the client, the nurse finds that the client is providing care for her mother who is terminally ill. The client is depressed and already mourning the loss. Which nursing diagnosis would be most appropriate for the client?
Anticipatory grieving
A man is diagnosed with terminal kidney failure. His wife demonstrates loss and grief behaviors. What type of loss is the wife experiencing?
Anticipatory loss
A terminally ill client reports excruciating pain in the back. Which intervention should the nurse adopt to control pain in the client?
Administer narcotics.
A client states, "My children still need me. Why did I get cancer? I am only 30." This client is exhibiting which stage, according to Kübler-Ross?
Anger
An appropriate nursing diagnosis for the family of a client dying of cancer, whose members have expressed sorrow over the forthcoming loss, would be:
Anticipatory Grieving related to loss of family member, as evidenced by sorrow
The nurse is caring for a client who is dying. She overhears the client saying, "God, if you will only let me live to see my daughter get married, I promise I will start going to church again." The nurse understands that the client is in which stage of grief according to Kübler-Ross?
Bargaining
What is Kübler-Ross's third stage of grief?
Bargaining
According to the Harvard University Medical School committee, what function must be irreversibly lost to define death?
Brain function
A client severely injured in a motor vehicle accident is rushed to the health care facility with severe head injuries and profuse loss of blood. Which sign indicates approaching death?
Client's breathing becomes noisy.
Upon admission, the nurse should give priority to addressing which need of a client who is displaying symptoms of dysfunctional grief?
Coping strategies
A client's son is named to make decisions for his mother in the event she cannot speak for herself. This is an example of a(an) ...
Durable power of attorney
The husband of a client with terminal cancer is afraid of hurting his wife during sexual intercourse. Which action by the nurse is likely to be most helpful in reducing this client's fears?
Encourage discussion between the husband and wife regarding their intimacy needs
A terminally ill client states to the nurse, "My situation is hopeless; I have no control over anything." The nurse implements which interventions to enable hope for the client? Select all that apply.
Encourage the client to discuss his feelings. Sit in a chair next to the client. Hold the client's hand.
When planning care for a 55-year-old male client with newly diagnosed terminal pancreatic cancer, which nursing diagnosis would be most appropriate?
Death anxiety
The nurse is assessing a client who was diagnosed with metastatic prostate cancer. The nurse notes that the client is exhibiting signs of loss, grief, and intense sadness. Based upon this assessment data, the nurse will document that the client is in which stage of death and dying, according to Kübler-Ross?
Depression
A client is being discharged from the hospital with terminal brain cancer and a life expectancy of 1 month. When planning this client's discharge, it is most important for the nurse to include a referral to which agency?
Hospice
The wife of a client who has been diagnosed with a terminal illness asks the nurse about the differences between palliative care and hospice care. Which information would the nurse most likely include in the response?
Hospice care is provided for clients who have 6 months or less to live; palliative care is provided at any time during illness.
A 66 year-old client is dying of cancer on the palliative unit of the local hospital. The client's husband has asked the nurse why his wife has been requiring higher doses of analgesics in recent days and is concerned that her pain may have been inadequately treated in the past. The nurse should understand that the client's increased analgesic needs are likely the result of:
Increasing drug tolerance
The client is a young mother whose spouse died 3 months ago. The client is tearful and unkempt, eats a poor diet, and has lost 50 pounds since the death of the spouse. The client states, "I can't do this anymore." The nursing diagnosis best supported by these data is
Ineffective Coping related to failure of previously used coping mechanisms.
A home hospice client, who has Medicare, is experiencing extreme pain at home and is refusing to receive inpatient care due to concerns over the cost of inpatient care. What teaching will the nurse include in the plan of care?
Inpatient pain management for hospice patients is covered by Medicare.
In the United States, what belief is the hospice movement based on?
Meaningful living during terminal illness is best supported in the home.
The emergency department (ED) nurse accepts an unconscious client brought in by ambulance. The client's family presents a durable power of attorney for health care for the client. Which action should the nurse take?
Obtain contact information for the person designated to make decisions for the client.
A client is diagnosed with a terminal illness. Who is usually responsible for deciding what, when, and how the client should be told?
Physician
The nurse is preparing a care plan for a client with the nursing diagnosis of Dysfunctional Grieving. Which nursing intervention should the nurse include? Select all that apply.
Provide the client with information regarding a grief support group. Encourage the client to have regular check-ups with the health care provider. Refer the client to a grief specialist.
An 84 year-old client with a do-not-resuscitate order has just died on the subacute unit of the hospital. When providing postmortem care, what action should the nurse perform?
Remove tubes, catheters and IV access devices from the body
A dying client is crying. She states, "I can't pray. I can't forgive myself." What would be an appropriate nursing diagnosis based on this data?
Spiritual Distress
An 81 year-old client is exhibiting many of characteristic signs and symptoms of imminent death. What individual should the nurse first inform of the client's change in status?
The client's physician
A 70-year-old woman has just died of pancreatic cancer in the hospital, and the members of her family are now gathering. The woman's daughter has made a comment to the nurse that her mother would be "alive and well if she had gotten some decent care in here." The nurse should recognize that the daughter may be experiencing which stage of grief?
anger
A terminally ill client is being cared for at home and receiving hospice care. The hospice nurse is helping the family cope with the client's deteriorating condition, educating them on the signs of approaching death. Which sign would the nurse include in this education plan?
difficulty swallowing
The nurse is providing care to a group of terminally ill clients. The client who exhibits signs of impending death is the client who has:
distended abdomen, Cheyne-Stokes respirations.
The family of a client with a severe traumatic brain injury is considering the withdrawal of his mechanical ventilation. What is the nurse's primary role in the preparation for terminal weaning?
educating the family on what to reasonably expect after ventilation is discontinued
As his condition has deteriorated, an elderly client has required increasing time and assistance for each meal. The client's family members have organized a rotating schedule to assist the client with each of the three meals of the day. How should the nurse best understand this family's actions?
The nurse should encourage family members' participation in care, provided it is within each member's comfort level
The hospice nurse is assessing the wife of a client who died 14 months ago. The nurse is concerned that the wife is still grieving the death of her husband. Which objective assessment finding would suggest that the wife is not still grieving?
The wife's hair is clean and styled.
Which manifestation of grief by the client who lost his wife 3 years earlier is considered abnormal?
leaving the wife's room and belongings intact
A terminally ill client states, "I am ready to die". What stage of grief does the nurse suspect?
acceptance
A nurse is conducting a program for a local community support group about grieving. The nurse would describe grief as fulfilling which function? Select all that apply.
allowing the outer reality of loss to become internally accepted altering the emotional attachment to that which was lost