Deck 31: End-Of-Life Care

Question 1

The nurse is caring for a patient who just died.Which action does the nurse take first to determine if the patient is an organ or tissue donor?

A) Delegate the task to nursing assistive personnel (NAP).
B) Determine the patient's legal representative.
C) Request a copy of the patient's driver's license.
D) Ask the spouse to sign an organ donation consent.

Answer 1

Determine the patient's legal representative.

Question 2

The patient is in the final stage of dying.Which action does the nurse implement?

A) Maintain a darkened, cool room.
B) Elevate the head of the bed.
C) Catheterize the patient frequently.
D) Provide warm, soothing liquids.

Answer 2

Elevate the head of the bed.

Question 3

A patient with bone cancer and severe pain is nearing the end of life and is now unresponsive.The nurse continues to administer round-the-clock opioid analgesics.What does the nurse explain to the nursing student about this activity?

A) "The patient was in pain before so it's wise to assume the pain is still present."
B) "These medications are ordered to be given around-the-clock."
C) "This is a standing palliative care medication routine."
D) "Opioids help with breathing and restlessness, making the family feel better."

Answer 3

"The patient was in pain before so it's wise to assume the pain is still present."

Question 4

The family wants to see their family member who has just died.What actions does the nurse take when the family comes to visit?

A) Provide hygienic care, including hair care, in their presence.
B) Tell the family to ask any questions that they have about the patient.
C) Place patient valuables in the body bag to go with the body to the morgue.
D) Share other families' past experiences of grief so they know they are not alone.

Question 5

The nurse provides postmortem care for an unfamiliar patient.Which approach should the nurse use to best care for the body after death?

A) Ask about the patient's cultural or spiritual practices.
B) Remove tubes and lines before they become difficult to remove.
C) Cover the patient and transfer the body to the morgue.
D) Remove the old patient identification (ID) band and apply a new one.

Question 6

The nurse is caring for a patient who is dying but is receiving palliative care.What reason should the nurse give to the patient's family for this type of care?

A) It eliminates all adverse symptoms.
B) It improves the patient's quality of life.
C) It increases the daily caloric and fluid intake.
D) It improves the amount of activity tolerated.

Question 7

The family of a dying patient asks the nurse "Why bother giving the patient laxatives and stool softeners now?" What response by the nurse is best?

A) "They were ordered by the provider so I have to give them."
B) "I don't know but I can find out and let you know."
C) "Constipation causes abdominal discomfort so we try to prevent it."
D) "You don't want the patient to get constipated, do you?"

Question 8

The nurse is caring for a dying patient and delegates hourly oral care to the nursing assistive personnel.What actions does the NAP perform? (Select all that apply.)

A) Swabbing mouth with alcohol-containing mouthwash
B) Applying nonpetroleum lip balm when lips are dry
C) Wiping mouth out with moist toothette or cloth every 2 hours
D) Applying antifungal balm to patient's tongue and gums
E) Brush the patient's teeth once a day

Question 9

The nurse and nursing assistive personnel are collaborating to perform post-mortem care on a recently deceased patient.What action by the NAP requires the nurse to intervene?

A) Raises the head of the bed 30 degrees.
B) Closes the patient's eyes.
C) Ties the hands together over the abdomen.
D) Replaces the patient's dentures in the mouth.

Question 10

A patient on hospice care has been nauseated for two days, but now feels better and wishes to drink a little fluid.What fluid would the nurse bring the patient?

A) Coca-Cola
B) Milkshake
C) Orange juice
D) Chicken broth
E) Ice chips

Question 11

The nurse is caring for a patient who is dying.What action by the nurse facilitates family grieving?

A) Understand that grief can begin long before the patient dies.
B) The family needs to say good-bye to the patient.
C) Update the family on every patient change.
D) Provide a list of the area funeral homes and available services.

Question 12

The nurse is caring for a Hindu patient receiving hospice care.Which does the nurse expect to facilitate for the family when the patient dies?

A) Allowing the family members to wash and prepare the patient's body
B) Helping the family arrange for burial of the body
C) Communion and prayers by the hospital minister
D) Discussion of the finality of death

Question 13

The nurse is explaining to the patient the transition phase from palliative care to hospice care.Which statement by the patient indicates a good understanding of the process?

A) "I will go into a hospice bed."
B) "I will no longer focus on a cure."
C) "My pain-management program will change."
D) "My physician team will change."

Question 14

The family of a dying patient is distressed that their loved one does not want to eat or drink and is constantly asking the patient to eat or drink something.What response by the nurse is best?

A) Tell the family they shouldn't try to force food and fluid on the patient.
B) Tell the family that it's the patient's right to refuse food and fluids.
C) Explain to the family that loss of interest in food and fluid is normal at the end of life.
D) Explain to the family that blood flow to the intestines decreases and eating is not desired.

Question 15

The nurse is explaining the similarities between palliative care and hospice care to the family of a patient.Which statements indicate a need for further education? (Select all that apply.)

A) Palliative care is used for patients nearing the end of their life.
B) Palliative care is only for those patients who are terminally ill.
C) Patients who are receiving palliative care continue treatments aimed at cure.
D) Patients are active participants in their care and decisions.
E) Patients are cared for by an interdisciplinary team.

Question 16

During postmortem care, the patient's family says that the patient didn't have his dentures to place in his mouth.Which action does the nurse take at this time?

A) Place a rolled-up towel under the patient's chin.
B) Stuff the mouth with cotton to maintain the facial contour.
C) Tell the family to take the dentures to the funeral home.
D) Ask the family what they want to do about this situation.

Question 17

The nurse plans nonpharmacological comfort measures for a patient who is dying.What activity by the nurse is most appropriate?

A) Keep the head of the bed lowered.
B) Provide regular hygiene and skin care.
C) Reduce the amount of analgesics given.
D) Encourage the patient to eat frequently.

Question 18

The nurse wants to provide specialized nursing care for a patient with a serious degenerative illness that is not life threatening but for which there is no cure.Which approach would the nurse use in the care of this patient?

A) Hospice care
B) A combination of hospice care and palliative care
C) Palliative care
D) Experimental curative therapy with hospice care

Question 19

The family of the patient receiving hospice care is at the bedside expecting an imminent death.They become upset when the patient suddenly becomes restless and disoriented.Which action by the nurse is most appropriate?

A) Apply oxygen with a face mask.
B) Ask the family to leave the room.
C) Speak to the patient calmly and softly.
D) Administer extra pain medication.