MCC Unit 5 loss, grief and dying

Hospice nursing care has a different focus for the patient. The nurse is aware that patient care provided through a hospice is: 1.Designed to meet the patient's individual wishes, as much as possible 2.Usually aimed at offering curative treatment for the patient 3.Involved in teaching families to provide postmortem care 4.Offered primarily for hospitalized patients

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In Kubler-Ross's stage of dying, there are five stages of response to dying. The nurse knows that these include: 1.Denial, anger, bargaining, depression, acceptance 2.Numbing, yearning, searching, disorganization, reorganization 3.Shock, yearning, anguish, avoidance, confrontation 4.Closed awareness, mutual pretense, open awareness, acceptance

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When caring for a terminally ill patient, you understand that one of the most important interventions is: 1.Touching and listening 2.Encouraging the patient to express any regrets 3.Assessing for signs and symptoms of impending death 4.Talking to the patient about how other patients have handled the dying process

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You are caring for a terminally ill patient who is an Orthodox Jew. The physician has given DNR orders. The patient is alone and is having signs of impending death. You should: 1.Notify the family 2.Wait until the patient dies and then notify the family 3.Transfer the body to the mortuary or morgue immediately after death 4.Stay with the patient until death occurs, prepare the body, then call the family

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A nurse caring for a dying patient should understand the importance of: 1.Frequent, thorough physical assessments 2.Not imposing repeated, unnecessary assessments 3.Current, updated health history from the patient 4.Limiting the amount of visitors allowed

2

A patient has been diagnosed with terminal cancer of the liver and is receiving chemotherapy on a medical unit. In an in depth conversation with the nurse, the patient states, "I wonder why this happened to me." According to Kubler-Ross, the nurse identifies that this stage is associated with: 1.Anxiety 2.Denial 3.Confrontation 4.Depression

2

Following the death of a patient, the nurse should position the body: 1.Prone 2.Supine 3.On the side 4.In Fowler's position

2

When planning the care of a terminally ill patient, you must include the prevention of pain and relief from discomfort. When administering pain medication, you must keep in mind: 1.Narcotics have the potential for addiction 2.Pain meds must be given before the pain becomes unbearable 3.Pain meds should be given no more often than every 6 hours 4.Narcotics must be given PRN only.

2

You are assessing a terminally ill patient for clinical signs of impending death. When assessing the patient's respirations, you would expect: 1.Deep, clear breath sounds 2.Noisy, wet sounding respirations 3.Even unlabored respirations 4.Shallow, clear breath sunds

2

You are caring for several terminally ill patients. She begins to feel helpless and frustrated. The best action by the nurse would be to: 1.Find another job 2.Express her feelings to a friend or co worker 3.Ignore these feelings, they will soon be gone 4.Ask to care for different patients

2

An identified outcome for the family of a patient with a terminal illness is that they will be able to provide psychological support for the dying patient. To assist the family to meet this outcome, the nurse arranges to include in the teaching plan: 1.Demonstration of bathing techniques 2.Application of oxygen devices 3.Recognition of patient needs and fears 4.Information on when to contact the hospice nurse

3

The nurse is assigned to a patient who was recently diagnosed with a terminal illness. During morning care, the patient asks about organ donation. The nurse should: 1.Have the patient first discuss the subject with the family 2.Suggest the patient delay making a decision at this time 3.Recognize patient needs and fears 4.Contact the physician so consent can be obtained from the family.

3

When the nurse is dealing with a patient who is grieving, she must understand grief that is helpful or that assists the person in accepting the reality of death is called: 1.Dysfunctional grief 2.Unresolved grief 3.Adaptive grief 4.Maladaptive grief

3

You are the nurse on duty in the ED. A patient is brought in that has died. The family states the patient has had no history of medical problems and there is no other apparent reason for death. You know that in this situation: 1.The police must be notified 2.The family may choose to have an autopsy performed 3.An autopsy is required by law, and the coroner or medical examiner must be notified 4.The body must be held at the hospital for 24 hours

3

You are working with a patient in an inpatient hospice unit. To maintain the patient's sense of self worth during the end of life, you should: 1.Leave the patient alone to deal with final affairs 2.Request the patient's spiritual advisor to take over care 3.Plan regular visits throughout the day 4.Have a grief counselor visit

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A newly graduated nurse is assigned to his first dying patient. The nurse is best prepared to care for this patient if he: 1.Has completed a course dealing with death and dying 2.Is able to control his own emotions about death 3.Has experienced the death of a loved one 4.Has developed a personal understanding of his own feelings about death

4

During the death process, you should understand that it is believed that the last sense to remain intact 1.Touch 2.Sight 3.Smell 4.Hearing

4

The nurse is discussing future treatments with a patient who has a terminal illness. The nurse notes that the patient has not been eating and then responds to the nurse's information by saying, "What does it matter?" The most appropriate nursing diagnosis for this patient is: 1.Social isolation 2.Spiritual distress 3.Denial 4.Hopelessness

4

The nurse is preparing to assist the patient in the end stage of her life. To provide comfort for the patient in response to anticipated symptom development, the nurse plans to: 1.Decrease the patient's fluid intake 2.Limit the use of analgesics 3.Provide larger meals with more seasoning 4.Determine valued activities and schedule rest periods

4

The nurse recognizes that anticipatory grieving can be most beneficial to a patient or family because it can: 1.Be done in private 2.Be discussed with others 3.Promote separation of the ill patient from the family 4.Help a person progress to a healthier emotional state

4

Which of the following is the primary concern of the nurse when providing care to a dying patient? The nurse should: 1.Promote optimism in the patient and be a source of encouragement 2.Intervene in the patient's activities of daily living and promote as near normal functions as possible 3.Allow the patient to be alone and expect isolation on the part of the dying person 4.Promote dignity and self esteem in as many interventions as possible

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