Question 1

The plan of care for a client in hospice care should include:

Accepted Answer

Control of symptoms is a key component of hospice care, as it helps to improve the client's quality of life.

Question 2

The nurse is using the Karnofsky Performance Scale to determine the performance status of a client in palliative care with end-stage lung cancer. With a score of 50, what activity level should the nurse anticipate?

Accepted Answer

A score of 50 on the Karnofsky Performance Scale indicates that the patient requires considerable assistance with activities of daily living and frequent medical care.

Question 3

Which of the following pain medication orders for a client with ovarian cancer would be most appropriate for the nurse to use to control a client's chronic pain?

Accepted Answer

Long-acting pain medication administered around the clock is most appropriate for managing chronic pain, as it provides consistent pain control and prevents pain from becoming severe.

Question 4

The nurse is caring for a client in palliative care who is alert and oriented to person, place, and time. Which assessment data would be most appropriate in determining the client's need for pain medication?

Accepted Answer

The most appropriate way to assess pain in a client who is alert and oriented is to ask them directly to rate their pain, as pain is a subjective experience.

Question 5

What is the best way for the nurse to determine if a client is experiencing dyspnea?

Accepted Answer

Obtaining subjective data from the client is the best way to determine if they are experiencing dyspnea, as it involves directly asking the client about their breathing difficulties and symptoms.

Question 6

Which nursing intervention would be a priority in managing dyspnea in the hospice client?

Accepted Answer

The answer of Which nursing intervention would be a priority...

Question 7

Which action by the spouse of a hospice client indicates understanding of the nurse's teaching plan for reducing dyspnea?

Accepted Answer

Using a fan near the client's face can help reduce the sensation of dyspnea by increasing air circulation and providing a cooling effect, which can be comforting for the client.

Question 8

At the time of death, which finding is the nurse most likely to assess?

Accepted Answer

At the time of death, the most immediate and definitive sign is the lack of heartbeat. Other signs like rigor mortis and livor mortis develop after some time, and body temperature equalizing with room temperature occurs later.

Question 9

The nursing care plan for a client in hospice who is experiencing daytime coughing due to excessive accumulated secretions should include:

Accepted Answer

Chest physiotherapy can help mobilize and clear secretions, providing relief from coughing due to accumulated secretions.

Question 10

The daughter of a client, who is at the end of life, is concerned that the gurgling sound she hears is her father drowning in his own secretions. What is the best initial response by the nurse?

Accepted Answer

The nurse should first provide reassurance to the daughter by explaining that the gurgling sound, often referred to as the "death rattle," is common and not necessarily indicative of suffering.

Question 11

A client at the end of life has an antimuscarinic medication ordered for secretion management. When is the ideal time for the nurse administer this medication?

Accepted Answer

The answer of A client at the end of life...

Question 12

The nurse would expect to assess which metabolic condition in the client at the end of life who is vomiting?

Accepted Answer

Vomiting leads to a loss of stomach acid, which can result in metabolic alkalosis due to the decrease in hydrogen ion concentration.

Question 13

What suggestions should the nurse give the family of a client with end-stage cancer who is experiencing nausea and vomiting?

Accepted Answer

Encourage ingestion of foods that appeal to the client.

Question 14

How should the nurse respond when the son of an end-stage cancer patient tells the nurse that his "dad is refusing to eat" and he fears that his father has "given up hope"?

Accepted Answer

In end-stage cancer, loss of appetite and reduced food intake are common and can be part of the natural dying process. The nurse should reassure the son that this is a normal part of the progression and focus on comfort measures.

Question 15

A client in the terminal phase of dying reports feeling very tired and no longer wants to get out of bed and engage with family. What is the best response for the nurse to make to the family?

Accepted Answer

It is important to respect the wishes of a terminally ill patient and provide comfort. Pressuring them to engage can cause distress. Being present and supportive without pressure is the most compassionate approach.

Question 16

When starting a terminal client on an opioid for pain control, which action should be included in the plan of care?

Accepted Answer

Opioids often cause constipation as a side effect, so administering a daily laxative can help prevent or manage this issue.

Question 17

An alert and oriented female client in early hospice care is experiencing urinary incontinence. Which is the most appropriate initial intervention for this client?

Accepted Answer

Establishing a voiding schedule is a non-invasive and supportive initial intervention that can help manage urinary incontinence by promoting regular bathroom use and reducing accidents.

Question 18

The nurse is assessing a hospice client who has had changes in cognition due to delirium. Using the Confusion Assessment Method, what would the nurse expect to find?

Accepted Answer

Delirium is characterized by an acute and fluctuating change in mental status, including attention and cognition, which can vary in severity throughout the day.

Question 19

What action should the nurse take when a home hospice client exhibits Cheyne-Stokes breathing?

Accepted Answer

Cheyne-Stokes breathing is a pattern of breathing that often occurs near the end of life, indicating that death may be imminent. The nurse should prepare the family for this possibility.

Question 20

Which is the best way for the nurse to assess pain in the neonate?

Accepted Answer

The CRIES scale is specifically designed to assess pain in neonates by evaluating behavioral and physiological indicators, making it the most appropriate tool for this age group.

Quiz 53: Pathophysiology at the End of Life