Course Point Prep U Questions- Exam 4

Which is a sign of approaching death? 1. Insomnia 2. Clear sensorium 3. Irregular breathing patterns 4. Increase in urinary output

3. Irregular breathing patterns Explanation: Irregular breathing patterns are a sign of impending death. Other signs of approaching death include decreased urinary output, mental confusion, and sleeping for longer periods of time.

The nurse is caring for a client who just learned of his terminal diagnosis. After the physician leaves, the nurse remains to answer further questions so that the client can make an informed decision about further treatment. By providing all available information, the nurse is promoting which ethical principle? 1. The principle of justice 2. The principle of fidelity 3. The principle fo nonmaleficence 4. The principle of autonomy

4. The principle of autonomy

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. 1. End-stage renal disease 2. Type 2 diabetes mellitus 3. Coronary artery disease 4. Carcinoma-in-situ

1. "End-stage renal disease"

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? 1. "I am surprised that you would ask me to do something like that." 2. "I will notify the physician that the current dose of medication is not relieving your pain." 3. "I can't do that, I will just go to jail." 4. "I will see if the physician will order enough for that to occur."

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

The spouse of a terminally ill client is confused by the new terminology being used during discussions regarding the client's treatment. The nurse should explain that palliative care is: 1. offered to terminally ill clients who wish to remain in their homes in lieu of hospice care. 2. care that will reduce the client's physical discomfort and manage clinical symptoms. 3. care that is provided at the very end of an illness to ease the dying process. 4. an alternative therapy that uses massage and progressive relaxation for pain relief.

2. care that will reduce the client's physical discomfort and manage clinical symptoms.

Which statements made by the nurse demonstrates that the nurse is providing spiritually sensitive care? 1. "A key component of hospice care is following your family for up to a year after your death." 2. "Denial, sadness, anger, fear, and anxiety are normal grief reactions." 3. "Mourning may be demonstrated by emotional feelings of sadness, anger, guilt, and numbness." 4. "Tell me who or what gives you strength."

4. "Tell me who or what gives you strength."

A nurse is providing care to a client experiencing symptoms associated with terminal illness. Which of the following would be most appropriate to use as a means for managing the client's symptoms? 1. Client's goals 2. Physician's orders 3. Invasiveness of the treatment 4. Length of required treatment

1. Client's goals Explanation: When managing the symptoms of a client with a terminal illness, the client's goals take precedence over the clinician's goals to relieve all symptoms at all costs. Although the length and invasiveness of the treatment may influence decision making, ultimately it is the client's goals that determine what will be done.

A client is dying, and the client and loved ones are in the grieving period. The nurse wants to support them in the grieving process. Which is the best intervention the nurse could perform? 1. Encourage loved ones to express their feelings. 2. Spend time alone with the client. 3. Disengage to give the grieving individuals privacy. 4. Provide palliative care to the client.

1. Encourage loved ones to express their feelings.

A nurse has been providing in-home hospice care to an older adult client with lung cancer for more than 6 months. The family asks the nurse how long the Medicare hospice services will continue. What is the nurse's best response? 1. The Medicare hospice services can continue as long as the physician and hospice director agree about the client's terminal condition. 2. The client must begin to pay for other home health services since six months of hospice care have been received. 3. The hospice services need to end now that the client has had the services for six months. 4. Medicare hospice services end at the seventh month of care.

1. The Medicare hospice services can continue as long as the physician and hospice director agree about the client's terminal condition.

A patient with end-stage chronic obstructive pulmonary disease is admitted to a hospice facility and asks the admitting nurse, "How long will I be allowed to stay here?" What is the best response by the nurse? 1. "There is no time limit for your stay. You can stay until you die." 2. "When your stay reaches 6 months, you will be recertified for a continued stay." 3. "You will be able to stay only for approximately 1 month and then you will be discharged." 4. "You will be able to stay for 2 months before being discharged."

2. "When your stay reaches 6 months, you will be recertified for a continued stay."

All nurses care for clients who are grieving. It is important for the nurse to understand the grieving process for which reason? 1. Allows the nurse to express his or her feelings 2. Allows for the nurse to facilitate the grieving process 3. Allows for the nurse to take the client through in the appropriate order 4. Allows for the nurse to understand when the grieving process should be concluded.

2. Allows for the nurse to facilitate the grieving process

Which is the initial stage of grief, according to Kubler-Ross? 1. Bargaining 2. Denial 3. Anger 4. Depression

2. Denial Explanation: The stages of grief include denial, anger, bargaining, depression, and acceptance. Anger is the second stage of the process. Bargaining is the third stage of the process. Depression is the fourth stage of the process.

A nurse is caring for a client with a terminal illness. The client asks the nurse to help him end his own life to alleviate his suffering and that of his family. When responding to the client, the nurse integrates knowledge of which of the following? 1. A client has the right to make independent decisions about the timing of his or her death. 2. Participating in assisted suicide violates the Code of Ethics for Nurses. 3. Nurses mat administer medications prescribed by physicians to hasten end of life. 4. Most states have enacted laws that allows for physician-assisted suicide.

2. Participating in assisted suicide violates the Code of Ethics for Nurses.

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? 1. altered gastrointestinal function 2. weight loss and inadequate food intake 3. drop in blood pressure and rapid heart rate 4. irregular eating habits

2. weight loss and inadequate food intake

The physician is attending to a 72-year-old client with a malignant brain tumor. Family members report that the client rarely sleeps and frequently reports seeing things that are not real. Which intervention is an appropriate request for the hospice nurse to suggest to the physician? 1. Begin radiation therapy to prevent cellular growth. 2. Perform surgery to remove the tumor from the brain. 3. Add haloperidol to the client's treatment plan. 4. Obtain a biopsy to analyze the lymph nodes.

3. Add haloperidol to the client's treatment plan.

The nurse is caring for a pediatric client who is dying. The best way to provide care and comfort to dying clients and their families is to first do which of the following? 1. A workshop on caring for the dying client 2. Participate in a support group to learn clients' feeling on care. 3. Explore own feelings on mortality and death and dying. 4. Use evidence-based practice in daily care regimen.

3. Explore own feelings on mortality and death and dying.

A nurse is assessing a client with terminal illness and finds that the client has cachexia. The nurse interprets this as indicating which of the following? 1. Starvation 2. Extreme anorexia 3. Profound protein loss 4. Severe asthenia

3. Profound protein loss Explanation: Cachexia is associated with anabolic and catabolic changes in metabolism that relate to activity of neurohormones and proinflammatory cytokines, resulting in profound fluid loss. Although anorexia may exacerbate cachexia, it is not a primary cause. Starvation refers to simple food deprivation and is not cachexia. Anorexia-cachexia syndrome, characterized by disturbances in carbohydrate, protein, and fat metabolism, endocrine dysfunction, and anemia results in severe asthenia (loss of energy).

Which of the following may be contained in an "emergency kit" for a hospice patient exhibiting restlessness? 1. Laxative 2. Oral sucrose 3. Atropine sulfate drops 4. Benzodiazepine

4. Benzodiazepine

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? 1. Lack of fully credentialed and trained hospice nurses. 2. Difficulty obtaining Medicare certification for hospice services 3. Lack of Medicare/Medicaid funding for hospice 4. Clients and families view hospice care as giving up

4. Client's and families view hospice care as giving up

Which "awareness context" is characterized by the client, family, and health care professionals understanding that the client is dying, but all pretend otherwise? 1. Open awareness 2. Closed awareness 3. Suspected awareness 4. Mutual pretense awareness

4. Mutual pretense awareness