Deck 18: End-Of-Life Care and Bereavement

Question 1

The nurse is speaking with a preschool-age child whose sibling recently died. The nurse understands that preschool-age siblings might feel that the death was due to:

A)The child's being bad, and the sibling is being punished.
B)The child's having a fight with their sibling.
C)The child's having thoughts about their sibling dying.
D)Their parents' not liking that sibling.

Answer 1

The child's having thoughts about their sibling dying.

Question 2

The nurse is having difficulty coping with the impending death of a child. Which would most likely be the best resource for the nurse at this time?

A)Co-workers
B)Hospice nurses
C)Unit manager
D)Spouse

Answer 2

Hospice nurses

Question 3

The mother of a dying three-year-old child posts on Facebook: "Family and friends. Michael's heart is giving out. Looks like it will be tonight. He is surrounded by family and not in pain. I treasure every minute of being his mother. Pray for us." The nurse who has worked with the family recognizes that Michael's mother is in which stage of grieving according to Kubler-Ross?

A)Denial
B)Acceptance
C)Bargaining
D)Depression

Answer 3

Acceptance

Question 4

The nurse working on a pediatric unit is speaking to a child who is terminally ill. The child is describing her illness in terms of mutilation to her body. The nurse understands this to be representative of the development of which age group?

A)Adolescents
B)Preschoolers
C)School-age children
D)Infants

Question 5

A woman gives birth to a stillborn infant. It is the policy of the maternity unit to create a memory box for parents of a fetal demise. Without parental permission, the nurse should avoid which intervention?

A)Making a plaster cast of the infant's foot
B)Placing the blanket the baby was wrapped in into the memory box
C)Making hand- and footprints of the infant
D)Clipping a lock of hair to include in the memory box

Question 6

The nurse is counseling some parents on how they will feel after the death of a child. The nurse understands that the parents might feel which of the following? Standard Text: Select all that apply.

A)Loneliness
B)Guilt
C)Anger
D)High energy
E)Depression

Question 7

The nurse is leading a recovery group made up of parents who have lost a child. As the opening topic for the night's discussion, the nurse has again reviewed information about the grief process to the parents and talked about how different people grieve. During the discussion phase, several fathers speak. The nurse recognizes that the father who needs more time to understand the grief process is the father who says:

A)"I understand that everyone grieves differently."
B)"Looking back, I realize why I became so angry when the doctors didn't cure my daughter."
C)"It's been six months since my son died, so why isn't my wife ready to move on with our lives?"
D)"I'm glad you described some common grief reactions.I thought I was going crazy for a while."

Question 8

The nurse is working in a PICU with several children with life-threatening illnesses. The children come from a variety of cultural and religious groups. Because of their religious beliefs, the parents of which religious group should not be contacted regarding organ and tissue donation?

A)Jehovah's Witness
B)Islam
C)Hinduism
D)Buddhism

Question 9

A child's understanding of death changes as the child matures. When describing the adolescent's understanding of death, which of the following concepts puts the adolescent at risk for driving under the influence (drunk driving) accidents?

A)A sense of invincibility
B)The idea that death is universal
C)The understanding that death is permanent
D)An understanding that death has an effect on survivors

Question 10

The nurse is caring for a child who is dying. The parent asks that the child not be told he is dying. The child asks the nurse if he is dying. Which of the following would be the most appropriate action by the nurse at this time?

A)Ignore the child's question and change the subject.
B)Offer to bring in the child life therapist.
C)Suggest the parents meet with the health care team.
D)Tell the child he is dying and offer to stay with him.

Question 11

The nurse is performing post-mortem care for a child of the Hindu faith. In the process of removing medical equipment, intravenous lines, and urinary catheters, the nurse discovers a thread wrapped around the child's neck. The nurse should:

A)Report this finding to social services as a possible act of child abuse.
B)Assume the thread became wrapped around the neck during the unsuccessful resuscitation effort and remove it.
C)Remove the thread for safe keeping and return it to the family with the child's other possessions.
D)Leave the thread in place.

Question 12

The hospital unit is very busy and nursing is understaffed. The nurse recognizes that death is imminent in one of her assigned patients. Nursing behaviors to offer family support would include: Standard Text: Select all that apply.

A)Using active listening techniques when in the child's hospital room.
B)Sitting in the room as time permits and looking the parents in the eye.
C)Avoiding tears in the child's room.
D)Offering to call and notify family.
E)Recognizing that these parents' needs are greater than the other patients and staying with the parents.

Question 13

The nurse is caring for a child with a terminal illness. Physical care for the dying child would include which interventions? Standard Text: Select all that apply.

A)Providing oral care to moisten a dry mouth
B)Administering ordered laxatives to counter the effects of opioids
C)Encouraging a favorite food
D)Keeping the child pain-free
E)Taking vital signs and blood pressure every two hours

Question 14

A three-year-old child has a brain tumor and is now dying. The child has an Allow Natural Death order (AND order). Which of the following care and interventions are allowed for a child with an AND order? Standard Text: Select all that apply.

A)Oxygen
B)Suctioning
C)Use of a ventilator if respiratory failure occurs
D)Pain control
E)Cardiac compressions

Question 15

The nurse has been working with the parents of a dying child. The nurse has explained signs of imminent death. Which statement by the parents indicates that they understand the teaching?

A)"I understand that my child can see me until the very end."
B)"Dying children always lose consciousness a few hours before they pass."
C)"My child may become flushed as his heart slows down."
D)"My child may see visions that I cannot see."

Question 16

The nurse is taking care of a child who is showing signs of imminent death. What changes should the nurse expect to see related to the cardiovascular system?

A)An increase in the volume of Korotkoff's sounds
B)Mottling, cool and clammy skin
C)Peripheral pulses will remain when the heart beat is not heard on auscultation.
D)Increase in cardiac output

Question 17

The nurse is taking care of a child who is terminally ill. The nurse notices the child is having periods of shallow breathing followed by short periods of apnea. The nurse recognizes that this is:

A)Normal respiratory function of a young child.
B)Cheyne-Stokes respiration, which is a sign of imminent death.The child should be assessed for other signs of imminent death.
C)Dyspnea secondary to muscle relaxation.
D)A sign of air hunger.

Question 18

The nurse is providing postmortem care to a child. Along with following the facility's guidelines, what else should the nurse consider?

A)Identifying the family's wishes for postmortem care before performing care
B)Avoiding delay in moving the body to the morgue
C)Removing all articles from patient's body
D)Leaving all equipment in the room during postmortem care

Question 19

The nurse is doing a follow-up home visit to a family who lost their three-month-old infant to SIDS eight weeks ago. The mother answers the door in her nightgown with hair uncombed. During the interview, the mother states: "I don't see the point of getting dressed each day." The nurse recognizes that the mother is demonstrating which stage of grief behavior?

A)Recovery
B)Yearning, pining
C)Hostile
D)Disorganization