Question 1

The nurse recognizes the client's death is impending when which assessment finding is noted?&#10;A)Extremities appear mottled and cyanotic&#10;B)Client requests a meeting with spiritual counselor&#10;C)Heart rate and blood pressure increases&#10;D)Increased appetite&#10;

Accepted Answer

Mottling and cyanosis of the extremities are signs of reduced blood flow, which indicates that the client's organs are shutting down and death is imminent.

Question 2

The nurse is providing care for a client with terminal breast cancer.The client's children ask if their mother will exhibit any signs and symptoms prior to death.When responding to the family,which statements regarding the expected clinical manifestations of impending death will the nurse include?

A)"Your mother's jaw may sag."
B)"Your mother may have difficulty speaking."
C)"Your mother may have trouble swallowing."
D)"Your mother may feel hot to the touch."
E)"Your mother may begin to breathe only through her nose."

"Your mother's jaw may sag."
"Your mother may have difficulty speaking."
"Your mother may have trouble swallowing."

Accepted Answer

Signs of impending death often include a sagging jaw due to muscle relaxation, difficulty speaking, and trouble swallowing due to weakening of muscles and decreased reflexes. These are common as the body's systems begin to shut down.

Question 3

Which is not the nurse's role when working with families of dying clients?&#10;A)Providing financial support&#10;B)Providing emotional support&#10;C)Assisting with connecting families with available resources&#10;D)Assessing families' coping and grieving process&#10;

Accepted Answer

Providing financial support is not within the nurse's role. The other options are within the nurse's responsibilities when working with families of dying clients.

Question 4

The nurse is providing care to a client who is diagnosed with a terminal illness.When meeting the physiological needs of this dying client,which items will the nurse include in the assessment process?&#10;A)Determine if the client has advance directives.&#10;B)Determine if the client is experiencing any physiological signs of impending death.&#10;C)Ask questions to determine ways to support the client and family.&#10;D)Ask the family if they want to view the body after death.&#10;E)Provide adequate pain control.&#10;

Accepted Answer

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

Question 5

The nurse is caring for a client diagnosed with a terminal illness and experiencing a great deal of pain.After administration of IV analgesia,the client continues to complain of severe pain.Which action by the nurse is the most appropriate in this situation?

A)Explain to the client the need to wait for further medication to prevent overdosage complications.
B)Ask the family to help divert the client from the discomfort.
C)Call the health care provider,if necessary,to request an order for additional analgesia.
D)Wait an hour for the medication to take effect.

Accepted Answer

If the client's pain is not relieved after initial analgesia, it is appropriate for the nurse to contact the health care provider for additional orders. Waiting for the medication to take effect or diverting the client's attention will not address their pain. Explaining the need to wait can also be perceived as dismissive of the client's needs.

Question 6

The nurse is caring for a client who has just died.When performing postmortem care,which nursing actions are appropriate for this client?&#10;A)Positing the client in a supine position&#10;B)Placing the client's arms crossed over the chest&#10;C)Closing the client's eyes&#10;D)Inserting the client's dentures in the mouth&#10;E)Pulling the top linens to the client's shoulder.&#10;

Accepted Answer

The answer of The nurse is caring for a client...

Question 7

When delegating postmortem care to unlicensed assistive personnel (UAP),it is essential that the nurse inform the UAP of which piece of information?&#10;A)The tubes or other medical devices to be left in place&#10;B)The disposition of the body after postmortem care is completed&#10;C)The method to contact the family&#10;D)The information to be documented in the medical record&#10;

Accepted Answer

It is important for the nurse to inform the UAP which tubes or medical devices should be left in place after the patient has passed away. This is because the removal of certain medical devices may be traumatic for both the patient and the family. Additionally, leaving certain devices in place may be necessary for postmortem examinations or organ donation purposes. Informing the UAP of this important piece of information will ensure that postmortem care is provided in a compassionate and respectful manner.

Question 8

The nurse is providing postmortem care,and elevates the client's head in order to avoid discoloration of the face secondary to which process?&#10;A)Rigor mortis&#10;B)Livor mortis&#10;C)Algor mortis&#10;D)Post mortis&#10;

Accepted Answer

Livor mortis is the settling of blood in the body after death, resulting in discoloration of the skin. Elevating the head can help prevent or minimize this discoloration. Rigor mortis is the stiffening of the body after death, algor mortis is the cooling of the body after death, and post mortis is not a recognized medical term.

Question 9

The client is maintained on mechanical ventilation,but is found to have irreversible destruction of the cerebral cortex.When documenting this client's condition,which term will the nurse use?&#10;A)Heart-lung death&#10;B)Higher brain death&#10;C)A persistent vegetative state&#10;D)Death&#10;

Accepted Answer

The irreversible destruction of the cerebral cortex is indicative of higher brain death, which is a form of brain death. A persistent vegetative state is a condition where the client has brainstem function but not higher brain function, and heart-lung death refers to the cessation of cardiac and respiratory function as a sign of death. Death is a broad term that can refer to either brain death or heart-lung death.

Question 10

Immediately after a client dies,who is the nurse responsible for notifying?&#10;A)Family&#10;B)Primary care provider&#10;C)Funeral home&#10;D)Coroner,if indicated&#10;

Accepted Answer

The nurse is responsible for notifying the primary care provider immediately after a client dies. The provider will then confirm the death and may provide further instructions regarding notifying the family, funeral home, or coroner if necessary.

Deck 34: End-Of-Life Care