Question 1

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:

Accepted Answer

Dentures may be inserted gently to maintain the normal facial appearance.If the dentures cannot be inserted easily,do not force them.

Question 2

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:

Accepted Answer

Strauss and Glaser have identified three states of awareness: (1)closed awareness,(2)mutual pretense,and (3)open awareness.

Question 3

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:

Accepted Answer

The physician should be notified immediately because some tissues must be harvested within hours after death.The decision to donate orgAnswer may be made by the patient or immediate family.

Question 4

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:

Accepted Answer

Pain control must be consistent to provide constant relief rather than wait until the pain is unbearable and then try to relieve it.Addiction to narcotics is of little concern.

Question 5

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:

Accepted Answer

Written information concerning a patient's rights to accept or refuse treatment must be provided to the patient.Advance directives are written statements of a person's wishes regarding medical care.

Question 6

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:

Accepted Answer

Only designated Orthodox Jewish persons or a Jewish burial service may care for the body.The dying person is not left alone.The body is not left alone between death and burial,which must occur within 24 hours.The body is not to be touched for up to 30 minutes after death.

Question 7

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

Accepted Answer

The simple presence of someone provides support and comfort.Neither words nor actions are necessary unless the patient requires something.Holding hands,touching,and listening are quality nursing responses.

Question 8

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:

Accepted Answer

A medical power of attorney allows someone other than the patient to make medical decisions for the patient only if the person is incapable of making decisions as certified by the physician.

Question 9

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

Accepted Answer

Hearing is commonly believed to be the last sense to remain intact during the death process.

Question 10

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

Accepted Answer

The body should be placed in the supine position,with the arms at the sides or with the hands across the abdomen.

Question 11

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:

Accepted Answer

Under law,in most states,an autopsy is required if a person expires by suicide,homicide,within 24 hours of admission to a health care facility,or from unknown causes.

Question 12

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:

Accepted Answer

Adaptive grief assists the person in accepting the reality of death.

Question 13

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:

Accepted Answer

Kübler-Ross identifies denial as the person refusing to acknowledge the impending loss.

Question 14

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:

Accepted Answer

Martocchio's clusters of grief identify yearning and protest as anger directed toward God,health care providers,and survivors,as well as toward even the deceased for dying.

Question 15

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:

Accepted Answer

Breathing may sound wet and noisy.Noisy,wet-sounding respirations,termed the death rattle,are a response based on mouth breathing and accumulation of mucus in the upper airways.

Question 16

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

Accepted Answer

A chemical code involves the use of medications for resuscitation without the use of CPR.

Question 17

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

Accepted Answer

Being sensitive and not imposing repeated and unnecessary assessments on the dying patient are important.

Question 18

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

Accepted Answer

The Omnibus Reconciliation Act requires that all institutions that participate with Medicare must provide written information to patients concerning their rights to accept or refuse treatment.

Question 19

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

Accepted Answer

The body gradually relaxes until all functions end.The respirations cease first,and then the heart stops beating within a few minutes.

Question 20

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:

Accepted Answer

Anger is a common and normal response to grief.Therapeutic communication should focus on the patient's feelings.

Quiz 24: Loss,Death,and End-of-Life Care