adn 420 grief, death, & dying

Which of the following nursing interventions is appropriate with regard to pain control in the dying client? a. Explain that narcotics can cause addiction. b. Explain that oxygen will eventually be used. c. Give pain medications on a routine schedule. d. Explain that morphine will be avoided because of its sedative effects.

c. Give pain medications on a routine schedule.

Which are considered physiological signs the nurse expects to observe in a grieving individual? Select all that apply. a. hypersomnia b. weight gain c. indigestion d. palpitations e. lack of energy

c. indigestion d. palpitations e. lack of energy

A 14-year-old client has died from drowning. The client's parents have decided to donate the child's organs and ask the nurse, "What will our child look like after organs are taken out?" What is the best way for the nurse to respond? a. Explain that there will be no visible signs of organ donation. b. State that it is recommended that family members do not see their loved ones after organ removal. c. Provide photos of how clients appear after organs are harvested. d. Ask someone from the organ donation team to speak with the parents.

a. Explain that there will be no visible signs of organ donation.

A nurse is assessing several clients who have expereinced loss. Which client would the nurse most likely identify as experiencing complicated grieving? Select all that apply. a. The spouse of a person who died 7 years ago and visits the grave several times a day. b. The grandchild of a soldier killed in war who visits the grave once a year on Memorial Day. c. A driver whose spouse and children all died as a result of his driving drunk. d. An adult who insisted for many years that the adult hated the adult's deceased parent. e. The parent of a child who died after the having left the child in a car on a hot day.

a. The spouse of a person who died 7 years ago and visits the grave several times a day. c. A driver whose spouse and children all died as a result of his driving drunk. d. An adult who insisted for many years that the adult hated the adult's deceased parent. e. The parent of a child who died after the having left the child in a car on a hot day

The nurse is caring for a client whose death is imminent and who is therefore receiving hospice care. In preparing the family members for the death of their loved one, the nurse assists the family with which areas, regardless of the family's cultural preferences? Select all that apply. a. Dealing with the shock of losing a loved one b. Burial plans after death has occurred c. Efforts to stay connected to the client after death d. Use of support from family and friends e. Anger at the loss of a loved one

a. Dealing with the shock of losing a loved one c. Efforts to stay connected to the client after death e. Anger at the loss of a loved one

During unplanned, spontaneous moments, dying clients usually discuss fears or concerns that nurses should not ignore or rush. What is the nurse's best response in such situations? a. Communicate interest and a willingness to listen by sitting down, leaning forward in the client's direction, and making direct eye contact. b. Call the client's family members and ask them to sit next to the client to listen. c. Change the subject and talk about other things to distract the dying client. d. Offer the client a sedative to help the them rest more easily.

a. Communicate interest and a willingness to listen by sitting down, leaning forward in the client's direction, and making direct eye contact.

The nurse anticipates a dying client to exhibit which signs of impending death? Select all that apply. a. incontinence b. restlessness c. loss of sensation d. flushed extremities d. increased body temperature e. cheyne-stokes respirations

a. incontinence b. restlessness c. loss of sensation e. cheyne-stokes respirations

A young client died following a cardiac arrest. The nurse caring for the client and the family notes that some members of the family refuse to accept that the client has died.What stage of grief is the family experiencing? a. shock and disbelief b. developing awareness c. restitution period d. idealization

a. shock and disbelief

The nurse is caring for a client who is dying. The nurse 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? a. denial b. bargaining c. depression d. acceptance

b. bargaining

A client comes to the health care provider's office for an annual checkup. During the interview, the nurse learns that the client's spouse died unexpectedly of a heart attack 2 months ago. Which would be the most appropriate response by the nurse? a. "At least you and your spouse enjoyed life right until the end." b. "It's better to go quickly like your spouse did instead of suffering." c. "The loss of your spouse must be very painful for you." d. "You'll feel better after you get over the shock of your spouse's death."

c. "The loss of your spouse must be very painful for you."

Which statement, made by the nurse, focuses on the purposeful assessment of a client coping with a terminal diagnosis? a. "How can I help you right now?" b. "Social services will help make the arrangements for your hospice care." c. "Who do you want to share information about your prognosis with?" d. "Getting such news has to be upsetting; can we talk about your feelings?"

c. "Who do you want to share information about your prognosis with?"

The client is actively dying and has a prescription for Do Not Resuscitate. The nonresponsive client is mouth breathing and has noisy respirations. The client is incontinent of urine and feces. The family is at the bedside. What interventions would be appropriate for the nurse to perform to meet the needs of the client and the family? Select all that apply. a. Provide ice chips for the family to administer to the client. b. Insert a catheter for the client's urinary incontinence. c. Elevate the head of the bed to a semi-Fowler's position. d. Encourage the family to reminisce about positive, enjoyable events that the client and family shared together. e. Cleanse the client's mouth every shift and PRN

c. Elevate the head of the bed to a semi-Fowler's position. d. Encourage the family to reminisce about positive, enjoyable events that the client and family shared together. e. Cleanse the client's mouth every shift and PRN

The oncology nurse is learning to care for dying clients. Which ideals should guide the nurse in facilitating a good death for these clients? Select all that apply. a. The care of the dying client should be guided by the values and preferences of the nurse. b. Care for dying clients should focus on pharmacologic relief of pain. c. Independence and dignity are central issues for many dying clients. d. A good death is one that allows a person to die on his family's terms. e. The characteristics of a good death vary for each client.

c. Independence and dignity are central issues for many dying clients. e. The characteristics of a good death vary for each client.

Which of the following would not be consistent with promoting nutrition in terminally ill patients? a. Maintaining a balanced diet b. Offering small portion of favorite foods c. Avoiding arguments at mealtime d. Offering cool foods rather than hot foods

a. Maintaining a balanced diet

A patient on the medical unit is dying and the nurse has determined that the family's psychosocial needs during the dying process need to be addressed. What is a cause of many patient care dilemmas at the end of life? a. Poor communication between the family and the care team b. Denial of imminent death on the part of the family or the patient c. Limited visitation opportunities for friends and family d. Conflict between family members

a. Poor communication between the family and the care team

A terminally ill client told her family, "I am ready to die." Her family is very upset that she has given up and wants the nurse to intervene. Which nursing intervention is most appropriate? a. Explain to the family that acceptance is part of the grieving process. b. Explain to the family that giving up is expected with terminal illness. c. Explain to the client that she cannot give up because her family needs her. d. Encourage the client to think about living instead of dying.

a. Explain to the family that acceptance is part of the grieving process.

The nurse is assessing a client who reports feeling hopeless since a divorce. Which would be an appropriate question for the nurse to ask in order to determine mental health status for this client? a. "Do you ever use drugs to help feel less emotional pain?" b. "Is there a history of mental illness in your immediate family?" c. "Would you consider marrying again?" d. "Do you feel that someone else could ever love you?"

a. "Do you ever use drugs to help feel less emotional pain?"

Two days after surgery to amputate the left lower leg, a client reports pain in the missing extremity. Which action by the nurse is most appropriate? a. Administer medication, as ordered, for the reported discomfort. b. Contact the health care provider. c. Initiate a consult with a psychologist. d. Do nothing because it isn't possible to have pain in a missing limb.

a. Administer medication, as ordered, for the reported discomfort.

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. a comfortable, dignified death for the client b. prevention of family from making health care decisions c. use of all available life-sustaining measures d. harvesting of the client's organs for donation

a. a comfortable, dignified death for the client

To adequately assist a client and family from a different culture with the death and dying process, the nurse should: a. be aware of the client's cultural beliefs b. progress through the stages of grief c. experience death in his or her own life d. have felt distress and anger

a. be aware of the client's cultural beliefs

A nurse is conducting an in-service program for a group of hospice nurses. When describing the grief response in adults and older adults as compared to children, which would the nurse most likely include? Select all that apply. a. The grief of adults and older adults is less intense. b. Adults and older adults grieve more continuously. c. Children need to go through the same grief reactions as adults do d. Adults and older adults do not seek an immediate replacement for the lost loved one. e. Middle-age adults usually cope well with loss.

b. Adults and older adults grieve more continuously. c. Children need to go through the same grief reactions as adults do d. Adults and older adults do not seek an immediate replacement for the lost loved one.

While caring for a female client near end of life, a nurse talks to the client. A nurse's aide asks why the nurse is talking to someone who is dying. Which response would be accurate? a. "It makes me feel better to talk to my clients." b. "I do this so I won't be so afraid the client will die." c. "I believe the client can hear me as long as the client is alive." d. "I don't know; the client's family asked me to do this."

c. "I believe the client can hear me as long as the client is alive."

The nurse is caring for a dying child. The parents have been discussing changes in their child's appetite. Which statement indicates that the parents require more education about the care of their child? a. "We had to force her to eat all of her breakfast this morning." b. "She said she has wants a grilled cheese sandwich, so we just ordered one from dietary for her." c. "She said she wants to try to eat, so can she get some anti-nausea medicine?" d. "After she vomits, we help her brush her teeth."

a. "We had to force her to eat all of her breakfast this morning."

Which is a true statement regarding hospice care? a. Clients have a life expectancy of 6 months or less. b. It is cure-focused. c. It encourages the prolongation of life through artificial means. d. Patients have an acute illness.

a. Clients have a life expectancy of 6 months or less.

The nurse is caring for a client at the end of life. The client is prescribed a regularly scheduled dose of narcotics and short-acting narcotic for breakthrough pain. Which action should the nurse take when administering the narcotics to manage this client's pain? a. Assess for signs of drug dependence. b. Prepare to treat any drug side effects. c. Recgonize that dosages will be restricted. d. Administer all analgesics on a PRN basis.

b. Prepare to treat any drug side effects.

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

d. Irregular breathing patterns

The hospice nurse is caring for a 45-year-old mother of three young children in the patient's home. During the most recent visit, the nurse has observed that the patient has a new onset of altered mental status, likely resulting from recently diagnosed brain metastases. What goal of nursing interventions should the nurse identify? a. Helping the family to understand why the patient needs to be sedated b. Making arrangements to promptly move the patient to an acute-care facility c. Explaining to the family that death is near and the patient needs around-the-clock nursing care d. Teaching family members how to interact with, and ensure safety for, the patient with impaired cognition

d. Teaching family members how to interact with, and ensure safety for, the patient with impaired cognition

The nurse is preparing a care plan for a client experiencing grief. What are the expected outcomes of a successful intervention? Select all that apply. a. The client will actively participate in social activities. b. The client will identify the meaning of the loss. c. The client will develop healthy strategies for coping with loss. d. The client will try to solve problems without any assistance. e. The client will recognize the negative effects of the loss on the client's life.

b. The client will identify the meaning of the loss. c. The client will develop healthy strategies for coping with loss. e. The client will recognize the negative effects of the loss on the client's life.

A nurse is planning the care of a client with osteomyelitis that resulted from a diabetic foot ulcer. The client requires a transmetatarsal amputation. When planning the client's postoperative care, which of the following nursing diagnoses should the nurse most likely include in the plan of care? a. Ineffective Thermoregulation b. Risk-Prone Health Behavior c. Disturbed Body Image d. Deficient Diversion Activity

c. Disturbed Body Image

A hospice nurse is providing emotional care and support for a family who lost a child. The nurse will provide care on the basis of what knowledge? a. All members of the family will react to loss in the same way b. Grief is an abnormal physical reaction to a loss c. Stages of grief reactions may overlap and are individualized d. Bereavement is a normal process, requiring little intervention

c. Stages of grief reactions may overlap and are individualized

A female client who has recently been diagnosed with end-stage lymphoma tells the nurse, "I need to be able to go to my son's wedding. God, will you please just give me a little more time so I can see my first grandchild?" The nurse identifies that the client is experiencing which stage of Kubler-Ross' stages of grieving? a. denial b. depression c. bargaining d. acceptance

c. bargaining

A nurse is providing end-of-life care to a terminally ill client. Which action should the nurse take to remove mucus and saliva from the client's mouth? a. Apply mineral oil to the lips. b. Position the client in the supine position. c. Perform suction in the client's mouth. d. Administer oxygen to the client.

c. Perform suction in the client's mouth.

The nurse is assessing the new grieving widow. Which are critical components to assess in a grieving person? Select all that apply. a. genetic risk b. perception of the loss c. support system d. coping behaviors e. religion

b. perception of the loss c. support system d. coping behaviors e. religion

After being laid off from work, a client becomes increasingly withdrawn and fatigued, spends entire days in bed, is unkempt, and is eating and sleeping poorly. The nurse would recognize that the client is in which stage of grieving, according to Kubler-Ross? a. anger b. bargaining c. denial d. depression

d. depression

The hospice nurse is educating a client's family on the physical signs of approaching death. The nurse identifies that the education has been effective when the family says they will know that death is imminent when they see which related symptoms? Select all that apply. a. Irregular respiratory rate b. Restlessness c. Increased body temperature d. Bowel incontinence e. Cyanosis of dependent areas

a. Irregular respiratory rate b. Restlessness d. Bowel incontinence e. Cyanosis of dependent areas

The nurse is caring for a child who is nearing death. When assisting the child and family to make end-of-life decisions, what practices should be incorporated? Select all that apply. a. Limit the amount of time spent discussing this topic with the child's siblings. b. Ask the child what things he or she would like to see done. c. Assess the family's cultural requests. d. Encourage the child's parents to make the decisions to limit possible conflict with the child. e. Ask the child what concerns or fears he or she may have.

b. Ask the child what things he or she would like to see done. c. Assess the family's cultural requests. e. Ask the child what concerns or fears he or she may have.