Question 1

The nurse provides care to a terminally ill patient who is in the late stage of the dying process. Which family member statement indicates an accurate understanding of this stage of the dying process?

Accepted Answer

A

Question 2

Which response by the nurse indicates the use of reflective listening when communicating with the family of a patient who is in the process of dying?

Accepted Answer

Reflective listening involves acknowledging and reflecting back the feelings or emotions that the other person is expressing. Choice A, "I can see this is difficult for you," is an example of reflective listening because it acknowledges the family's feelings of difficulty and distress without imposing judgment or offering unsolicited advice.

Question 3

The nurse is providing care to a patient who is diagnosed with terminal lung cancer. The patient is lying in the supine position with noisy wet respirations noted and is not breathing well. The patient has an advance directive that designates the implementation of comfort measures only. Which action by the nurse is the priority at this time?

Accepted Answer

Repositioning the patient to a lateral position with the head elevated can help improve breathing and reduce noisy respirations, aligning with the comfort measures directive.

Question 4

The nurse is assessing the patient for palliative care. When assessing the physical aspects of care, which should the nurse include?

Accepted Answer

Pain is a physical aspect of care that should be assessed in palliative care to ensure the patient's comfort and quality of life.

Question 5

It is most important for the nurse to provide education regarding hospice services to which patient?

Accepted Answer

The patient with stage 4 liver cancer who is classified as terminal is the most appropriate candidate for hospice services, as hospice care is typically recommended for patients who are considered to be in the terminal phase of their illness, with a life expectancy of six months or less, focusing on comfort and quality of life rather than curative treatments.

Question 6

The nurse is assessing the patient for palliative care. When assessing the cultural domain, which question does the nurse include?

Accepted Answer

Question D, "Do you have any specific dietary preferences that affect your care?" directly addresses the cultural domain by acknowledging that dietary preferences can be influenced by cultural beliefs and practices, which is important in providing culturally sensitive palliative care.

Question 7

The nurse is educating the family of a patient in hospice care who is receiving morphine for pain because of a terminal illness. Which statement by the family member indicates the need for further teaching?

Accepted Answer

The correct statement indicating a need for further teaching is A, as it suggests that pain medications should only be given when requested. In hospice care, it's important to manage symptoms proactively rather than waiting for the patient to request medication, especially since patients may not always be able to communicate their needs effectively. Pain management in hospice care often involves administering medications on a regular schedule to maintain comfort, as well as assessing non-verbal cues for pain.

Question 8

The nurse is educating the family of a patient who is receiving hospice care because of a terminal illness. The nurse instructs the family to administer which medication for this patient if delirium occurs?

Accepted Answer

Haloperidol is commonly used to manage delirium in palliative care settings due to its effectiveness in reducing agitation and confusion without causing significant sedation.

Question 9

The nurse is educating the family of a patient who is receiving hospice care because of a terminal illness. Which medication does the nurse tell the family to administer to treat the patient if hyperactive delirium occurs?

Accepted Answer

Lorazepam is commonly used to treat symptoms of hyperactive delirium in patients receiving hospice care due to its effectiveness in reducing agitation and confusion without causing significant respiratory depression, which is a critical consideration in terminally ill patients.

Question 10

The nurse is providing care to a patient who is approaching death. Which family member statement regarding the physical and psychological changes associated with death is reflective of the middle stage?

Accepted Answer

The answer of The nurse is providing care to a...

Question 11

A competent older adult patient has an advance directive that expresses the patient's desire to avoid resuscitation and heroic life support measures. The patient's family, however, is not supportive of this directive and plans to contest the living will. Which nursing action is appropriate based on the current situation?

Accepted Answer

The appropriate nursing action is to place the advance directive on the patient's medical record to ensure that the patient's wishes are known and can be followed by the healthcare team.

Question 12

Which is a team action that nurses can employ as a stress-reducing strategy?

Accepted Answer

Sending a bereavement card as a team action involves collective participation and can help in coping with the emotional stress related to patient care, fostering a sense of community and shared empathy among the staff.

Question 13

The wife of a patient with end-stage chronic obstructive pulmonary disease (COPD) tells the nurse that she wishes her husband were eligible for hospice care, but she thinks that hospice is only available for cancer patients and would require a change in healthcare providers. Which responses by the nurse are appropriate? Select all that apply.

Accepted Answer

Hospice care is available for patients with a variety of terminal illnesses, not just cancer, and patients can often retain their current healthcare providers when transitioning to hospice care.

Question 14

The nurse is providing care for a patient receiving curative care who is experiencing chronic pain as a result of cancer. Which type of care should the nurse plan for on discharge for this patient?

Accepted Answer

Palliative care is designed to relieve symptoms and improve the quality of life for patients with serious illnesses, such as cancer, regardless of the stage of the disease or the need for other therapies. It focuses on providing relief from the symptoms, pain, and stress of a serious illness, which aligns with the needs of a patient experiencing chronic pain due to cancer.

Question 15

The nurse is caring for a patient with an advance directive that includes the instruction that no invasive measures be implemented. The family and nursing staff do not agree on specific actions, and the patient is nonresponsive. Who can provide the best guidance in this situation?

Accepted Answer

The Ethics committee is best suited to provide guidance in situations where there are disagreements about the care of a nonresponsive patient with specific instructions in their advance directive. They specialize in addressing and resolving ethical issues related to patient care, including conflicts between family wishes and advance directives.

Question 16

The hospice nurse receives a phone call from the family of a patient who is experiencing the late stage of the dying process. Which family member statement indicates the need for additional education regarding the treatment of respiratory issues?

Accepted Answer

Removing extra pillows from behind the patient's head can actually worsen respiratory issues in the late stages of the dying process. Elevating the head helps to ease breathing. Choices A, C, and D are appropriate measures for managing respiratory symptoms in a hospice setting.

Question 17

Which concept exemplifies a well-managed death experience for a patient with a terminal diagnosis and the patient's family members?

Accepted Answer

Preparing the patient and the family for the process of dying is a key aspect of a well-managed death experience. It involves open communication, emotional support, and ensuring that the patient's and family's needs and wishes are respected and met during the end-of-life care. This approach helps in reducing fear, anxiety, and uncertainty, making the experience as peaceful and meaningful as possible for everyone involved.

Question 18

The nurse is assessing the patient for palliative care. When assessing the psychosocial and psychiatric domain, which should the nurse include?

Accepted Answer

The answer of The nurse is assessing the patient for...

Question 19

The nurse is assessing the patient for palliative care. When assessing the social domain, which should the nurse include?

Accepted Answer

Financial concerns are part of the social domain in palliative care, as they relate to the patient's social situation and support systems.

Question 20

The nurse is providing care to a patient who is approaching death. Which family member statement regarding the physical and psychological changes associated with death is reflective of this late stage?

Accepted Answer