Deck 10: Loss, Grief, and Dying

Question 1

The nurse provides care to a terminally ill patient.The patient's family asks the nurse what should be expected during the dying process.Which response by the nurse is accurate and appropriate?

A)"Everybody is different, so it is difficult to say."
B)"Your loved one's heart will stop, and then breathing stops a few minutes later."
C)"Respirations and heart rate first become very irregular and then stop altogether."
D)"Breathing will stop, and then the heart will cease beating within a few minutes."

Answer 1

"Breathing will stop, and then the heart will cease beating within a few minutes."

Question 2

The nurse provides care to a patient who experiences dyspnea.The patient states, "I don't want to take any more medication." Which nonpharmacological intervention does the nurse implement for this patient?

A)Implementing music therapy
B)Giving the patient small sips of warm water
C)Putting a fan near the bed to circulate the air
D)Providing additional movement and range-of-motion exercises

Answer 2

Putting a fan near the bed to circulate the air

Question 3

The nurse provides care to a patient who is actively dying.When planning care for this patient and the family, the nurse prioritizes interventions to address which physical change associated with the dying process to ease the family's anxiety?

A)Pallor and circumoral cyanosis
B)Restlessness and difficulty in sleeping
C)Accumulation of secretions in the trachea
D)Conjunctival dryness that causes tearing of the eyes

Answer 3

Accumulation of secretions in the trachea

Question 4

The nurse provides care to a patient who has a written document containing medical decisions should the patient be unable to make them as the illness progresses.Which end-of-life documentation does the patient have based on the current information?

A)Living will
B)Terminal illness
C)Durable power of attorney (DPR)
D)Do-not-resuscitate (DNR)prescription

Question 5

The nurse witnesses a terminally ill patient telling the health-care provider, "I don't want my life prolonged, as stated in my living will." Which action does the nurse anticipate from the health-care provider based on the patient's statement?

A)The provider will ignore the patient's request.
B)The provider will write a do-not-resuscitate (DNR)prescription.
C)The provider will explain to the patient the importance of positive thinking.
D)The provider will speak to the patient's family before writing a DNR prescription.

Question 6

The nurse provides care to a patient who has died.Which action does the nurse implement when preforming postmortem care?

A)Document the time when the patient stopped breathing and the heart ceased.
B)Insist that the family bathe the patient so they can begin the grieving process.
C)Bathe the patient's body and remove all tubes, unless an autopsy is prescribed.
D)Notifying the health-care provider so that the patient will be legally pronounced dead.

Question 7

The nurse provides care to a patient who is prescribed palliative care.The patient asks, "What is the difference between hospice care and palliative care?" Which does the nurse include in the response to the patient regarding palliative care?

A)It is aggressive but administered to cure the disease.
B)It is geared toward the patient, family, and their wishes.
C)It indicates the patient has fewer than six months to live.
D)It may be aggressive and is directed at eliminating discomfort.

Question 8

A terminally ill patient refuses to take adequate pain medication.The patient expresses worry that the use of pain medication may result in addiction.Which response by the nurse is appropriate?

A)Express admiration for the patient's strength.
B)Place the medication in an IV drip.
C)Explain to the patient that morphine does not cause addiction.
D)Teach the patient that addiction is not a concern during the terminal stages of illness.

Question 9

The nurse provides care to a patient who is terminally ill.Which nursing action is the priority when providing care to this patient at the end of life?

A)Touching the patient to show caring
B)Giving the patient prescribed pain medication
C)Encouraging the patient to reminisce about life
D)Encouraging visits from a member of the clergy

Question 10

The nurse provides care to a terminally ill patient.Which patient response indicates to the nurse a readiness to talk about dying?

A)"What do you think death feels like?"
B)"I'm feeling a little stronger each day."
C)"I've decided to begin taking chemotherapy again."
D)"Do you think you could just sit with me for a while?"

Question 11

The nurse provides care for a patient who is actively dying.The patient's spouse tells the nurse, "I am worried that my husband is not getting enough fluids." Which response by the nurse is appropriate?

A)"Your husband will drink when he gets thirsty.Don't worry about him."
B)"Your husband signed a living will indicating he doesn't want to be given food and water."
C)"I will let the doctor know about your concern.Your husband may need an IV to keep him hydrated."
D)"It is natural to become dehydrated before death.It will actually make him more comfortable."

Question 12

The nurse provides care to a patient who is dying of colon cancer who states, "I know I can beat this cancer if I just change the things that I eat." Based on Kübler-Ross' stages of grief, which stage does the nurse document in the medical record that the patient is experiencing?

A)Anger
B)Denial
C)Bargaining
D)Acceptance

Question 13

A patient's daughter approaches a nurse to explain that upon the death of a male, female nurses should not touch the body.The family also asks that the body remain completely covered with the feet turned toward Mecca.Based on the family's request, the nurse concludes that the family identifies with which faith?

A)Jewish
B)Muslim
C)Buddhist
D)Orthodox

Question 14

The nurse reinforces education to a terminally ill patient and family regarding the senses.Which statement by a family member indicates correct understanding of the information presented?

A)"My loved one will retain the ability to see until the very end."
B)"My loved one's taste will not be affected by the dying process."
C)"My loved one's ability to hear is the last sense to go at end of life."
D)"My loved one will not be able to smell once the dying process begins."

Question 15

The nurse reinforces education for the family of a terminally ill patient.When discussing respite care with the family, which statement by a family member indicates correct understanding of the information?

A)"Respite care means you will treat my family member for pain."
B)"Respite care means my family member will be given a medication to assist with death."
C)"Respite care means that when my spouse stops breathing no resuscitation will be implemented."
D)"Respite care means that I will be given an opportunity to have time away from my spouse without worrying about his care."

Question 16

The spouse of a dying patient states to the nurse, "I believe remorse for the dead leads to more suffering of the soul and will increase the soul's difficulty in leaving the earthly plane.I prefer to think only happy thoughts to facilitate the journey." Which culture does the nurse identify for the couple based on the spouse's statement?

A)Jewish
B)Hindu
C)Amish
D)Hispanic American

Question 17

When providing care to a patient diagnosed with a terminal illness, which traditional first stage of grief does the nurse not anticipate the patient will exhibit?

A)Bargaining
B)Anger
C)Denial
D)Depression

Question 18

The nurse provides care to a terminal patient who states, "I don't need anything from you.Leave me alone!" Based on this information, the nurse documents that the patient is likely experiencing which stage of grief?

A)Anger
B)Denial
C)Bargaining
D)Acceptance

Question 19

The nurse provides care to a patient who is actively dying.The patient's spouse is upset about her husband's respirations.Which response by the nurse is appropriate when providing education to the spouse about Cheyne-Stokes respirations?

A)"As your husband approaches end of life, breathing becomes slow and deep."
B)"As your husband approaches end of life, breathing becomes slow and shallow."
C)"As your husband approaches end of life, breathing causes cyanosis of the hands and feet."
D)"As your husband approaches end of life, breathing will be a cycle of shallow and deep respirations."

Question 20

The nurse provides care to a terminally ill patient.Upon entering the patient's room, the nurse notes the patient is not breathing.The patient does not have a do-not-resuscitate (DNR)prescription.Which action does the nurse implement based on the current data?

A)Ask another nurse to write a DNR prescription.
B)Notify the selected funeral home that the patient has expired.
C)Call the health-care provider to get a verbal DNR prescription.
D)Begin cardiopulmonary resuscitation (CPR)because a DNR prescription is not written.

Question 21

The nurse provides care to a terminally ill patient who has barely eaten anything for several days.Which nursing action is appropriate for this patient?

A)Place the patient on IV nutrition.
B)Ask the health-care provider to insert a feeding tube for the patient.
C)Insist that the patient eat something at least three to four times a day.
D)Encourage the patient to eat whatever foods he or she thinks sound and look appealing.

Question 22

An older adult patient becomes progressively more confused.The patient begins talking to long-gone loved ones about places and events that do not make any sense to the family.Which is the priority nursing action based on the current information?

A)Hydrate the patient.
B)Attempt to reorient the patient.
C)Verify the patient's level of consciousness.
D)Protect the patient from injury by bed rails or equipment.

Question 23

When asked by family members of a terminally ill patient what benefit their loved one would experience as a result of dehydration, a nurse explains that which of the following is true? Select all that apply.

A)Gastric fluid excretions increase so as to lessen nausea.
B)Dehydration will contribute to less edema and discomfort from ascites.
C)Urinary output decreases, which results in less discomfort from toileting.
D)Mucous secretions increase and provide comfort to the mouth and throat.
E)Dehydration increases endorphin production and decreases perception of pain.

Question 24

The nurse prepares to perform postmortem care on a patient who passed away.Which step does the nurse implement for safety during this procedure?

A)Donning gloves
B)Respecting cultural beliefs
C)Closing the door to the room
D)Determining if family members want to participate

Question 25

The nurse provides care to a terminal patient who is approaching end of life.Which information does the nurse reinforce with the family members as indicating death is very near? Select all that apply.

A)Nonresponsiveness
B)Slow and thready pulse
C)Mottling of feet and legs
D)Edema of lower extremity
E)Agitation and withdrawal