test 10

A client has an intravenous (IV) solution of 5% dextrose in water (D 5W) 250 mL to which 100 mg of morphine is added. The health care provider prescribes 14 mg of morphine per hour for end-of-life palliative treatment of a client. At how many milliliters per hour will the nurse set the IV pump? Record your answer using a whole number.

35 ml/hr

Which client's statement confirms they reached the integrity versus despair stage according to Erikson's theory of psychosocial development? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected A. "Looking back at my entire life, I find that I have actually achieved nothing." B. "I was in love, but my partner ditched me for someone who is good-looking." C. "In the twilight of my life, I regret not fulfilling the promises I made to my wife." D. "Could you prescribe some good medications that can help me get back to work as soon as possible, because I need money to support my family?" E. "Now that I am at the end of the road, I think I am the luckiest person on earth because God has given me everything that I asked for."

A. "Looking back at my entire life, I find that I have actually achieved nothing." C. "In the twilight of my life, I regret not fulfilling the promises I made to my wife." E. "Now that I am at the end of the road, I think I am the luckiest person on earth because God has given me everything that I asked for."

The student nurse is describing palliative care to a client's family. Which statement made by the student nurse indicates a need for correction by the registered nurse (RN)? A. "Palliative care is the same as hospice care." B. "Palliative care focuses on the care of the client." C. "Palliative care includes symptom management in the client." D. "Palliative care is an interprofessional approach to the delivery of care."

A. "Palliative care is the same as hospice care."

Which information would the nurse provide about respite care services? Select all that apply. One, some, or all responses may be correct. A. "Services are offered at home, in a day care setting, or in a health care institution that provides overnight care." B. "They include services such as laundry, assistance with meals and personal care, 24-hour oversight, and housekeeping." C. "A group of residents live together, but each resident has their own room and shares dining and social activity areas." D. "Medicare health care plans do not cover this service, and Medicaid has strict requirements for services and eligibility." E. "It is a service that provides short-term relief or 'time off' for people, providing home care to an ill, disabled, or frail older adult."

A. "Services are offered at home, in a day care setting, or in a health care institution that provides overnight care." D. "Medicare health care plans do not cover this service, and Medicaid has strict requirements for services and eligibility." E. "It is a service that provides short-term relief or 'time off' for people, providing home care to an ill, disabled, or frail older adult."

Which nursing assessment questions assess the faith, belief, fellowship, and community aspect of a client's spirituality? Select all that apply. One, some, or all responses may be correct. A. "What gives meaning to your life?" B. "What is your source of power, hope, and belief during difficult times?" C. "In what way do your beliefs help or strengthen you for coping with illness?" D. "How has the illness affected your capability to express what is essential in life?" E. "How do you feel the changes caused by the illness are affecting or will affect your life?"

A. "What gives meaning to your life?" B. "What is your source of power, hope, and belief during difficult times?" C. "In what way do your beliefs help or strengthen you for coping with illness?"

The registered nurse (RN) is assigning tasks to the health care team to provide care for a group of clients in hospice care. In assisting the health care team in attaining an effective outcome in hospice care, which action should the RN take? A. Assist the health care team in planning. B. Assist the health care team in interpreting. C. Assist the health care team in enhancing ability. D. Assist the health care team in achieving optimal functioning.

A. Assist the health care team in planning.

A client who had been receiving palliative care for cancer has deteriorated and now needs end-of-life care. The nurse identifies that which type of care will now be removed from the treatment plan? Select all that apply. One, some, or all responses may be correct. A. Chemotherapy B. Repositioning C. Regular oral care D. Blood transfusion E. Radiation therapy

A. Chemotherapy D. Blood transfusion E. Radiation therapy

Which problems would the nurse plan to address when dealing with ethical issues specifically related to end-of-life care? Select all that apply. One, some, or all responses may be correct. A. Clients may be unable to communicate effectively. B. All interventions for helping the clients seem futile. C. Clients are often unfamiliar with the concept of autonomy. D. Multiple medications affect the cognitive ability of the clients. E. Predictions regarding health outcomes are not always accurate.

A. Clients may be unable to communicate effectively. B. All interventions for helping the clients seem futile. E. Predictions regarding health outcomes are not always accurate.

An older adult says, "I regret so many of the choices I've made during my life." Which developmental conflict has the client failed to accomplish according to Erikson's psychosocial stages of development? A. Ego integrity versus despair B. Identity versus role confusion C. Generativity versus stagnation D. Autonomy versus shame and doubt

A. Ego integrity versus despair

Which nursing intervention is an example of the nurse as a caregiver? Select all that apply. One, some, or all responses may be correct. A. Encouraging the client to exercise daily B. Setting goals for the client to reduce weight C. Arranging for the client to meet a spiritual advisor D. Evaluating the client's understanding of prescribed diet E. Demonstrating the procedure to self-administer insulin injection

A. Encouraging the client to exercise daily B. Setting goals for the client to reduce weight C. Arranging for the client to meet a spiritual advisor

A client with advanced bone cancer is experiencing cachexia. The nurse reviews the nutritional components of palliative care with the client's family members. The nurse recognizes that the teaching is designed to achieve which outcome? A. Enhance the quality of the client's life B. Reduce the likelihood of a respiratory infection C. Prevent malabsorption syndrome D. Cure the cachexia that results from bone cancer and chemotherapy

A. Enhance the quality of the client's life

Which action would the nurse take initially to advocate for the client and achieve resolution when caring for a client with terminal cancer who desires to receive hospice care at home rather than pursue further treatment against the advice of both the health care provider and the immediate family? A. Help the client clarify their values prioritize actions. B. Brainstorm possible alternative solutions for this issue. C. Empower the client to decide to resolve the situation. D. Provide support and reassurance as the client makes decisions.

A. Help the client clarify their values prioritize actions.

A client suffering from cancer is near the end of life. Which action(s) would be performed by the nurse to support the client's family members? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected A. Helping the family set up hospice B. Taking time to make sure that the family understands care options C. Staying with the client in the absence of family members D. Giving the family information about the dying process E. Making sure that the family knows what to do at the time of death

A. Helping the family set up hospice B. Taking time to make sure that the family understands care options C. Staying with the client in the absence of family members D. Giving the family information about the dying process E. Making sure that the family knows what to do at the time of death

Which health care system focuses on palliative care? A. Hospice B. Rehabilitation C. Assisted living D. Extended care facilities

A. Hospice

Which member of the interprofessional team in a palliative care setting serves as the client advocate, evaluating the physical, emotional, and spiritual needs of the client? A. Nurse B. Pharmacist C. Music therapist D. Primary health care provider

A. Nurse

Which nursing action establishes the nurse as a caregiver for a client in spiritual distress? A. Provides therapeutic treatment to the client B. Teaches the client about signs of spiritual distress C. Communicates the wishes of the client to family members D. Collaborates with the agency chaplain to pursue the best treatment plan

A. Provides therapeutic treatment to the client

The nurse manager appointed a registered nurse (RN) to provide hospice care for a client and explained the tasks to be performed. Which tasks has the nurse manager delegated to the RN? Select all that apply. One, some, or all answers may be correct. Some correct answers were not selected A. Providing total client care B. Performing all the hygiene tasks C. Teaching the client and family members D. Teaching the client about personal hygiene E. Assisting the client in performing daily activities

A. Providing total client care C. Teaching the client and family members D. Teaching the client about personal hygiene

The nurse is working in a palliative care setting. Which members of the health care team would the nurse identify as providing ancillary services to clients? Select all that apply. One, some, or all responses may be correct. A. Some correct answers were not selected Pharmacists B. Spiritual advisors C. Occupational therapists D. Primary health care providers E. Unlicensed assistive personnel (UAP)

A. Some correct answers were not selected Pharmacists C. Occupational therapists E. Unlicensed assistive personnel (UAP)

The nurse is caring for clients who are in the terminal stage of illness. The nurse begins feeling depressed when coming to work. Which would the nurse do? A. Talk with other nurses on the unit. B. Take several personal days off from work. C. Limit emotional involvement with the clients. D. Request a transfer to another area of the hospital.

A. Talk with other nurses on the unit.

Which focus would the nurse associate with hospice care? A. To ease the pain from illness B. To provide curative treatment C. To assist with activities of daily living D. To adapt to the limitations due to an illness

A. To ease the pain from illness

After reviewing a client's reports, the primary health care provider suggests palliative care for the client. Which conditions would qualify the client for this type of care? Select all that apply. One, some, or all responses may be correct. A. Some correct answers were not selected Peptic ulcer disease B. Chronic renal failure C. Appendicitis D. Congestive heart failure E. Chronic obstructive lung disease

B. Chronic renal failure D. Congestive heart failure E. Chronic obstructive lung disease

Which action would the nurse take postoperatively when providing care for a client who has a permanent biliary drainage tube (T-tube) inserted to provide palliative care? A. Maintain intermittent low suction to limit trauma. B. Cleanse the area around the insertion site to prevent skin breakdown. C. Attach the tube to a negative-pressure drainage system to promote drainage. D. Reposition the client frequently to increase the flow of bile through the tube.

B. Cleanse the area around the insertion site to prevent skin breakdown.

A client who recently was told by her primary health care provider that she has extensive terminal metastatic carcinoma of the breast tells the nurse that she believes an error has been made. She states that she does not have breast cancer, and she is not going to die. Which stage of death and dying is the client experiencing? A. Anger B. Denial C. Bargaining D. Acceptance

B. Denial

Which interventions would the nurse implement for a dying client and the family? Select all that apply. One, some, or all responses may be correct. A. Arrange for restorative care. B. Help the family set up home care if required. C. Refrain from telling the family that the client is dying. D. Determine the client and family's strengths and weaknesses. E. Arrange for church or community support for the family.

B. Help the family set up home care if required. D. Determine the client and family's strengths and weaknesses. E. Arrange for church or community support for the family.

An older client states, "I've lived a good life. I don't want to die, but I accept it as a part of life." Which developmental task has the client achieved according to Erikson's psychosocial stages of development? A. Identity B. Integrity C. Despair D. Generativity

B. Integrity

Which action is appropriate for the registered nurse regarding assisted suicide? A. Nurses may have an open attitude toward the client's end of life. B. Nurses' participation in assisted suicide violates the code of ethics. C. Nurses may listen to the client's expressions of fear and attempt to control the client's pain. D. Nurses can participate in assisted suicide only if the individual could make an oral and written request.

B. Nurses' participation in assisted suicide violates the code of ethics.

The nurse reviews the medical record of a client who is eligible to receive hospice care. Which are the criteria for a client to receive this type of care? Select all that apply. One, some, or all responses may be correct. A. When the death of the client is imminent B. When the expected death of the client is within 6 months C. When the client seeks no aggressive disease management D. When a family member has signed an informed consent form E. When the client has been issued a "do not resuscitate" order

B. When the expected death of the client is within 6 months C. When the client seeks no aggressive disease management E. When the client has been issued a "do not resuscitate" order

A client with chronic renal failure stops responding to the treatment. On examination, the primary health care provider determines that the client is terminally ill. Which is the correct nursing intervention in this situation? A. Provide information to the family members about getting a second opinion. B. Suggest that the family members continue to try different treatments. C. Encourage the family members to provide palliative care to the client. D. Inform the family members that the disease is no longer curable and the client will die shortly.

C. Encourage the family members to provide palliative care to the client.

The nurse is educating the caregivers of an elderly adult with advanced Parkinson disease about continuing care. Which information would the nurse provide? Select all that apply. One, some, or all responses may be correct. A. "Home care is a type of continuing care in which the primary objectives are health promotion and education." B. "Continuing care is necessary for clients who are recovering from an acute or chronic illness or disability." C. "Adult day care centers are ideal for clients whose caregivers have to be away from home during the day." D. "Hospice care is a continuing care system that allows terminal clients to live at home with comfort, independence, and dignity." E. "Nursing centers provide 24-hour custodial care to help residents achieve and maintain their highest level of functioning."

C. "Adult day care centers are ideal for clients whose caregivers have to be away from home during the day." D. "Hospice care is a continuing care system that allows terminal clients to live at home with comfort, independence, and dignity." E. "Nursing centers provide 24-hour custodial care to help residents achieve and maintain their highest level of functioning."

During an assessment, which client statement may indicate to the nurse that the client is experiencing spiritual distress? A. "I want to find out whether any divine force truly exists in this world." B. "I am sure that God is with me; otherwise I could have suffered a lot more." C. "I deserve a better life than this. I don't understand why God decided to make me ill." D. "I wish I didn't need help with daily activities, but I am grateful the universe gave me a strong support system."

C. "I deserve a better life than this. I don't understand why God decided to make me ill."

Which statements made by a terminally ill client address primary goals regarding end-of-life (EOL) nursing care? Select all that apply. One, some, or all responses may be correct. A. "I want my children and my grandchildren to carry my casket." B. "I've prepaid all my funeral costs so there's no burden on my family." C. "My living will states that I want no heroic measures to prolong life." D. "Pain is a concern, so I've discussed that thoroughly with my doctor." E. "I've made arrangements to spend my final days in my own home."

C. "My living will states that I want no heroic measures to prolong life." D. "Pain is a concern, so I've discussed that thoroughly with my doctor." E. "I've made arrangements to spend my final days in my own home."

When assessing a client who is receiving palliative care, which question regarding spiritual health is correct? A. "Are you afraid of death?" B. "After hearing about your condition, didn't you lose faith?" C. "What is your source of spiritual strength during hard times?" D. "May I ask the chaplain to visit you to help you cope? "

C. "What is your source of spiritual strength during hard times?"

A client decides to have hospice care rather than an extensive surgical procedure. Which ethical principle does the client's behavior illustrate? A. Justice B. Veracity C. Autonomy D. Beneficence

C. Autonomy

The nurse is caring for a client who has developed dysphagia and is unable to swallow. The client is receiving around-the-clock opioid pain medications for cancer pain, and hospice has recently begun to care for the client. Which is the best nursing intervention in preparing for the client's discharge? A. Contact the client's health care provider to ask to substitute a liquid form of medications for the pill form. B. Teach the client and family members to crush the pills and administer them with applesauce. C. Contact the client's health care provider to discuss use of transdermal medications for pain control. D. Teach the client and family members about addiction that may occur as a result of regular opioid use.

C. Contact the client's health care provider to discuss use of transdermal medications for pain control.

Which information will the nurse provide to a client in a hospice home care program who is prescribed morphine? A. Medication addiction is a concern with this medication. B. Request the medication before the pain becomes severe. C. Dosages of the medication will be given automatically at regular intervals around the clock. D. Intermittent administration of the medication is possible after an intermittent lock is inserted.

C. Dosages of the medication will be given automatically at regular intervals around the clock.

The nurse is assisting with the end-of-life care of a client. Which activity is performed when the nurse views family as context? A. Assess the resources available to the family. B. Meet the client's family's comfort and nutritional needs. C. Meet the client's comfort, hygiene, and nutritional needs. D. Determine the family's need for rest and their stage of coping.

C. Meet the client's comfort, hygiene, and nutritional needs.

Which interventions would the nurse perform while caring for an actively dying client? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected A. Admit the client in hospice care. B. Perform aggressive laboratory tests. C. Provide client and family reassurance. D. Keep the client undisturbed for long periods of time. E. Offer symptom management to the client.

C. Provide client and family reassurance. E. Offer symptom management to the client.

A client on hospice care is receiving palliative treatment. Which is the goal of palliative care for this client? A. Restore the client's health. B. Promote the client's recovery. C. Relieve the client's discomfort. D. Support the client's significant others.

C. Relieve the client's discomfort.

The primary health care provider instructs the nurse to manage fluid replacement therapy in a client with cancer. Which type of care is the client receiving? A. Palliative care B. Comfort care C. Supportive care D. End-of-life care

C. Supportive care

Which information regarding palliative care as opposed to hospice care would the nurse provide during a home visit to a client with heart failure who asks about this option? A. To receive palliative care, a provider must certify that you have 6 months or less to live. B. The goal of palliative care is to humanize the end-of-life experience, allowing you to die with dignity. C. The focus of palliative care is to enhance you and your family's quality of life despite your heart failure. D. By making the choice to begin palliative care, you must no longer pursue lifeextending or curative medical treatment.

C. The focus of palliative care is to enhance you and your family's quality of life despite your heart failure.

An older client is able to perform activities of daily living, but has vague physical complaints and has experienced multiple deaths of friends and family and has lost their social roles. Which question is the most therapeutic? A. "Can you cope with being alone?" B. "Have you considered assisted living?" C. "What is the main problem today?" D. "How do you feel about your life now?"

D. "How do you feel about your life now?"

Which parent is expressing anticipatory grief? A. "My daughter died 4 years ago and I'm still crying and walking around like I'm in a dream." B. "My 4-year-old was diagnosed with diabetes mellitus, but I'm sure she'll outgrow it." C. "My son's treatments are painful. I'm so angry. Most days I just want to take him and run away." D. "My son was diagnosed with terminal cancer 2 months ago and they can't stop my son from dying."

D. "My son was diagnosed with terminal cancer 2 months ago and they can't stop my son from dying."

Which factor is most important in predicting a person's reaction to imminent loss and grief? A. Family interactions B. Social support system C. Emotional relationships D. Earlier experiences with grief

D. Earlier experiences with grief

Which intervention would the nurse use during the initial interaction with a 76-year-old widower who is terminally ill, very quiet, and unwilling to have visitors? A. Assess what the client knows about grief and loss related to the death and the dying process. B. Avoid talking about his health condition and isolation unless he initiates the discussion. C. Encourage him to accept phone calls from those who are concerned and wish to visit with him. D. Explore what he understands about his situation and what the implications mean to him.

D. Explore what he understands about his situation and what the implications mean to him.

Which intervention would the nurse include as a priority action when preparing to provide grief counseling to a client? A. Provide essential information honestly B. Inquire about the client's spiritual beliefs C. Know the reason why the loss happened in his or her family D. Provide an environment for the client to express their feelings

D. Provide an environment for the client to express their feelings

Which nursing intervention would be the priority for a client in hospice care with symptoms of dyspnea? A. Administer benzodiazepines B. Apply wet cloths on the client's face C. Encourage imagery and deep breathing D. Provide prescribed oxygen by nasal cannula

D. Provide prescribed oxygen by nasal cannula

When working with palliative care clients, which objective data is most helpful to monitor in the debilitated client with terminal liver cancer? A. Description of the client's pain B. Assessment of hunger C. Inspection of bowel patterns D. Record of daily weights

D. Record of daily weights

Which situation accurately describes hospice care? A. A resident's temporary or permanent home, where the surroundings have been made as homelike as possible B. Offers an attractive long-term care setting with an environment akin to the client's home, which offers the client greater autonomy C. Service that provides short-term relief for people providing home care to an ill, disabled, or frail older adult D. System of family-centered care that allows clients to remain at home in comfort while easing the pains of terminal illness

D. System of family-centered care that allows clients to remain at home in comfort while easing the pains of terminal illness

Based on the client's report about losing a life partner, which factors are most likely to contribute to a client's dysfunctional grieving? Select all that apply. One, some, or all responses may be correct. a) dependence on the decreased; made most of the big decision b) an unexpected or violent death; died in an automobile accident c) interference with function; kept me from moving on with my life d) relationship that has existed for a long time; began 10 years ago e) existence of unresolved conflict; had problems but i tried to forgive.

a) dependence on the decreased; made most of the big decision b) an unexpected or violent death; died in an automobile accident c) interference with function; kept me from moving on with my life e) existence of unresolved conflict; had problems but i tried to forgive.

Place the five stages of grieving identified and described by Elisabeth Kübler-Ross in order of progression from first to last. Denial 1. Bargaining 2. Depression 3. Anger 4. Acceptance 5.

denial, angry, bargaining, depression, acceptance