Question 1

Why is it important that clients and families receive quality end-of-life care from nurses?&#10;A) The World Health Organization mandates it.&#10;B) Hospital surveys ask about end-of-life care.&#10;C) Nurses provide most end-of-life care.&#10;D) It allows the client a &#34;good&#34; death.

Accepted Answer

Nurses provide most client care around the end-of-life, so receiving care from a nurse who has expertise in this area is vital. The WHO does not mandate end-of-life care. Hospitals do survey patients and/or families about their experiences, but this is not the most important rationale. Having excellent nursing care at the end of life can lead to a "good" death but does not guarantee it.

Question 2

The spouse of a former patient who died visits the grave site once a month. After doing this for a year, the family calls the bereavement nurse and asks what to do. What response by the nurse is best?&#10;A) &#34;As long as your loved one accepts the loss, this is perfectly normal.&#34;&#10;B) &#34;Did the death occur after a long or complicated illness?&#34;&#10;C) &#34;Your loved one needs to get therapy; can you help with that?&#34;&#10;D) &#34;This expression of grief is extreme; grief should not last over 6 months.&#34;

Accepted Answer

Uncomplicated grief is marked by acceptance of the death, but the bereaved person may continue rituals such as visiting a grave site, for years. This is normal. Asking about the circumstances of the death, recommending therapy, and saying that grief should be "over with" by 6 months are all incorrect and/or unnecessary responses.

Question 3

A person attending a grief support group wonders why there is no feeling of sadness after the person's spouse died from a 10-year battle with cancer. What response by the nurse facilitator is best?&#10;A) &#34;You may have experienced grief throughout the illness.&#34;&#10;B) &#34;Do you think you are depressed or in denial?&#34;&#10;C) &#34;What makes you think you are not grieving?&#34;&#10;D) &#34;You may be totally exhausted from the long illness.&#34;

Accepted Answer

Anticipatory grief begins before the person dies and when the family or friends are given bad news about the diagnosis and prognosis, or when things get worse. This person may already have done the work of grieving. Asking yes/no questions is not therapeutic. Asking why the person doesn't feel like grieving is occurring is demanding. The person may indeed be exhausted from grief, but the nurse wouldn't make this statement without further assessment.

Question 4

The nurse is caring for a terminally ill client. What question by the nurse would be best in preventing disenfranchised grief?&#10;A) &#34;Do you have your family affairs in order?&#34;&#10;B) &#34;Have you prepared an advanced directive?&#34;&#10;C) &#34;Who are the people most important to you?&#34;&#10;D) &#34;Would you like me to call your faith leader?&#34;

Accepted Answer

Disenfranchised grief occurs when open grieving is not acceptable for some reason. There are some complicating factors behind the loss. The best way to prevent this from occurring is clear communication with the client about who is important, who should be allowed to visit, whom can the nurse share information with. Family affairs and advanced directives are not related and are both yes/no questions which the nurse avoids. The client may or may not have a faith or faith leader, and this is another example of a yes/no question.

Question 5

What is the most important consideration when working with grieving children?&#10;A) Relationship to the deceased&#10;B) Age of the children involved&#10;C) Length of the terminal illness&#10;D) Age of the deceased

Accepted Answer

Because children's understanding of death and their ability to express grief varies with age and developmental level, the most important consideration is the child's age. Relationship to the deceased, length of time the deceased was ill, and the deceased person's age are other considerations but not as important as age.

Question 6

A client states &#34;I am not religious, I am spiritual.&#34; What does the nurse interpret that to mean?&#10;A) Client has no religious beliefs.&#10;B) Client does not belong to an organized church.&#10;C) Client does not believe in God.&#10;D) Client knows how to find hope and meaning.

Accepted Answer

Spirituality is how clients find hope, purpose, comfort, and a sense of meaning in their lives. People who identify as spiritual may or may not be religious, belong to a church, or believe in God. The two terms are often interchanged but spirituality is the broader perspective.

Question 7

The new nurse complains to the mentor that the spouse of a terminally ill client has climbed into bed and they are snuggling which will make giving care difficult. What response by the mentor is best?&#10;A) &#34;That may be against hospital policy; I will look.&#34;&#10;B) &#34;Did you tell the spouse this was allowed?&#34;&#10;C) &#34;Let them snuggle; it's probably comforting.&#34;&#10;D) &#34;That's not really appropriate in this setting.&#34;

Accepted Answer

Flexible visiting hours, allowing the client to choose who can visit, providing extra chairs and snacks all demonstrate caring and allow the client to remain autonomous as long as he or she is still living. It also provides a sense of dignity. Discussing policy, who gave permission, and appropriateness are unnecessary.

Question 8

A client's death is imminent. A large number of family members are present. What question or statement by the nurse is most important at this time?&#10;A) &#34;Would anyone like to stay during this time?&#34;&#10;B) &#34;Why don't you go get a cup of coffee?&#34;&#10;C) &#34;You shouldn't be here for the death.&#34;&#10;D) &#34;I will leave you alone for a while now.&#34;

Accepted Answer

Allowing family or friends to stay with the client during death may be very important to all parties. As death grows near, the nurse assesses who wishes to remain for the death. Other visitors can be shown the visiting room or bereavement room. Sending the visitors away or telling them they shouldn't be present is paternalistic and disrespectful. The nurse should stay with the family, or leave them alone depending on their wishes. Although asking if anyone wishes to stay is a yes/no question, the nurse does not probe with open-ended questions at this time and merely facilitates what the visitors want.

Question 9

A nursing student reports that a hospitalized client has end-stage congestive heart failure and only a few weeks to live. An important holiday is approaching and the client requests all the typical holiday food without regard to dietary restrictions. What response by the faculty is best?

A) "It doesn't matter much anyway, let the client eat desired foods."
B) "No, does the client understand that food will hasten death?"
C) "Sure as long as the client doesn't eat too much, it's fine."
D) "Of course, the client should be the center of our care."

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Accepted Answer

Allowing clients to maintain their holiday rituals demonstrates respect and caring and helps the client preserve personal identity. At the end of life, client wishes become paramount and what is comforting to the client takes priority if at all possible. Although the client is approaching the end of life, referring to that saying it doesn't matter much is callous.

Question 10

With which ethical principle is advance directives associated?&#10;A) Autonomy&#10;B) Justice&#10;C) Beneficence&#10;D) Veracity

Accepted Answer

Autonomy, or the ability to be self-directed and make one's own decisions, is the ethical principle at the heart of advance directives. Justice is treating people fairly. Beneficence is "doing good," which is related, but not as closely as autonomy. Veracity is truth-telling.

Question 11

The client tells the nurse he/she wishes to create advance directives. What response by the nurse is best?&#10;A) &#34;Choose carefully because the documents cannot be rescinded.&#34;&#10;B) &#34;Does your physician accept advance directives?&#34;&#10;C) &#34;I will call someone to help you with this process.&#34;&#10;D) &#34;Here are the papers for you to fill out.&#34;

Accepted Answer

The answer of The client tells the nurse he/she wishes...

Question 12

The nurse is caring for a dying client. What intervention takes priority?&#10;A) Frequent physical assessments&#10;B) Ensuring adequate hydration&#10;C) Keeping the skin dry&#10;D) Client comfort

Accepted Answer

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

Question 13

The school nurse is talking with a student who has recently had a parent die. What question by the nurse would be most important for the nurse to assess for exaggerated grief?&#10;A) &#34;How are you getting along with your siblings?&#34;&#10;B) &#34;Are you attending support groups?&#34;&#10;C) &#34;How have you been sleeping at night?&#34;&#10;D) &#34;Do you need an extension on assignments?&#34;

Accepted Answer

The answer of The school nurse is talking with a...

Question 14

A nurse is caring for a dying client for the third day in a row. Upon entering the room, the nurse notes a great deal of stress and anxiety. What response by the nurse is best?&#10;A) Perform needed care quickly and quietly.&#10;B) Leave the room and do client care later.&#10;C) Ask the family what is causing stress.&#10;D) Ask the family to tell funny stories about the client.

Accepted Answer

The answer of A nurse is caring for a dying...

Question 15

A client is going home to die with family caregivers. What action by the nurse is most important to support the caregivers?&#10;A) Provide them with written information on the dying process.&#10;B) Ensure the family knows what they can expect with death.&#10;C) Give the family members information on bereavement groups.&#10;D) Arranging for delivery of a hospital type bed.

Accepted Answer

The answer of A client is going home to die...

Question 16

The spouse of a dying client calls the clinic nurse to report the client has been refusing food and fluids. The spouse is devastated. What response by the nurse is best?&#10;A) &#34;You shouldn't force him/her to eat or drink.&#34;&#10;B) &#34;Do you want him to go to the hospital?&#34;&#10;C) &#34;Why is this so distressing for you?&#34;&#10;D) &#34;This is normal as organ function slows down.&#34;

Accepted Answer

The answer of The spouse of a dying client calls...

Question 17

A client is close to death and only semiconscious. An adult child, identified as the healthcare proxy, says &#34;I said yes, but I really don't know what that means.&#34; What response by the nurse is best?&#10;A) &#34;It means you are responsible for the client now.&#34;&#10;B) &#34;You will make medical decisions now that the client can't.&#34;&#10;C) &#34;That means you have to put the client's affairs in order.&#34;&#10;D) &#34;You are the first person we notify in case the client dies.&#34;

Accepted Answer

The answer of A client is close to death and...

Question 18

A nurse is assessing a recently bereaved client for signs of cognitive symptoms related to the loss. Which question is best to determine this information?&#10;A) &#34;Have you been more irritable than usual lately?&#34;&#10;B) &#34;Do you feel like you are confused at times?&#34;&#10;C) &#34;How has your sleep been since the death?&#34;&#10;D) &#34;Are you getting along well with your coworkers?&#34;

Accepted Answer

The answer of A nurse is assessing a recently bereaved...

Question 19

Which of the following are elements of a spiritual assessment as recommended by The Joint Commission? (Select all that apply.)&#10;A) Coping&#10;B) Spiritual practices&#10;C) Personal beliefs&#10;D) Burial plans&#10;E) Religious practices

Accepted Answer

The answer of Which of the following are elements of...

Question 20

Which of the following statements about a deceased client's body are correct? (Select all that apply.)&#10;A) Livor mortis is also known as postmortem lividity.&#10;B) Algor mortis refers to cooling of the body.&#10;C) Rigor mortis usually starts in 2 to 4 hours after death.&#10;D) Livor mortis can cause the client to &#34;sweat.&#34;&#10;E) Algor mortis causes the body to be cooler than the environment.

Accepted Answer

The answer of Which of the following statements about a...

Question 21

A student nurse has prepared a dead client's body for viewing by the family. What observations by the faculty member require correction by the student? (Select all that apply.)&#10;A) The client is lying flat in bed.&#10;B) The client has dentures in place.&#10;C) Clutter was moved to one corner of the room.&#10;D) A heavy blanket covers the body.&#10;E) Belongings are in a belongings bag.

Accepted Answer

The answer of A student nurse has prepared a dead...

Question 22

A client has died and is to have an autopsy. Which of the following interventions by the nurse are appropriate? (Select all that apply.)&#10;A) Leave all tubes and drains intact.&#10;B) Photocopy all paper chart forms.&#10;C) Leave the identification bracelet on.&#10;D) Obtain physician permission for autopsy.&#10;E) Facilitate organ donation first.

Accepted Answer

The answer of A client has died and is to...

Question 23

The student learns that which of the following are signs of impending death? (Select all that apply.)&#10;A) Noisy respirations&#10;B) Agitation&#10;C) Inability to swallow&#10;D) Lethargy&#10;E) Increased urine output

Accepted Answer

The answer of The student learns that which of the...

Question 24

Which advanced care planning tool is matched to its correct description? (Select all that apply.)&#10;A) Living will: Specifies what care the client wishes to receive or deny&#10;B) Durable Power of Attorney: Designate an individual who makes decisions for the client they are unable to&#10;C) Do Not Resuscitate: Prohibits lifesaving treatment&#10;D) Advance Directive: Distributes the client's assets prior to the client's death&#10;E) Medical Power of Attorney: appoints a physician to make decisions on the client's behalf

Accepted Answer

The answer of Which advanced care planning tool is matched...

Question 25

The nursing student learns what information about complicated grief? (Select all that apply.)&#10;A) Can lead to severe anxiety&#10;B) May occur when a child dies&#10;C) Could interfere with functioning&#10;D) Does not abate over time&#10;E) Can cause suicidal thoughts in survivors&#10;F) Does not result from disasters

Accepted Answer

The answer of The nursing student learns what information about...

Question 26

BSN competencies identified by the AACN for end-of-life care include which of the following? (Select all that apply.)&#10;A) Recognizing only the client as the unit of care&#10;B) Interdisciplinary cooperation&#10;C) Financial considerations at the end of life&#10;D) Attention to vulnerable populations&#10;E) Incorporating spirituality into care

Accepted Answer

The answer of BSN competencies identified by the AACN for...

Deck 8: End-Of-Life Care