Deck 24: Loss, death, and End-Of-Life Care

Question 1

The nurse understands that "chemical code only" means in the event the patient suffers respiratory or cardiac arrest,the physician will:

A) Use medications for resuscitation without CPR.
B) Use medications and CPR.
C) Use CPR only.
D) Use no means of resuscitation.

Answer 1

Use medications for resuscitation without CPR.

Question 2

The patient who is terminally ill asks the nurse what is meant by a medical power of attorney.The nurse's best response would be that it is a written document that:

A) "Allows another person to manage your financial affairs."
B) "Allows the physician to make any medical decisions that need to be made for you."
C) "Says you have given up all rights to make medical decisions for yourself."
D) "Allows you to select someone to make health care decisions for you only if you are unable to do so for yourself."

Answer 2

"Allows you to select someone to make health care decisions for you only if you are unable to do so for yourself."

Question 3

The nurse is on duty in the emergency department when a patient is brought in who has died almost immediately after admission.The family states that the patient has had no history of medical problems and that no apparent reason for death is known.The nurse knows that in this situation:

A) The police must be notified.
B) The family may choose to have an autopsy performed.
C) An autopsy is required by law, and the coroner or medical examiner must be notified.
D) The body must be held at the hospital for 24 hours.

Answer 3

An autopsy is required by law, and the coroner or medical examiner must be notified.

Question 4

During the death process,the nurse explains that it is believed that the last sense to remain intact is:

A) Touch
B) Sight
C) Smell
D) Hearing

Question 5

The nurse is assessing a patient who is terminally ill for clinical signs of impending death.When assessing the patient's respirations,the nurse would expect:

A) Deep, clear breath sounds
B) Noisy, wet-sounding respirations
C) Even, unlabored respirations
D) Shallow, clear breath sounds

Question 6

While the nurse bathes the patient,he says,"Why are you giving me a bath? I'm going to die no matter what." The nurse's most appropriate response would be:

A) "A bath will make you feel better."
B) "Would you like to talk about how you are feeling?"
C) "Don't you want your bath today?"
D) "I can give you some medicine to make you feel better."

Question 7

The nurse is preparing a patient's body after death and discovers the patient's dentures were not in his mouth before death.The nurse should:

A) Insert them gently into the mouth.
B) Give them to the family.
C) Throw them away.
D) Send them to waste management to be disposed of properly.

Question 8

After the death of a patient,the nurse should position the body:

A) Prone
B) Supine
C) On the side
D) In Fowler position

Question 9

The patient who is terminally ill has asked the nurse if he can request that cardiopulmonary resuscitation (CPR)not be used in the event he suffers respiratory or cardiac arrest.The nurse's best response would be:

A) "The physician is the only one that can make that decision."
B) "I will be glad to get you some information on advance directives, which are written statements of a person's wishes regarding medical care."
C) "Yes, you can make that decision; I will tell all the nurses."
D) "Your family will have to make the decision."

Question 10

According to Strauss and Glaser,three states of awareness of terminal illness have been identified.The nurse cautions the family that they should be aware that these states include:

A) Denial, anger, and depression
B) Shock, yearning, and anguish
C) Avoidance, confrontation, and accommodation
D) Closed awareness, mutual pretense, and open awareness

Question 11

When planning the care of a patient who is terminally ill,the nurse must include the prevention of pain and relief from discomfort.When administering pain medication,the nurse must keep in mind that:

A) Narcotics have the potential for addiction.
B) Pain medication must be given before the pain becomes unbearable.
C) Pain medication should be given no more often than every 6 hours.
D) Narcotics must be given as needed (PRN) only.

Question 12

The patient's family asks the nurse what to expect when the patient dies.The nurse's best response would be that:

A) His heart will stop, and then later he will quit breathing.
B) His respirations will cease first, and then the heart stops beating within a few minutes.
C) His heartbeat and breathing will just stop suddenly, without warning.
D) He will quit breathing first and then it could be several hours before his heart stops.

Question 13

In caring for a dying patient who is grieving,the nurse bases patient care on the theory that grief is helpful and assists the person in accepting the reality of death.This type of grief is called:

A) Dysfunctional
B) Unresolved
C) Adaptive
D) Maladaptive

Question 14

The family of a patient who is showing signs of impending death tells the nurse that they would like for any organs that can be used to be donated.The nurse should:

A) Wait until the patient has died before discussing organ donation with the family.
B) Tell the family that the patient has not signed a consent, so the organs cannot be donated.
C) Check the patient's record to see whether the physician has written an order for the patient to have organs donated.
D) Notify the physician of the family's wishes.

Question 15

The nurse caring for the dying patient should understand the importance of:

A) Frequent, thorough physical assessments
B) Not imposing repeated and unnecessary assessments
C) Current, updated health history from the patient
D) Limiting the amount of visitors allowed

Question 16

When caring for a patient who is terminally ill,the nurse understands that one of the most important interventions is:

A) Touching and listening to the patient.
B) Encouraging the patient to express any regrets.
C) Assessing for signs and symptoms of impending death.
D) Talking to the patient about how other patients have handled the dying process.

Question 17

The nurse is caring for a patient who is terminally ill and an Orthodox Jew who has orders to "Do not resuscitate" (DNR).The patient is alone and is having signs of impending death.The nurse should:

A) Notify the family.
B) Wait until the patient dies, and then notify the family.
C) Transfer the body to the mortuary or the morgue immediately after death.
D) Stay with the patient until death occurs, prepare the body, and then call the family.

Question 18

The wife of the patient who has just died states,"I hate all of you nurses and doctors for letting my husband die." The nurse recognizes this reaction as Martocchio's cluster of:

A) Shock and disbelief
B) Yearning and protest
C) Anguish, disorganization, and despair
D) Identification in bereavement

Question 19

A patient recently diagnosed with inoperable lung cancer tells the nurse,"I am looking forward to seeing my daughter graduate from college in 2 years." The nurse recognizes that,according to Elizabeth Kübler-Ross,this stage of grief is:

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

Question 20

The Omnibus Reconciliation Act of 1990 requires that institutions must provide written information to patients concerning their rights to:

A) Donate organs
B) Accept or refuse treatment
C) Have an autopsy
D) Physician-assisted suicide

Question 21

The nurse takes into consideration that in American society,death is frequently viewed as an event that is:

A) An integral part of life
B) Natural
C) Negative
D) Spiritually positive
E) Unacceptable

Question 22

The nurse outlines to a family that the focus of palliative care is to provide:

A) Care and not cure
B) Service only in the hospital
C) Environment a for pain-free death
D) Psychologic support to the patient
E) Psychologic support to the family

Question 23

The nurse explains that the study and discussion of end-of-life issues have been brought to public awareness because of an increase in death and terminal illnesses of young people with ____________________.

Question 24

According to Rando's phases of grief responses,the patient who is beginning emotional healing and learning to deal with their loss is in the phase of:

A) Avoidance
B) Confrontation
C) Accommodation
D) Depression

Question 25

The document "Five Wishes" helps a dying person communicate to the family his preferences as to:

A) Who should make decisions.
B) What medical treatment will be acceptable.
C) How to distribute assets such as real estate.
D) Degree of comfort desired.
E) How they wish to be treated.

Question 26

A 16-year-old boy who is positive of the human immunodeficiency virus (HIV)confesses to the school nurse that he sneaks out of his home at night and rides his motorcycle at high rates of speed.The nurse recognizes this behavior as:

A) An attempt at manipulation
B) Striving for identity
C) Defiance of impending death
D) A normal teenage prank

Question 27

The nurse counsels a family not to shield their 6-year-old child from the death of his grandfather because children who are protected from the pain of bereavement frequently develop feelings of:

A) Fear
B) Anger
C) Abandonment
D) Blame
E) Inability to express feelings

Question 28

Nurses who have been caring for patients who are terminally ill frequently begin to feel helpless and frustrated.The best action by the nurse would be to:

A) Find another job.
B) Express her feelings to a friend or co-worker.
C) Ignore these feelings, because they will soon be gone.
D) Ask to care for different patients.

Question 29

A dying 10-year-old boy tells the nurse,"I am going to leave and live with my grandpa in heaven." The nurse assesses this statement to show that he is:

A) Fearful of death
B) Accepting his own death based on adult attitudes
C) Experiencing death anxiety
D) Expressing anger

Question 30

When caring for the patient who is experiencing dysfunctional grieving,the nurse's primary goal should be for:

A) Enhancement of self-esteem
B) Resolution of grief
C) Provision of safety measures
D) Prevention of complications

Question 31

The patient who has been diagnosed with a terminal illness is crying when the nurse enters the room.The patient states,"I promised God that I would be a better person if He will just let me get over this disease." The nurse recognizes this as Kübler-Ross's dying stage of:

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

Question 32

The nurse assesses a Protestant ethic in place with a family of a dying patient.Having assessed this,the nurse will plan the care to respect their feelings of:

A) Independence
B) Privacy
C) Open expressions of grief
D) Repression of feelings
E) Toughing it out

Question 33

When the family of a dying person do not discuss the issue of death openly and avoid the subject of dying altogether,the nurse recognizes this behavior representative of the _________stage described by Straus and Glaser.