Prep-End of life and pallative

While providing care to a client near death, the nurse is helping the family to prepare by teaching them what to expect. Which of the following would the nurse include in the teaching plan as a sign of approaching death? Select all that apply.

Gurgling as the client breathes through the mouth Refusal to ingest food or fluids Decrease in amount of urine produced

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?

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

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?

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

A dying patient wants to talk to the nurse. The patient states, "I know I'm dying, aren't I?" What would an appropriate nursing response be?

"This must be very difficult for you."

A nurse is working with the family of a terminally ill client, providing them with suggestions about how to manage the client's anorexia. Which statement by the family indicates that they have understood the instructions?

"We'll try adding powdered milk to milk and other foods to make them more nutritious."

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?

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

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.

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?

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

While providing care to a terminally ill client, the client's niece asks the nurse about the client's condition and prognosis. Which of the following would be most appropriate?

Ask the client's consent before sharing any information with the niece.

Which of the following interventions should the nurse perform while providing spiritual care for a dying client?

Ask the family members about spiritual care.

A client is experiencing anorexia and the physician is to order a medication to stimulate the client's appetite. Which of the following would the nurse least likely expect the physician to prescribe?

Atropine

A nurse has been working in hospice care for 10 years. Based on her experience, she drafts her plan of care with the understanding that the most significant barrier to improving care at the end of life is the:

Attitude of health care professionals toward terminal illness.

Which term refers to the period of time during which mourning of a loss takes place?

Bereavement

Which is also known as a proxy directive?

Durable power of attorney for health care

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?

Clients and families view hospice care as giving up

A client diagnosed with a terminal illness appoints her oldest son as the authorized individual to make medical decisions on her behalf when she is no longer able to speak for herself. Which proxy directive is the patient using?

Durable power of attorney for health care

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?

Encourage loved ones to express their feelings.

The family members of a dying client are finding it difficult to verbalize their feelings for and show tenderness to the client. Which intervention should a nurse perform in such a situation?

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

A patient near the end of life is experiencing anorexia-cachexia syndrome. What characteristics of the syndrome does the nurse recognize? (Select all that apply.)

Endocrine dysfunction Alterations in carbohydrate, fat, and protein metabolism Anemia

The nurse is caring for a pediatric client who is dying. The best way to provide care and comfort to clients who are dying and their families is to first do which of the following?

Explore own feelings on mortality and death and dying.

A nurse is conducting a spiritual assessment of a terminally ill client using the four step FICA process and asks the question, "What gives your life meaning?" The nurse is assessing which of the following?

Faith and belief

A nurse is working with a family of a deceased client and assisting them in working through their grief and mourning. Which of the following would be the priority to promote healthy accommodation of the loss by the family?

Helping the family recognize the loss has occurred

Which term best describes a living will?

Medical directive

A hospice nurse should be aware that the most effective pain medication used at the end of life that also relieves dyspnea and anxiety is which of the following?

Morphine

Which of the following is a term that refers to individual, family, group, and cultural expressions of grief and associated behaviors?

Mourning

Which "awareness context" is characterized by the client, family, and health care professionals understanding that the client is dying, but all pretend otherwise?

Mutual pretense awareness

A nurse is providing care to a terminally ill client who follows Islamic traditions and is experiencing pain. When developing a plan of care for this client, an understanding of which of the following would the nurse need to integrate into the plan?

Pain is viewed as a means of cleansing by God.

A 50-year-old client is an alcoholic. The client has been diagnosed with pancreatic cancer and underwent surgery to remove the tumor. Despite the tumor being removed, the physician informs the client that chemotherapy needs to be started immediately. Using evidence-based practice, which intervention might the nurse expect the physician to include, with the goal of improving quality of life, mood, and median survival.

Palliative care

A client with a terminal illness who is incapacitated is experiencing intractable pain that is no longer effectively addressed by conventional pharmacology. Which type of pain management will the nurse anticipate for this client?

Palliative sedation

A client with a brain tumor recently stopped radiation and chemotherapy for treatment of the cancer. The client recently reported dry mouth. Which intervention by the hospice nurse demonstrates that the nurse understands treatment measures for dry mouth?

Provide gentle oral care after each meal.

A client in hospice has end-stage renal failure. The client states that, of late, he has lost his appetite and feels like everyday situations have become more stressful. The client reports feeling restless. In addition, the client's spouse notices that the client is becoming more confused. What is the most important nursing intervention that needs to be carried out at this point?

Provide the spouse with an emergency kit that contains small doses of oral morphine liquid.

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

When a person authorizes another to make medical decisions on his or her behalf, the person has written which of the following?

Proxy directive

Anorexia and cachexia are common problems at the end of life. The nurse plays an important role in managing symptoms and preventing complications. Which of the following are appropriate nursing interventions for these problems? Select all that apply.

Recommend that the patient eat when hungry, regardless of usual meal times

Which action by the nurse demonstrates an effective method to assess the client and the client's family's ability to cope with end-of-life interventions?

Remaining silent, allowing the client and family to respond after asking a question related to end-of-life care

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.

A terminally ill client is receiving morphine around-the-clock for pain control. As part of the client's plan of care focusing on pain management, which nursing diagnosis would the nurse most likely identify?

Risk for constipation related to the effects of an opioid

As the moment of death approaches, which of the following does the nurse encourage the family to do?Fas

Speak to the client in a calm and soothing voice.

A nurse has been providing in-home hospice care to an older adult client with lung cancer for more than six months. The family asks the nurse how long the Medicare hospice services will continue. What is the nurse's best response?

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

A nurse is caring for a client with end-stage testicular cancer who has been referred to hospice care. Which criterion indicates that the client requires more teaching about hospice care?

The client entered a clinical trial through the National Cancer Institute.

Which of the following does not coincide with Kübler-Ross's stages related to a dying client?

The dying client usually exhibits anger first.

The nurse is caring for a client who just learned of a 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?

The principle of autonomy

A nurse is developing a teaching plan for a terminally ill client and his family about the stages of dying and emotional reactions experienced. The nurse integrates knowledge of which of the following in the teaching plan?

The stages are applicable to any 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?

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?

Use imagery, humor, and progressive relaxation

When assessing a terminally ill client, the nurse notices that the client has copious secretions at the back of the throat and in the mouth. The nurse is preparing a teaching plan for the family about caring for these secretions. Which of the following would be least appropriate to include?

Using a soft toothbrush to vigorously clean the mouth SUBMIT ANSWER

A client states, "My children still need me. Why did I get cancer? I am only 30." This client is exhibiting which stage according to Kübler-Ross?

anger

How does a nurse who has been providing home care to a terminally ill client know that the client's condition is beginning to deteriorate?

apical pulse reaches 100 beats/minute

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:

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

A 90-year-old home care client's son has been designated to make decisions regarding the client's medical care when the client is no longer able to do so. As the client nears the end of life, the son is consulted on an ever-increasing basis. What legal instrument activates the son's decision-making designation?

durable power of attorney for health care

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.

end-stage renal disease

Which term is used to describe the personal feelings that accompany an anticipated or actual loss?

greif

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?

weight loss and inadequate food intake

A nurse is assessing a terminally ill female client. Which client statement indicates that the client is in the bargaining stage of dying?

"I just want to see my daughter graduate from college. That's all."

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.

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