end of life quiz

Immediately on cessation of vital functions, the body begins to change. The nurse would expect which physical change to occur following death? Dusky appearance Increased body temperature Flushed appearance Absence of incontinence

Dusky appearance

After multiple treatment plans, a client with cancer has been told that the tumors continue to grow and have metastasized. The nurse is assisting with arranging hospice care for the client. The nurse assesses the client is in which phase of the Trajectory Model of Chronic Illness? Dying Downward Comeback Unstable

Dying

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.

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

A client is declared to have a terminal illness. What intervention will a nurse perform related to the final decision of a dying client? Respect the client's and family members' choices. Share emotional pain. Abide by the dying client's wishes. Ask the family members about spiritual care.

Respect the client's and family members' choices.

The family of a terminally ill client tells the nurse that the client has been breathing irregularly and, at times, it appears that he is not breathing at all. The client's daughter states, "He moans when he breathes. Is he in pain?" Which response by the nurse would be most appropriate? "His moaning does indicate pain, so we'll increase his pain medication." "The moaning you hear is from air moving over very relaxed vocal cords." "He has secretions that are collecting at the back of the throat." "He is getting less oxygen to the brain, so the moaning means he is dreaming."

"The moaning you hear is from air moving over very relaxed vocal cords."

A terminally ill patient in pain asks the nurse to administer enough pain medication to end the suffering forever. What is the best response by the nurse? "I can't do that, I will go to jail." "I am surprised that you would ask me to do something like that." "I will see if the physician will order enough for that to occur." "I will notify the physician that the current dose of medication is not relieving your pain."

"I will notify the physician that the current dose of medication is not relieving your pain."

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."

A terminally ill patient is admitted to the hospital. The patient grabs the nurse's hand and asks, "Am I dying?" What response would be best for the nurse to give? "Why do you think that?" "Did someone tell you that you are dying?" "Tell me more about what's on your mind." "I am not at liberty to disclose that information."

"Tell me more about what's on your mind."

The nurse identifies a nursing diagnosis of Imbalanced nutrition: less than body requirements for a terminally ill client who is near the end of life. Which of the following would the nurse expect to include in the client's plan of care? Suggestions that the family offer the client foods that are hot. Encouragement of the family to serve the client meat, especially beef. Advice for the family to have fruit juices readily available at the client's bedside. Arrangements for the client to eat meals while others are out of the home.

Advice for the family to have fruit juices readily available at the client's bedside.

A family of a dying client reports that their loved one is experiencing more shortness of breath. Which nursing intervention is most appropriate at this time? Offer the bedpan to urinate or defecate Call the health care provider to obtain an oxygen order Get the client out of bed to the chair. Offer the client sips to drink.

Call the health care provider to obtain an oxygen order

Medicare and Medicaid hospice benefit criteria allow clients with a life expectancy of 6 months or less to be admitted to hospice. However, the median length of stay in a hospice program is just 21.3 days. Which reason explains the underuse of hospice care services? Lack of fully credentialed and trained hospice nurses Clients and families view hospice care as giving up Lack of Medicare/Medicaid funding for hospice Difficulty obtaining Medicare certification for hospice services

Clients and families view hospice care as giving up

A client approaching end-of-life reports dyspnea as being 7 on a scale from 0 to 10. Which action will the nurse take to assist this client? Lower the head of the bed. Restrict the intake of oral fluids. Coach to use pursed lip breathing. Increase the air temperature in the room.

Coach to use pursed lip breathing.

A client who has been demonstrating signs of impending death is awake, alert, and wants to see grandchildren after they attend school. Which action will the nurse take to support this client's request? Suggest the family bring one grandchild per day to visit the client. Contact the family to ask for grandchildren to come to visit the client. Tell the family that the client will most likely not last until the end of the day. Remind the client that they need rest and the grandchildren can visit another time.

Contact the family to ask for grandchildren to come to visit the client.

A patient with a "Do Not Resuscitate" (DNR) order requires large doses of a narcotic for pain that rates a 10 on a 0-10 scale. After the patient requests pain medication, the nurse assesses a respiratory rate of 12 breaths per minute. What intervention by the nurse would be considered ethical? Ask the patient to wait 20 minutes and reassess. Give half of the prescribed dose. Give the pain medication without fear of respiratory depression. Withhold the pain medication and contact the physician.

Give the pain medication without fear of respiratory depression.

A nurse is preparing a presentation for a local senior center about the health status of older adults. What trends in health promotion and disease prevention activities would the nurse explain as contributing to declining death rates in the older adult population? Select all that apply. decreased smoking improved nutrition screening for hypertension early detection of elevated cholesterol levels decreased exercise decreased community-based services

decreased smoking improved nutrition screening for hypertension early detection of elevated cholesterol levels

For individuals known to be dying by virtue of age and/or diagnosis, which sign indicates approaching death? Increased wakefulness Increased eating Increased restlessness Increased urinary output

Increased restlessness

The nurse is describing hospice services to the family of a patient with end-stage heart failure. Which of the following would the nurse be least likely to include as a major focus of care? Symptom management Pain control Emotional support Invasive therapy

Invasive therapy

Which guideline is appropriate for a nurse to implement while helping family members cope with the sudden death of a loved one? Inform the family that the client has passed on. Obtain orders for sedation for family members. Show acceptance of the body by touching it, giving the family permission to touch. Provide details of the factors attendant to the sudden death.

Show acceptance of the body by touching it, giving the family permission to touch.

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.