Deck 40: Hospice Care

Question 1

The nurse carefully assesses the symptom faced by the dying patient that often disrupts the quality and enjoyment of life and can be excruciating and terrifying.That symptom is:

A) fear.
B) anger.
C) grief.
D) pain.

Answer 1

pain.

Question 2

Because the family is confused about the meaning of palliative care,the hospice nurse explains it as treatment that is centered on a(n):

A) aggressive approach to prolong life.
B) protocol of pain relief.
C) form of organized care which relieves the family of responsibility.
D) integrated service of support for alleviation of symptoms.

Answer 2

integrated service of support for alleviation of symptoms.

Question 3

The hospice nurse clarifies that hospice service is initiated when what type of treatment is no longer effective?

A) Proactive
B) Palliative
C) Alternative
D) Curative

Answer 3

Curative

Question 4

The hospice nurse explains to the family that the overall objective of hospice service is to:

A) relieve symptoms of terminal disease.
B) educate the patient about the process of death.
C) keep the patient comfortable as death approaches.
D) relieve the family of the stress of death.

Question 5

The hospice nurse provides time to confer with the patient and family to:

A) show concern.
B) report changes in the plan of care designed by the team.
C) confirm the ongoing reimbursement.
D) plan for changes in the scope of care.

Question 6

In 1960,the hospice philosophy was launched by:

A) Cicely Saunders.
B) Lillian Wald.
C) Dorothea Dix.
D) Florence Nightingale.

Question 7

The hospice nurse tells the family that the nurse coordinator,an RN,will visit them to:

A) collect initial fees for the hospice service.
B) officially admit the patient to the hospice service.
C) give the family a copy of the standardized plan of care.
D) distribute drugs prescribed for palliation.

Question 8

The hospice spiritual coordinator can be affiliated with any church,assists with the spiritual assessment of the patient,and develops the plan of care regarding spiritual matters.The spiritual coordinator must possess a(n):

A) bachelor's degree.
B) master's degree.
C) seminary degree.
D) associate degree.

Question 9

The nurse differentiates for the family active and palliative care,in that active care is:

A) centered on symptom control.
B) focused on treatment for a cure.
C) not concerned with dying.
D) covered by health insurance.

Question 10

The hospice nurse recognizes that the role of the medical director is to:

A) design and direct the plan of care.
B) evaluate the appropriateness of the care.
C) function as mediator between the team and the attending physician.
D) take the place of the patient's attending physician.

Question 11

The nurse recognizes that pain can be managed what percentage of the time?

A) 50% to 55%
B) 60% to 65%
C) 70% to 80%
D) 95% to 97%

Question 12

The social worker evaluates and assesses the psychosocial needs of the patient.To work in a hospice,the social worker must have at least which degree?

A) Associate
B) Bachelor's
C) Master's
D) Doctorate

Question 13

The hospice nurse introduced the family to the volunteer coordinator who will assign a volunteer to the patient who will:

A) give the family respite.
B) give necessary medication in the absence of the nurse.
C) be at the family's disposal 16 hours a week.
D) find appropriate recreational activities for the patient.

Question 14

When a deficiency in nutritional status of a patient is assessed,the hospice nurse should:

A) make a comprehensive grocery list for the caregiver.
B) alert the licensed medical nutritionist.
C) seek culturally appropriate methods to increase nutrition.
D) instruct the caregiver to give the patient multivitamins.

Question 15

The hospice nurse instructs the family that they have access to a hospice pharmacist,who is available for consultation on the drugs the hospice patient may be taking and who will:

A) provide all drugs necessary for pain alleviation.
B) evaluate drug interactions with food and other medications.
C) evaluate the safety of the drug storage in the patient's home.
D) monitor drug effectiveness by frequent phone interviews with the family.

Question 16

The nutritional assessment is done at the time of admission by the:

A) physician.
B) hospice nurse.
C) caregiver.
D) nursing assistant.

Question 17

The hospice nurse instructs the family that they have access to a bereavement coordinator who follows the plan of care focused on the caregiver after the death of the patient for at least:

A) one week.
B) one month.
C) one year.
D) two years.

Question 18

The patient informs the hospice nurse,"I'm not sold on this hospice thing.I'm not looking for Jesus,I'm just dying." The most therapeutic response by the nurse would be:

A) "Spiritualism is as you define it."
B) "Rejecting the spiritual aspect of yourself may not be in your best interest."
C) "Hospice service is about how to make your remaining time meaningful."
D) "Based on what you say,hospice service may not answer your needs."

Question 19

The hospice nurse explains that to qualify for admission to a hospice,the attending physician must certify that the patient has a life expectancy of fewer than:

A) 2 months.
B) 3 months.
C) 4 months.
D) 6 months.

Question 20

The hospice nurse requests that the patient designate a primary caregiver for himself.The primary caregiver:

A) must be a relative.
B) has complete control over the patient's care.
C) acts as the patient's spokesperson when necessary.
D) must have power of attorney.

Question 21

During a pain assessment,the patient tells the nurse that the pain is aching,stabbing,and throbbing.The nurse recognizes this pain to be:

A) visceral.
B) neuropathic.
C) somatic.
D) psychogenic.

Question 22

What are the goals of hospice service? (Select all that apply.)

A) Alleviating symptoms of approaching death
B) Educating and supporting primary caregivers
C) Using family input for designing a plan of care
D) Encouraging patients and caregivers to enjoy life
E) Focusing on patient desires in the plan of care

Question 23

When air hunger is assessed in the dying patient,the nurse can perform which intervention(s)? (Select all that apply.)

A) Circulate the air with a fan.
B) Use a tranquilizer to decrease anxiety.
C) Provide good oral hygiene.
D) Perform careful suctioning.
E) Raise the head of the bed 30 degrees.

Question 24

The nurse prepares the family for the most common problem of the terminally ill patient caused by narcotics,which is:

A) malnutrition.
B) constipation.
C) fluid retention.
D) dehydration.

Question 25

When the dying patient becomes confused,the nurse should ____________ him or her.

Question 26

The hospice nurse documents an assessment finding of cachexia in the patient record,which describes a state of:

A) deep sleep and unresponsiveness.
B) marked weakness and emaciation.
C) total addiction to opioids.
D) renewed energy.

Question 27

The nurse assures an anxious family that medication that will relax the patient's respiratory effort and thus increase the efficiency of respiratory status is:

A) aminophylline.
B) theophylline.
C) epinephrine.
D) morphine.

Question 28

The nurse explains that because they can be delivered by all routes,give good pain control,and have no limit on the dose amount,the drugs of choice when caring for the hospice patient are:

A) nonsteroidal anti-inflammatory drugs.
B) anticholinergic drugs.
C) Duragesic patches.
D) opioid derivatives.

Question 29

The nurse must educate the patient and caregiver that large doses of narcotics are required to control pain.It is good to educate the patient and caregiver that the dose that works is the dose:

A) the physician ordered.
B) that provides pain relief.
C) that is not addictive.
D) agreed upon by the patient.

Question 30

The nurse warns that nausea is a common side effect with opioid treatment,and rather than discontinuing the opioid,it is better to treat the nausea with:

A) antiemetics.
B) ice chips.
C) dry crackers.
D) ginger ale.

Question 31

During a visit by the hospice nurse,an older adult Hispanic male patient dies.To honor the cultural traditions,the nurse should:

A) have the body removed as quickly as possible.
B) call the priest immediately.
C) cover the face with a clean white cloth.
D) provide time for lengthy family visitation.

Question 32

The hospice nurse delays the use of oropharyngeal suctioning because it:

A) will decrease mucus production.
B) will be tiring to the patient.
C) is not necessary.
D) puts the patient at risk for infection.

Question 33

The hospice nurse educates the patient and family about the members of the interdisciplinary team.Which caregivers are included? (Select all that apply.)

A) Medical director
B) Nurse coordinator
C) Social worker
D) Spiritual coordinator
E) Psychologist

Question 34

The hospice nurse recommends that the patient prepare the document that provides guidance to the family concerning the patient's wishes regarding life-support measures and organ donation.This document is called a(n):

A) power of attorney.
B) living will.
C) advance directive.
D) conservatorship.

Question 35

The nurse reassures the patient and caregiver that part of the end-of-dying process is:

A) denial.
B) despair.
C) anorexia.
D) depression.

Question 36

Which are signs and symptoms of approaching death? (Select all that apply.)

A) Mottled extremities
B) Significant decrease in urine output
C) Increased restlessness and pulling at bed linens
D) Alteration in rhythmic respiration
E) Increased pulse rate

Question 37

The hospice nurse instructs caregivers in repositioning the patient because the patient spends most of the time reclining,which can lead to:

A) contractures.
B) pressure ulcers.
C) bruising.
D) excoriation.

Question 38

When educating a patient concerning ways to prevent nausea,the nurse suggests that eating slowly in a pleasant atmosphere will help,as well as taking an antiemetic how many minutes before meals?

A) 10
B) 20
C) 30
D) 60