Question 1

At the time of admission, a patient tells the nurse that his daughter will be allowed to make health-related decisions if he becomes incapacitated. The nurse realizes this patient is describing which of the following?

Accepted Answer

A healthcare surrogate, also known as a healthcare proxy, is a person who is appointed to make healthcare decisions for a patient who is unable to do so. It is a legal document that ensures that the patient's wishes are carried out in case of incapacity.

Question 2

A patient tells the nurse that her husband passed away a year ago and is now beginning to realize that he truly gone. The patient is planning to begin a new job and possibly move to a new community. The nurse realizes that this patient is in which of the following stages of Bowlby's theory of attachment?

Accepted Answer

The patient is in the detachment stage of Bowlby's theory of attachment. This stage is characterized by reorganization and recovery after the loss, where the individual starts to accept the reality of the loss and begins to plan for the future without the deceased, as evidenced by the patient's plans to start a new job and possibly move to a new community.

Question 3

A patient tells the nurse that since his wife died he has not been able to sleep and sees no reason to continue living without her. If using Freud's theory on grief and loss, the nurse realizes this patient is experiencing which of the following?

Accepted Answer

According to Freud's theory of grief and loss, the individual goes through a process of mourning, which includes denial, bargaining, anger, depression, and acceptance. In this scenario, the patient is experiencing symptoms of depression, as he cannot sleep and sees no reason to continue living.

Question 4

A terminally ill patient, without an advance directive or do-not-resuscitate order, stops breathing. Which of the following should the nurse do to assist this patient?

Accepted Answer

CA) Calling a code is appropriate in this situation because, in the absence of an advance directive or do-not-resuscitate order, the default action is to attempt resuscitation to preserve life.C) Contacting the physician to assess the patient for death is also a correct action. After resuscitation efforts, or if they are deemed not feasible or successful, a physician's assessment is necessary to officially determine death.

Question 5

A patient has decided to join a support group for surviving spouses of victims of violent crime. According to Engel's theory of grief and loss, the nurse identifies that this patient is in the stage of which of the following?

Accepted Answer

The stage of restitution in Engel's theory of grief and loss is characterized by the survivor's focus on restoring balance to their life after the loss. Joining a support group would be an example of taking steps towards healing and resuming normal activities.

Question 6

A competent elderly patient has a living will that states to avoid resuscitation and heroic life support measures. The family members are not supportive of this directive. Which of the following actions by the nurse is the most appropriate?

Accepted Answer

The most appropriate action by the nurse is to place the living will document on the patient's chart, as this documents the patient's wishes for end-of-life care. The nurse should also facilitate a conversation between the patient and family members to ensure that the patient's wishes are respected and understood. Contacting social services or notifying the hospital attorney may be necessary in some situations, but placing the document on the chart should be the first step. Explaining to the patient that the conflict could invalidate the document is not appropriate, as the patient has the right to make decisions concerning their own healthcare.

Question 7

A terminally ill patient nearing end of life is dehydrated and complains of being thirsty. Which of the following can the nurse do to assist this patient with comfort during this time?

Accepted Answer

Providing oral care every two hours can help alleviate the sensation of thirst and dry mouth. Increasing fluids through IV or enteral feedings may not be appropriate for a patient nearing end of life, and raising the head of the bed may provide comfort for other symptoms such as difficulty breathing, but it will not address the patient's thirst.

Question 8

A 30-year-old terminally ill patient is concerned about how her 7-year-old child will perceive her death. What advice from the nurse would be most beneficial?

Accepted Answer

The answer of A 30-year-old terminally ill patient is concerned...

Question 9

The brother of a terminally ill patient states, "I'll donate a million dollars to the hospital if they cure my brother." The nurse realizes this statement is indicative of which phase of Kübler-Ross's loss stages?

Accepted Answer

The statement made by the brother is an attempt to bargain with the hospital in exchange for a cure. This is indicative of the bargaining phase in Kübler-Ross's loss stages.

Question 10

While preparing for the discharge of an elderly, terminally ill patient, the family asks for information concerning the most appropriate time to become involved with a hospice agency. Which action by the nurse is most correct?

Accepted Answer

Hospice care is designed to provide support and care for patients in the last phases of incurable disease so that they may live as fully and comfortably as possible. The best time to contact a hospice is at the time of a terminal diagnosis so that the patient and family can be supported throughout the course of the illness, not just at the very end.

Question 11

A terminally ill patient is experiencing dyspnea and tells the nurse that he feels like he is suffocating. Which of the following can the nurse do to assist this patient?

Accepted Answer

The answer of A terminally ill patient is experiencing dyspnea...

Question 12

After an unsuccessful resuscitation attempt, a patient dies. Which of the following should the nurse do first at this time?

Accepted Answer

The nurse should first document the time of death. This is a crucial step in the process of handling a deceased patient and should be done immediately. Once the time of death has been documented, the nurse can then proceed with contacting the physician, notifying the family, and arranging for transport to the morgue. The funeral home does not need to be notified at this point as the family will likely make their own arrangements.

Question 13

A terminally ill patient is demonstrating signs of spiritual distress. Which of the following can the nurse do first to assist this patient?

Accepted Answer

Using the FICA assessment allows the nurse to assess the patient's spiritual beliefs and practices and address any distress related to them. This can guide the nurse in providing appropriate interventions and support for the patient's spiritual needs. Options B, C, and D may be appropriate interventions later on, but it is important to assess the patient's spiritual needs first.

Question 14

A patient with a chronic illness asks the nurse if the new medication is going to cure his disease. Which of the following is the nurse's best response?

Accepted Answer

The nurse should be honest and provide accurate information. It is not appropriate to give false hope or make promises that cannot be kept. The nurse should explain that the new medication will help manage symptoms and improve the patient's quality of life, but it is unlikely to cure the disease.

Question 15

A terminally ill patient is receiving palliative care. The nurse recognizes that the purpose of this type of care is to

Accepted Answer

Palliative care is a type of care that focuses on relieving symptoms and improving quality of life for individuals who have a serious illness or are approaching the end of their life. The goal of palliative care is to alleviate suffering and improve overall quality of life, rather than curing the underlying illness or prolonging life. It involves a holistic approach to care that addresses physical, emotional, and spiritual needs.

Question 16

A terminally ill patient is experiencing secretions pooling in the back of the throat. Which of the following can the nurse do to help this patient feel more comfortable?

Accepted Answer

Raising the head of the bed can help prevent secretions from pooling in the back of the throat, making the patient more comfortable.

Question 17

A patient tells the nurse that her estranged husband died a little over a year ago and states, "I am not sure why this is so difficult, I really couldn't stand him near the end." Which response by the nurse is most appropriate?

Accepted Answer

The nurse's response acknowledges the patient's feelings and offers an explanation for why they might be struggling to grieve. It also opens the door for further discussion and support. The other options may not be as helpful or relevant.

Question 18

A terminally ill patient and family agree that the physician write a do-not-resuscitate order for the patient. The nurse realizes that which of the following should be implemented when following this order?

Accepted Answer

A do-not-resuscitate order (DNR) means that cardiopulmonary resuscitation (CPR) should not be performed if the patient's heart stops beating or if they stop breathing. Therefore, option A is the correct choice. However, it is important to note that withholding food and fluids should not be implemented unless explicitly stated in the DNR order, and providing pain medication is always appropriate regardless of the patient's code status.

Question 19

A patient of American Indian descent is expected to die. The family arrives at the hospital and wants to observe most of their religious and cultural traditions. Which of the following interventions by the nursing staff would be most appropriate?

Accepted Answer

Offering the family a private room allows them to observe their cultural and religious traditions in privacy and comfort, which is respectful and supportive of their needs during this difficult time.

Question 20

A patient asks the nurse what it means to have hospice care at home. Which of the following is the most correct response to this patient?

Accepted Answer

Hospice care is focused on providing comfort and relieving symptoms for patients who have a limited life expectancy. This care is typically provided in the patient's home or a hospice facility rather than in a hospital. The nurse's response that hospice care "makes sure that you are comfortable at home" is the most correct and succinct explanation of hospice care.

Quiz 5: Nursing Care of Patients Experiencing Loss, Grief and Death