Deck 26: Loss,Death,and Dying in Late Life

Question 1

The Oregon State Death with Dignity Law:

A) enables an Oregon resident who is terminally ill and mentally competent to obtain the assistance of a physician for the purpose of a dignified death at a time and manner of his or her choosing.
B) enables an Oregon resident who is terminally ill to appoint another individual to communicate his wishes related to health care in the event that he or she is not able to do so.
C) enables an Oregon resident who is terminally ill to have active euthanasia.
D) has resulted in Oregon residents experiencing a deterioration in end-of-life care.

Answer 1

enables an Oregon resident who is terminally ill and mentally competent to obtain the assistance of a physician for the purpose of a dignified death at a time and manner of his or her choosing.

Question 2

An 82-year-old patient has end-stage congestive heart failure.Her primary care physician requests a consult from the palliative care service to assist in developing a discharge plan of care.Her son asks the nurse,"What is palliative care? Does it mean Mom is going to die in the next few days?" The nurse's best response is:

A) "Palliative care is only available to persons in the last 6 months of life."
B) "Palliative care focuses on care rather than cure."
C) "Palliative care is only offered to patients whose deaths are imminent."
D) "Palliative care means that your mother will not be resuscitated in the event of a cardiac or respiratory arrest."

Answer 2

"Palliative care focuses on care rather than cure."

Question 3

Select the true statement regarding gender and loss of a spouse.

A) Men are less likely to grieve than women in response to loss of a spouse.
B) Men carry attachments to their spouses that are less deep than women's attachments.
C) Three out of four women will be widowed at some point because women tend to live longer than men and frequently marry older men.
D) The male response to grief has been thoroughly studied and documented in the literature.

Answer 3

Three out of four women will be widowed at some point because women tend to live longer than men and frequently marry older men.

Question 4

A woman died after a lengthy illness.Her brother failed to attend the funeral and family gatherings because he was on a drinking binge.He has always been the "black sheep" of the family due,in part,to his history of alcohol abuse.What best describes the brother's behavior?

A) Pathological grief
B) Anticipatory grief
C) Acute grief
D) Disenfranchised grief

Question 5

The nurse aide reports to the registered nurse that her 97-year-old patient is not breathing well and that she feels "cold and clammy" and "looks blue." The patient has an advance directive that states "comfort care only" and is designated as a DNR (do not resuscitate).The registered nurse should:

A) not administer pain medication or hygiene because the patient is dying.
B) contact the physician for order to address the patient's breathing problems.
C) ask the patient's family what they want to be done for the patient.
D) instruct the nurse aide to provide personal hygiene and make the patient comfortable as outlined in the plan of care.

Question 6

A woman is terminally ill.Although it has never been discussed in the family nor stated outright by her physician,she suspects that she will die because of her illness.This situation is:

A) closed awareness.
B) suspected awareness.
C) mutual pretense.
D) open awareness.

Question 7

An 80-year-old woman has been admitted to your acute care facility.She is unconscious and unable to speak for herself,but she had prepared an advance directive stating that her son should make medical decisions on her behalf.You recognize this type of advance directive as:

A) a Patient Self-Determination Act (PSDA).
B) a living will.
C) a directive to physician.
D) a durable power of attorney for health care (DPAHC).

Question 8

The family of a 78-year-old patient who is dying of colon cancer with metastases to the liver is concerned because he refuses to eat or drink.He is alert and oriented,and states that he has no desire to eat.What should the nurse do?

A) Comply with the patient's wishes.
B) Force fluids.
C) Contact the physician for an order for enteral feeding.
D) Contact the dietitian for feeding supplements.

Question 9

A nurse was caring for a patient who died of a chronic illness.The family had been present with the patient constantly during the previous week,experiencing the dying process.The family was present when the patient stopped breathing,and had a very emotional reaction as if they were in a state of disbelief.The nurse interprets this behavior to be:

A) a normal response when experiencing the death of a loved one.
B) a maladaptive coping mechanism.
C) an irrational response.
D) an expression of anger toward the staff.

Question 10

The nurse is discussing hospice care with the wife of an 88-year-old patient who has end-stage liver cancer.The wife is worried that Medicare will stop paying for hospice at home if her husband lives longer than 6 months.What can the nurse tell the wife in order to allay her anxiety?

A) Medicare does not limit the hospice benefit.
B) The doctor should explain the hospice benefit.
C) The finance department should answer questions about hospice benefits.
D) Most patients with liver cancer do not live longer than 6 months.

Question 11

When working with a bereaved individual,the goal of nursing interventions is to:

A) assist the individual to go through the stages of grief work in the optimal order.
B) assist the individual to attain a healthy adjustment to the loss experience.
C) encourage the individual to talk about his or her feelings about the deceased individual.
D) offer support and advice about grief work.

Question 12

An 87-year-old patient who is dying of metastatic ovarian cancer tells the nurse that she is concerned about being discharged home and living alone.She is independent in activities of daily living at present and is eager to maintain this independence for as long as possible.She expresses concern about dying alone and losing control.The nurse determines that the patient's concerns are:

A) signs of depression.
B) unrealistic fears because the client shows no signs at present.
C) common fears of the dying person.
D) appropriate to institute a referral to hospice.