Chapter 25&40 adaptive quizzing
An inquest is ordered after the death of a patient in a motor vehicle accident. Who conducts the inquest? 756 O Health care provider O Nurse O Judge O Coroner
O Coroner
A patient has been told that cancer has metastasized (spread) throughout the entire body. A 6-month survival rate has been established. The patient refuses to accept the diagnosis and denies the conversation ever took place. Which stage of grief is the patient experiencing? 739 O Anger O Denial O Depression O Acceptance
O Denial
A 79-year-old woman is brought to the clinic for fatigue, weakness, anorexia, and weight loss. The nurse notices that the patient has poor personal hygiene, refusing to care for herself. She has also withdrawn herself socially. On further assessment, the nurse learns that her husband died about a year ago and that her only son recently died in a motor vehicle accident. The attending nurse lists the patient problem, patient goals and expected outcomes, and nursing interventions. Which data written by the attending nurse would the nursing supervisor question? 741 O Bereavement overload O Patient will establish new and meaningful relationships and interests O Facilitate discussion of the positive aspects of loss O Assure the patient that feelings are normal
O Facilitate discussion of the positive aspects of loss
The nurse is caring for a terminally ill patient suffering from colon cancer. If the patient dies, which team member should break the bad news to the family members?744 O Health care provider O Nurse O Staff supervisor O Mortuary in charge
O Health care provider
A patient in a hospice unit is close to death. WWhich therapeutic communication technique will be most helpful for the patient when verbal communication dwindles? 751 O Holding the patient's hand O Verifying the patient's thoughts O Maintaining appropriate eye contact O Allowing the patient to express and fears
O Holding the patient's hand
A patient recently diagnosed with a terminal illness is crying. When the nurse enters the room, the patient states, "I hate everything and everyone including you." How should the nurse respond to the patient? 751 O I see that you're upset; let's talk about how you're feeling." " O I'll let you have some time alone, and I'll return when you feel better." " O What family member should I call to help you deal with these feelings?" O Hate is temporary; your feelings will change as you begin to experience death."
O I see that you're upset; let's talk about how you're feeling."
A seasoned nurse has been assigned a patient with cancer. The patient is highly upset that failing vision is preventing the reading of scriptures. Which immediate action, if taken by the nurse, would meet the patient's needs? 751 O Medicate the patient and encourage a rest period. O If comfortable, offer to read the scripture for the patient. O Ask the nursing staff to come and have church with the patient. O Notify members of the congregation to come and visit the patient...
O If comfortable, offer to read the scripture for the patient.
A charge nurse in an end-of-life care unit is preparing an inservice on grief and loss for the nursing staff. Which essential information should be included as part of the presentation? O Grief is objective in nature. O Grief is an isolated episode. O Individuals perceive loss differently. O Loss is an actual, not a perceived, event.
O Individuals perceive loss differently.
A terminally ill patient experiencing the final stages of death is incontinent. Which nursing intervention should be implemented to address skin breakdown caused by urinary incontinence? O Using adult diapers O Encouraging voiding as needed OChanging the bed linens every 2 hours OInserting a catheter or condom catheter
O Inserting a catheter or condom catheter
A do-not-resuscitate (DNR) order has been placed on the chart of a patient with cirrhosis of the liver. Which care will be withheld as a treatment option for this patient? Select all that apply. 750 O Hygiene Nutrition OIntubation Medication O Intravenous fluids OChest compressions
O Intubation OChest compressions
A dying patient wants to make a deathbed confession. Which community does the patient most likely belong to? 756 O Roman Catholics O Jews O Buddhists O Hispanic Americans
O Jews
An unlicensed assistive personnel (UAP) is preparing to perform morning care on a dying patient. The UAP informs the nurse that the patient is complaining of severe fatigue. Which action should the nurse instruct the UAP to do? 755 O Perform all grooming needs during a single visit. O Choose which tasks will be performed for the patient. O Limit care to essential tasks the patient wants to perform. O Have family members assume the responsibility of caring for the patient.
O Limit care to essential tasks the patient wants to perform.
The nurse is teaching the family members of a dying patient the technique of interacting with the patient. Which discussion points would be part of the nurse's teaching plan? Select all that apply. 751 O Listening attentively to the patient ODiscouraging open expression of grief I Giving false reassurance to the patient O Discussing family problems with the patient O Conversing about normal family activities
O Listening attentively to the patient O Discussing family problems with the patient O Conversing about normal family activities
Loss is a natural part of our lives. Which type of loss is felt when one leaves home for college? 736 OPersonal O Perceived O Situational O Maturational
O Maturational
An elderly man is depressed over losing his hair at an alarming rate. He visits the community care nurse for counseling. Which type of loss is the man experiencing? 736 O Perceived loss O Situational loss O Personal loss O Maturational loss
O Maturational loss
Prevention, relief, reduction, or soothing of symptoms of a disease state describes which type of care? 752 O Physical O Palliative O Preventive O Precautionary
O Palliative
A patient facing death is experiencing pain. Which information, if found in the nurse's documentation, indicates that the goal related to pain has been achieved? O Patient is exhibiting a decrease in mobility. O Facial grimacing is noted as patient paces in the hallway. O The patient is crying and complaining of severe pain to the entire body. O Patient reports that pain has decreased from 9 to 4 after taking pain medicine.
O Patient reports that pain has decreased from 9 to 4 after taking pain medicine.
The nurse identifies the patient as experiencing complicated grief. Which patient goal and expected outcome is the most reasonable? 741 O Patient will establish new and meaningful relationships and interests. O Patient will engage in a new lifestyle different from the precrisis level. O Patient will relate realistically to the disappointments of the lost relationiships. O Patient will cooperate with recommended treatment within 2 days.
O Patient will establish new and meaningful relationships and interests.
A nurse has prepared the body of a deceased patient. Which intervention, if implemented by the nurse, would reduce or eliminate discoloration to the patient's face? O Use the Trendelenburg's position. O Place a pillow under the patient's head. O Place the patient in the high-Fowler's position. O Apply gentle pressure on the carotid arteries.
O Place a pillow under the patient's head.
A terminally ill cancer patient who is on opioids for pain relief develops constipation. Which direct nursing measures would be helpful to this patient? Select all that apply. O Using laxatives O Promoting exercise O Using stool softeners O Encouraging a high-fiber diet O Encouraging fluid intake
O Promoting exercise O Encouraging a high-fiber diet O Encouraging fluid intake
A nurse is caring for a critically ill patient in a large hospital. Which set of data, if documented in the notes by a nurse, would indicate death may be imminent? 755 O Pupils are dilated and fixed. O Skin is warm and dry to touch. O Peripheral pulses are palpable. O Vital signs are within normal limits.
O Pupils are dilated and fixed.
A hospice patient in the last stage of death is experiencing dyspnea. Which interventions should the nurse perform? Select all that apply. 755 O Provide ice chips. OReduce anxiety and fear. O Maintain a patent airway. O Position the patient supine. OProvide axygen as prescribed.
O Reduce anxiety and fear. O Maintain a patent airway. O Provide axygen as prescribed.
An oncology nurse is caring for a terminally ill patient. Which expected outcome for the patient, if found on the nursing care plan of this patient, is inappropriate? O Maintain dignity until death. O Express concerns and hopes through the illness. O Regain function at or above the pre-illness phase. O Verbalize an understanding of the disease process.
O Regain function at or above the pre-illness phase.
A nurse has been assigned to a hospice floor for over 3 years. Lately the nurse is becoming emotionally involved with each patient and is devastated when death occurs. Which action would help the nurse cope with the emotional trauma? 738 O Changing professions temporarily O Assuming the role of patient advocate O Decreasing the number of hours worked O Requesting a transfer to a less stressful unit
O Requesting transfer to a less stressful unit
A terminally ill patient who is on lifesaving medications and other supportive measures wishes to die at home. How does the nurse manage this situation? 735 O Obtain family members' opinions. O Insist the patient stay in the hospital. O Modify the patient's room to look homelike. O Respect the patient's desire and let the patient go home.
O Respect the patient's desire and let the patient go home.
A nurse is attempting to prioritize nursing problems on the care plan of a terminally ill patient whose condition is consistently changing. Which nursing action would best meet the needs of this patient? 745 O Ask the family which problems are most important. O Make all nursing problems a priority for the patient. OHave the patient identify and prioritize problems OShift the priorities according to the patients condition.
O Shift the priorities according to the patients condition.
A nurse is caring for a dying patient and is showing attentiveness both verbally and nonverbally. Which intervention is effective to demonstrate attentiveness? 751 O Using a loud, clear voice O Standing in the doorway to ask questions O Avoiding touching the patient as much as possible O Sitting in a chair close to the bed, facing the patient
O Sitting in a chair close to the bed, facing the patient
The physical needs of the dying patient should be of utmost importance to the nurse giving care. Which patient situation would require an intervention? O Lying in bed with side rails up O Soiled and needs clothing changed O Eating a high-protein, high-calorie diet O Being transferred from the bed to the chair with two assistants
O Soiled and needs clothing changed
The physical needs of the dying patient should be of utmost importance to the nurse giving care. Which patient situation would require an intervention? 740 O Lying in bed with side rails up O Soiled and needs clothing changed O Eating a high-protein, high-calorie diet O Being transferred from the bed to the chair with two assistants
O Soiled and needs clothing changed
The nurse caring for a terminally ill patient sets a nursing goal that the patient will actively participate in grief work. Which action by the patient signifies the achievement of the goal? 747 O The nurse observes that the patient makes a plan for the future. O The nurse finds that the patient progresses in the resolution of grief. O The patient informs the nurse that he or she finds "peace" in meditation. O The nurse observes that the patient is discussing loss with his or her significant other.
O The nurse observes that the patient makes a plan for the future.
A patient who has signed a do-not-resuscitate (DNR) order is in the last stage of metastasis and is experiencing acute pain. Which intervention would the nurse perform for this patient? 750 O The nurse would stop any interventions. OThe nurse would suggest alternative therapies. O The nurse would opt for noninvasive procedure. O The nurse would administer pain-control medication.
O The nurse would administer pain-control medication.
The health care provider asks the nurse to withhold feeding tubes, life-support systems, and medications for a terminally ill patient. Which action by the patient would justify this order? 749 O A signed do-not-resuscitate (DNR) order .. O A signed medical durable power of attorney O The wish for passive euthanasia O The wish for active euthanasia
O The wish for passive euthanasia
Which purpose of palliative care would be identified for a patient with a terminal illness? 752 O To place the patient in long-term care to receive 24-hour care OTo provide no treatment and let nature take its course by following a patient's do-not-resuscitate (DNR) status O To take the patient's decision-making ability away and give it to the person with the power of attorney OTo provide prevention, relief, reduction, or soothing of symptoms of a disease without affecting a cure
O To provide prevention, relief, reduction, or soothing of symptoms of a disease without affecting a cure
A dying patient has been nauseated. Which nursing intervention should the nurse execute to assist the patient? O Offer a pureed diet. 755 O Provide coffee, milk, and juice. O Uncover food outside of the room. O Administer an analgesic per prescription.
O Uncover food outside of the room.
A patient with advanced cancer wishes to have a natural death without much medical intervention. How can this patient execute this wish when unable to express it during the dying process? O Write a diary to mention the wish. O Get a court order for this wish. O Use an advance directive to convey the wish. O Keep the family members informed about the wish.
O Use an advance directive to convey the wish.
A 72-year-old patient is in the terminal stage of prostate cancer. The patient is weak, anxious, experiences loss of appetite, and is in severe pain. Which nursing goals are ideal for this patient? Select all that apply. O Control pain O Ensure safety OnRelieve anxiety OIndependent activities of daily life OAdequate nutrition, hydration, and elimination
OControl pain O Ensure safety ORelieve anxiety OAdequate nutrition, hydration, and elimination
The nurse is assessing the family members of victims of suicide at a local counseling center. Which symptoms would the nurse expect to find in this group? Select all that apply. 749 O Sorrow OGuilt OGrief O Shame OHope
OGuilt OGrief O Shame
Which vital signs, when assessed in a dying patient, are indicative that the end of life is imminent?754 O Fast, bounding pulse; lowered blood pressure; abnormally slow respirations O Fast, bounding pulse; increased blood pressure; rapid, shallow, irregular respirations O Slow, weak, and thready pulse; lowered blood pressure; rapid, shallow, irregular respirations O Slow, weak, and thready pulse; increased blood pressure; rapid, shallow, irregular respirations
OSlow, weak, and thready pulse; lowered blood pressure; rapid, shallow, irregular respirations
terminally ill patient in the intensive care unit is on life-supporting measures. To support the patients' rights, which intervention does the nurse perform when caring for the patient? O Avoid using opioids to control the pain. OTreat the body respectfully after death. O Don't let the patient change religious beliefs. O Avoid informing the patient of impending death.
OTreat the body respectfully after death.
A 75-year-old man visits the community nurse for a regular check-up. Which statement would this man be expected to make regarding death? 740 O "Death is the inevitable end of life." O "Man is mortal; I will die anyway." O "After death I can see my deceased father." O "I will not die so easily. I would dare to meet it."
O "After death I can see my deceased father."
A terminally ill patient has signed a do-not-resuscitate (DNR) order. The adult child of the patient asks the nurse in charge to remove the patient's nasogastric tube and stop administering the medications. How should the nurse respond to this request? 750 O"Please ask the health care provider; he can officially order it." O "I will ask the trainee nurse to remove the tubes and stop the medicines." ON"A DNR order does not mean to withhold nutrition or medications." O "Please submit a signed request so that I can carry out your request."
O A DNR order does not mean to withhold nutrition or medications."
Which stages would a nursing student identify as the part of Kübler-Ross's stages of dying? Select all that apply. O Acceptance O Anger O Bargaining O Denial O Depression O Reorganization
O Acceptance O Anger O Bargaining O Denial O Depression
A terminally ill patient is in a state of impending death with noisy, irregular, and labored respirations. Upon auscultation, the nurse finds crackles in the lungs, likely to be caused by accumulated secretions. Which nursing intervention does the nurse perform? 755 OSuctioning the airways O Administering oxygen O Withholding morphine O Withholding scopolamine
O Administering oxygen
A young widowed patient struggling with grief returns to the clinic for a 2-week follow-up appointment. Which patient behavior, if witnessed by the nurse, indicates the patient may be resolving complicated grief? 741 O Being unable to return to work O Allowing children to make all decisions O Admitting to attending a grief support group OBecoming emotional when discussing the loss
O Admitting to attending a grief support group complicated
A patient is being cared for in the hospital and had the opportunity to formulate a living will and durable power of attorney for health care. These are examples of which type of documents? O DNR O Patient rights O Federal statutes O Advance directives
O Advance directives Advance directives are signed and witnessed documents thes provide specific instructions for health care treatment in the event that a person is unable to make those decisions personally at the time they are needed.
A 9-year-old child is having great difficulty with death and dying. Which intervention, if implemented, would best help the child cope with emotions of death? 748 O Reassure the child that death is not permanent. O Ask the parent how the child normally deals with death. O Allow the child to express feelings and thoughts via play. O Provide a movie that will explain detailed stages of dying.
O Allow the child to express feelings and thoughts via play.
A terminal cancer patient is experiencing nausea and vomiting. Which intervention should be first when caring for this patient?755 O Small servings of food O Antiemetics O Favorite homemade food O Frequent mouth washes
O Antiemetics
A night nurse is providing postmortem care for a patient with acquired immunodeficiency syndrome (AIDS). Which intervention is essential for the nurse to carry out to prevent risk to individuals handling the body after death? 754 ODress open wounds with gauze. ORemove any bandages or dressings. O Disconnect tubing from the patient. O Attach special label for contagious disease.
O Attach special label for contagious disease.
A child's reaction to death and dying is dependent on the developmental stage. Which parental factor(s) should the nurse examine in an effort to help the child understand the concepts of death and dying? Select all that apply. 748 O Anger O Beliefs O Culture O Perception O Religious orientation
O Beliefs OCulture O Religious orientation
A nurse is caring for the dying mother of a 6-year-old child. Based on the developmental age of the child, which beliefs and feelings about death might the child have? 740 O Fears death O Seldom thinks about death O Believes that death is reversible O Believes wishes can be responsible for death
O Believes wishes can be responsible for death
Which nursing actions reflect good care when the nurse is caring for a dying patient? Select all that apply. 753-755 O Communicate the goals of the treatment. O Stop the medications for symptom control. O Prepare the patient and family for the death. O Continue the medications for pain management. O Avoid involving the family in the decision-making process. O Coordinate effectively with the health care providers.
O Communicate the goals of the treatment. O Prepare the patient and family for the death. O Continue the medications for pain management. O Coordinate effectively with the health care providers.
An elderly patient who attends the community counseling session regularly after the loss of his spouse became more depressed upon hearing about the death of his only son in a distant city. How would the nurse identify this patient's condition? 739 O Complicated grieving O Bereavement overload O Anticipatory grief O Maturational loss
O Complicated grieving
A young patient recently lost her father to prostate cancer and tells the nurse, "If I took my father to the oncologist earlier, he would not have died." The nurse identifies the patient in which phase of mourning, according to Bowlby's theories of grief and mourning? 739 ONumbing O Yearning and searching O Disorganization and despair O Reorganiation
O Disorganization and despair
The nurse is assessing an older patient experiencing grief. Which factors would the nurse assess in the patient in order to identify the reason for the grief? Select all that apply. 749 O Employment status O Sexual activity O Social respect O Functional ability OPhysical apgarance
O Employment status O Social respect O Functional ability OPhysical apgarance
A young mother with three children is visibly upset after she has been told that she has less than a year to live and will not get a chance to see her children grow up. Which intervention should the nurse employ to help the young mother cope with the concern? 752 O Call family members to sit with the patient until she is no longer upset. O Encourage the mother to write letters and make videos for the children. O Have the spouse and children stay with the mother until death is imminent. O Devise a plan so that the children will not be present at their mother's death.
O Encourage the mother to write letters and make videos for the children.
The nurse asks the family members of a terminally ill patient with a reduced appetite to bring home-cooked food. Which benefits result from this nursing intervention? Select all that apply. O Faster patient recovery O Enhancing the patient's comfort level O Providing the patient's preferred food I Extra nutrients in home-cooked foods OAllowing the family to participate in the patient care
O Enhancing the patient's comfort level O Providing the patient's preferred food OAllowing the family to participate in the patient care
The nurse is assessing the cognitive level of a patient and understands that the patient is able to conceptualize death as the inevitable end of life. What is the youngest likely chronologic age this patient can be? 740
9 years of age