Chapter 16

Which of the following statements when made by the nurse demonstrates the nurse is providing spiritually sensitive care?

"Tell me who or what gives you strength?"

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."

What major complication is associated with oral intake in the client with a decreased level of consciousness?

Aspiration

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

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.

The family members of a dying patient are finding it difficult to verbalize their 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.

The physician is attending to a 72-year-old patient with a malignant brain tumor. Family members report that the patient rarely sleeps and frequently reports seeing things that are not real. Which of the following interventions is an appropriate request for the hospice nurse to suggest to the physician?

Add haloperidol (Haldol) to the patient's treatment plan.

Which of the following is an appropriate method of assessing the dying client?

Focus on the client's basic needs.

Which of the following nursing actions by the nurse demonstrates an effective method to assess the patient and the patient's family's ability to cope with end-of-life interventions?

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

A patient has been declared to have a terminal illness. What is the nursing intervention a nurse will perform in the final decision of a dying patient?

Respect the patient and family members' choices

A patient is declared to have a terminal illness. What is the nursing intervention a nurse will perform in the final decision of a dying patient?

Respect the patient and family members' choices.

The patient is 45 years old and has a family history of breast cancer. She herself was diagnosed with breast cancer 2 months ago. On a routine visit, the physician prescribes dexamethasone to be taken over a 3-week period. Which of the following symptoms would prompt the physician to add dexamethasone to the patient's treatment plan?

The patient has lost 8 pounds.

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?

The principle of autonomy

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

grief

Which of the following is one of the levels of hospice care covered under Medicare and Medicaid hospice benefits that includes a 5-day inpatient stay and is provided on an occasional basis to relive the family caregivers?

Respite care

You are providing home care to a dying client and have noticed over the course of several weeks that the client's daughter is usually quiet and withdrawn when in the client's room. Which of the following nursing interventions should you perform in this situation?

Sit with the client's daughter privately and encourage her to express her feelings frankly.

A terminally ill patient has feelings of rage toward the nurse. According to Elisabeth Kübler-Ross, the patient is in which stage of dying?

anger

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 patient's family member asks the nurse what the purpose of hospice is. What is the best response by the nurse?

"It will enable the patient to remain home if that is what is desired."

The nurse is caring for a dying client in a hospice setting. The family is unsure whether to go home for rest or spend the night with the client. Which body system would the nurse assess to provide the first data on decline?

Cardiovascular system

A patient 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 of the following proxy directives is the patient using?

Durable power of attorney for health care

For individuals known to be dying by virtue of age and/or diagnoses which of the following signs indicate approaching death?

Increased restlessness

For individuals known to be dying by virtue of age and/or diagnoses, which of the following signs indicate approaching death?

Increased restlessness

Medicare and Medicaid hospice benefits criteria allow patients with a life expectancy of 6 months or less to be admitted to the hospice. However, the median length of stay in a hospice program is just 21.3 days. Which of the following reasons explains underuse of hospice care services?

Patients/families view palliative care as giving up

A patient with brain tumor recently stopped radiation and chemotherapy for treatment of his cancer. Of late, he is complaining of dry mouth. Which of the following interventions by the hospice nurse demonstrates the nurse understands treatment measures for dry mouth?

Provide gentle mouth care after each meal.

Despite having been administered the prescribed pain medication, a dying patient is still in pain due to fear and anxiety. Which of the following nursing interventions should a nurse use to potentiate the effects of pain medication?

Using imagery, humor, and progressive relaxation

In spite of administering the prescribed pain medication, a dying patient is still in pain due to fear and anxiety. Which of the following nursing interventions should a nurse use to potentiate the effects of pain medication?

Using imagery, humor, and progressive relaxation

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

Which of the following is the initial stage of grieving according to Kubler-Ross?

denial

The wife of your terminally ill client is confused by the new terminology being used during discussions regarding her husband's treatment. How would you explain palliative care to her?

It is care that will reduce her husband's physical discomfort and manage clinical symptoms.