Prep U Grief and loss

The admissions department at a local hospital is registering a 78-year-old client for an outpatient diagnostic test. The admissions nurse asks if the client has an advance directive. The client reports not wanting to complete an advance directive because they do not want anyone controlling their finances. What would be appropriate information for the nurse to share with this client?

"Advance directives are limited only to health care instructions and directives."

A nurse has been present for the hospital death of a Muslim client who was surrounded by family members when the client passed. The nurse demonstrates appropriate cultural considerations when stating:

"Are there any rituals you will observe here for your loved one?"

A nurse is caring for a client who is terminally ill and is inquiring about physician-assisted suicide. Which statement if made by the nurse would correctly inform the client of this practice?

"The health care provider provides the means for the clients to take their life."

A nurse is caring for a terminally ill client who is receiving chemotherapy and radiation for an aggressive lung cancer. The treatment success is limited in shrinking the tumor, and the treatments are making the client very ill. The client states, "I feel that I would like to stop treatments. I would like to enjoy the time that I have remaining with my family." Which emotional reaction does the nurse recognize that the client is experiencing?

acceptance

The nurse is aware that clients in the initial stages of a terminal diagnosis may present with which behavior?

asking for other medical opinions

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

aspiration

A nurse is caring for a client with terminal cancer. The client states, "If I promise to change my bad habits, the cancer will go away." The nurse knows that this statement is an example of which of Kubler-Ross's stages of grief?

bargaining

To adequately assist a client and family from a different culture with the death and dying process, the nurse should:

be aware of the client's cultural beliefs.

Which clinical signs would indicate to a nurse caring for a terminally ill client that death may be imminent?

diminished urine output and Cheyne-Stokes respirations

A patient with chronic obstructive pulmonary disease has asked an adult child to make medical decisions in the event the patient will not be able to make them. What type of advance directive should the patient sign?

durable POA for health care

A seriously ill client asks the nurse "Am I dying?" What is the best response the nurse can give to enhance therapeutic communication with this client?

"This must be very difficult for you. What is on your mind?"

A client on the palliative unit discusses treatment with the nurse. The client wants to refuse further chemotherapy and request pain management strategies only. What is the appropriate action by the nurse in relation to the client's requests?

Acknowledge the client's right to make the choices regarding treatment.

A nurse is most likely to experience ethical distress in which client situation?

Continuing intravenous fluids for a client who wants to die

The hospice nurse is caring for a group of clients with terminal illness. Which is the highest care priority for a client in the process of dying?

Pain management

A client on the medical unit is dying and the nurse has determined that the family's psychosocial needs during the dying process need to be addressed. What is a cause of many client care dilemmas at the end of life?

Poor communication between the family and the care team

The hospice nurse is assigned to care for a patient with metastatic bone cancer who wants to remain at home. What is the therapeutic goal in the care of this patient?

Relieve pain and discomfort while promoting quality of life.

A nurse is caring for a Jewish client with a terminal illness who is on a ventilator. The spouse of the client intends to stay near the client when the ventilator is removed. What is the reason for such a request, according to the Jewish culture? Choose the best answer.

The soul of the deceased should not be alone while leaving the body.

A 60-year-old client who has been fighting cancer for more than 20 years has just been diagnosed with metastases to the brain. The client finds it difficult to get out of bed in the morning, has no interest in eating, and no longer finds fulfillment in favorite hobbies. Within which emotional reaction is the client functioning?

depression

Which intervention should a nurse perform during the grieving period when caring for a dying client?

Avoiding criticizing or giving advice

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

Ask the family members about spiritual care.

The nurse should explain to the client's family member that a comfort-measures-only order is being implemented to obtain which expected outcome?

a comfortable, dignified death for the client

A client with a terminal illness has feelings of rage toward the nurse. According to Kubler-Ross, the client is in which stage of dying?

anger

A client is diagnosed with a terminal illness and has been given less than 6 months to live. What type of referral should the nurse make to assist this patient and family at home?

hospice

Which culture believes that leaving the body alone after death is disrespectful?

orthodox jewish americans

The client just received a diagnosis of end-stage renal disease. After hearing options, the client visited a lawyer and documented what treatment is to be held in the event that the client is unable to make decisions. The nurse asks for a copy of this document for the chart. The name of this document is:

living will