Chapter 16 end of life care

A patient's family member asks the nurse what the purpose of hospice is. What is the best response by the nurse? "It will hasten the death of the patient." "It will prolong life in a dignified manner." "It will use artificial means of life support if the patient requests it." "It will enable the patient to remain home if that is what is desired."

"It will enable the patient to remain home if that is what is desired."

The nurse is providing home care to a dying client and has noticed over the course of several weeks that the client's daughter is usually quiet and withdrawn when in the client's room. Which intervention should the nurse perform in this situation? Sit with the client's daughter privately and encourage her to express her feelings frankly. Remind the daughter of the client's impending death and the importance of expressing herself. Remain focused on the client's needs and care because these are your main responsibilities. Insist that the daughter try her best to make the client's final days happy ones.

Sit with the client's daughter privately and encourage her to express her feelings frankly.

Based on the most common concern of a dying patient, the hospice nurse should: Administer pain medication on a schedule that prevents pain from intensifying. Position the patient to prevent difficulties with breathing. Offer supplemental fluids to prevent dehydration. Turn the patient every 2 hours to prevent decubitus ulcers.

Administer pain medication on a schedule that prevents pain from intensifying.

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

Allows for the nurse to facilitate the grieving process

Which of the following may be contained in an "emergency kit" for a hospice patient exhibiting restlessness? Benzodiazepine Oral sucrose Laxative Atropine sulfate drops

Benzodiazepine

Glaser and Strauss (1965) identified four "awareness contexts." Which awareness context occurs when the client is unaware of their terminal state, whereas others are aware? Suspected awareness Open awareness Closed awareness Mutual pretense awareness

Closed awareness

A nurse is providing hospice care in Portland, Oregon to a client with terminal liver cancer. The client confides to the nurse, "I'm in agony all the time. I want this to be over now—please help me." Which interventions should the nurse implement? Select all that apply. Control the client's pain with prescribed medication. Advise the client's health care provider of the client's condition. Comfort the client by saying it will all be over soon. Encourage the client to explain his or her wishes. Recommend that the client consider physician-assisted suicide.

Control the client's pain with prescribed medication. Advise the client's health care provider of the client's condition. Encourage the client to explain his or her wishes.

Which is the initial stage of grief, according to Kübler-Ross? Anger Bargaining Denial Depression

Denial

The family members of a dying patient are finding it difficult to verbalize feelings and show tenderness for the dying person. Which of the following nursing interventions should a nurse perform in such situations? Encourage the family members to express their feelings and listen to them in their frank communication. Encourage conversations on the impending death of the patient. Be a silent observer and allow the patient to communicate with the family members. Encourage the patient's family members to spend time with the patient.

Encourage the family members to express their feelings and listen to them in their frank communication.

Which is a sign of approaching death? Increase in urinary output Clear sensorium Insomnia Irregular breathing patterns

Irregular breathing patterns

The nurse practitioner has four patients with chronic illness that require consistent medical and nursing management. Select the condition that is the best example of a "chronically critical and progressively ill" condition. Type 2 diabetes mellitus Carcinoma-in-situ Coronary artery disease End-stage renal disease

End-stage renal disease

Which of the following is an appropriate method of assessing the dying client? Stimulate the client every 30 minutes. Focus on the client's basic needs. Repeat assessments as necessary. Sedate the client before completing range-of-motion exercises.

Focus on the client's basic needs.

A nursing instructor is preparing a class discussion about hope and end-of-life care. Which of the following would the instructor include as an example of a hope-fostering activity? Pain Abandonment Isolation Humor

Humor

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. Provides pain relief Includes chemotherapy Integrates spirituality Hastens death Offers a team approach to care Enhances quality of life

Provides pain relief Integrates spirituality Offers a team approach to care Enhances quality of life

When a person authorizes another to make medical decisions on his or her behalf, the person has written which of the following? Treatment directive Living will Standard addendum to a will Proxy directive

Proxy directive

The nurse visits the home of a client with terminal illness. Which assessment findings indicate to the nurse that the client might die within a few months? Select all that apply. Refuses to eat Sleeps most of the day Reports feeling fatigued Onset of generalized weakness Does not want to visit with family members

Refuses to eat Reports feeling fatigued Onset of generalized weakness Does not want to visit with family members

When describing the term "grief" to a group of students, which of the following would the instructor include? A part of the life cycle in the form of change, growth, and transition The response experienced by anyone who has suffered a loss A feeling of connectedness with one's self and others Feelings of apprehension or worry in response to a situation

The response experienced by anyone who has suffered a loss

Despite having been administered prescribed pain medication, a dying client is still experiencing dyspnea due to fear and anxiety. Which nursing intervention should the nurse use to potentiate the effects of pain medication and help reduce the dyspnea? Offer small amounts of nourishment frequently Gently massage the arms and legs Use imagery, humor, and progressive relaxation Encourage the patient to sleep

Use imagery, humor, and progressive relaxation

In spite of administering the prescribed pain medication, a dying client is still experiencing dyspnea due to fear and anxiety. Which nursing intervention should the nurse use to potentiate the effects of pain medication and help reduce the dyspnea? Offer small amounts of nourishment frequently Gently massage the arms and legs Use imagery, humor, and progressive relaxation Encourage the patient to sleep

Use imagery, humor, and progressive relaxation

A nurse is evaluating a client with a terminal illness. What should the nurse report so that the health care team can consider alternative nutritional approaches and fluid administration routes for the client at the end of life? altered gastrointestinal function drop in blood pressure and rapid heart rate weight loss and inadequate food intake irregular eating habits

weight loss and inadequate food intake