NCLEX - PN End - of - Life - Care

A client who was struck by a car while jogging is brought to the emergency department by emergency medical services. The client is unconscious, and a ruptured spleen is suspected. Emergency measures are instituted but are unsuccessful. The client's fiancé is with the client and tells the nurse that the client is an organ donor. In anticipation that the client's eyes will be donated, which should the nurse implement?

Close the deceased client's eyes and place gauze and a small ice pack on the eyes.

A client has a terminal illness, and her spouse is distraught about the unrelenting pain she experiences. Which should the nurse implement as the most effective measures to alleviate the spouse's distress? Select all that apply.

Convey respect for the couple's wishes. Maintain a presence to answer questions. Encourage the spouse and client to hold hands.

The nurse is preparing to care for a dying client and several family members are at the client's bedside. Which therapeutic techniques should the nurse use when communicating with the family? Select all that apply.

Encourage expression of feelings, concerns, and fears. Extend touch, and hold the client or family member's hand if appropriate. Be honest and truthful, and let the client and family know that you will not abandon them.

The nurse is preparing to care for a dying client and several family members are at the client's bedside. Which therapeutic techniques should the nurse use when communicating with the family? Select all that apply.

Encourage expression of feelings, concerns, and fears. Explain everything that is happening to all family members. Touch and hold the client's or family member's hand if appropriate. Be honest and let the client and family know that they will not be abandoned by the nurse.

A client's spouse becomes distraught when thinking about his wife's terminal prognosis. Which action should the nurse implement to promote hope for the spouse?

Encourage formation of achievable goals.

The nurse is participating in a care plan session for a client with a terminal illness. Which nursing actions should be included? Select all that apply.

Follow standard care plans for end-of-life care. Respond to requests from the client and family promptly. Support the client's decision-making in order to promote client control. Provide information about what to expect during the dying process to the client and family.

A 39-year-old man learned today that his 36-year-old wife has an incurable cancer and is expected to live not more than a few weeks. The nurse identifies which responses by the husband as indicative of effective individual coping? Select all that apply.

He expresses his anger at God and the primary health care providers for allowing this to happen. He tells the nurse he has prayed that God will allow his wife to live long enough to watch their children's high school graduation. .He has asked his wife and children to assist him in making funeral arrangements, such as casket selection and cemetery burial sites.

The nurse is caring for a client at the end of life. Which late cardiovascular and respiratory findings should the nurse expect to note while collecting data? Select all that apply.

Irregular heart rate Decreased pulse rate Decreased blood pressure Irregular breathing patterns

The nurse is caring for an older client who is terminally ill. Which signs indicate to the nurse that death may be imminent?

Irregular, noisy breathing and cold, clammy skin

The nurse is caring for a client with terminal cancer who is close to death. In reviewing the plan of care, the nurse determines that which action is a priority?

Maintain the client's dignity and self-esteem, and make the client as comfortable as possible.

The nurse is caring for a client at the end of life. Which gastrointestinal findings indicate that death is approaching? Select all that apply.

Nausea Incontinence Accumulation of gas Abdominal distention

A client and her husband are being discharged from the hospital after delivering a stillborn infant. They ask about the possibility of attending a bereavement support group in the community. The nurse realizes this action corresponds to which aspect of grieving?

Normal grieving

The nurse is caring for an 8-year-old child in the late stage of a terminal illness. The child is semiconscious. The nurse notices that the child has a dry mouth and the family believes the child is thirsty. The family is attempting to give the child a large glass of apple juice. Which actions should the nurse take? Select all that apply.

Perform frequent oral care with mouth swabs. Encourage the family to participate in oral care as much as desired. Give the child small sips of water or ice chips if alert and requested by the child.

A licensed practical nurse (LPN) is providing instructions to an unlicensed assistive personnel (UAP) who is preparing to care for a deceased client whose eyes will be donated. The nurse intervenes if the UAP performs which action?

Places a dry sterile dressing over the open eyes

The nurse is caring for a client at the end of life. The client is withdrawn and agitated and is experiencing visual hallucinations. Which actions should the nurse take to provide end-of-life psychological care? Select all that apply.

Provide privacy to the client and family. Encourage the family to talk with and reassure the client. Encourage visits by appropriate spiritual services as desired.

A client has died, and the nurse asks a family member about the funeral arrangements. The family member refuses to discuss the issue. Which is the appropriate nursing action?

Remain with the family member without discussing funeral arrangements.

The nurse is working with a new nurse employee in a hospice agency. The nurse recognizes the new employee needs further assistance in facilitating effective communication between a client and the family if the new nurse employee performs which action?

The new nurse employee makes decisions for the client and family in order to relieve them of unnecessary demands.

The nurse is caring for a client who has just died. Which end-of-life information needs to be documented in the client's medical record? Select all that apply.

Time and date of death Time of body transfer and destination Medical tubes, devices, or lines left in the body Name of primary health care provider certifying death

The nurse is caring for a client at the end of life. Which skin changes would the nurse expect to note? Select all that apply.

Waxlike texture Mottling of arms, legs, hands, and feet Cyanosis of the nose, nail beds, and knees