Question 1

The primary goal of end-of-life care is:

Accepted Answer

When modern technology and pharmacology can no longer keep someone alive,the dying person's bill of rights states that he or she has the right to die in comfort and with peace and dignity.

Question 2

A 90-year-old West Indian man is dying,and 20 family members fill the hall as they try to crowd into the room.The culturally competent health-care worker will:

Accepted Answer

Making room for the family at bedside is comforting to West Indian families as they prefer to be at bedside at time of death to pray for their loved one.

Question 3

The sensitive health-care worker can demonstrate therapeutic presence by:

Accepted Answer

Therapeutic presence can be accomplished by simply being near the patient and available.

Question 4

A terminally ill patient is unresponsive and having periods of apnea.The patient's family is arguing at the bedside about where the funeral should be held.The health-care worker should:

Accepted Answer

Although the dying person may appear to be in a coma,hearing is the last sense to be lost.Asking the family to leave the room without an explanation is inappropriate.

Question 5

As a Native American elder is dying,a young health-care worker complains to her supervisor that the eldest son is not at his father's bedside and is nowhere to be found.The culturally competent health-care worker responds:

Accepted Answer

Native Americans avoid contact with the dying person and grieve in private,away from the person who is dying.

Question 6

The statement that best depicts the preschooler's understanding of death is:

Accepted Answer

Preschoolers engage in magical thinking and think that death is reversible.They frequently believe their own behavior caused the illness or death of a sibling.

Question 7

Denial is a common reaction to the diagnosis of a terminal illness,because the use of this defense mechanism:

Accepted Answer

Denial may allow the patient to function adaptively and productively through the grief process.It is helpful for gradual adaptation and does not interfere with problem-solving behavior.

Question 8

When a terminally ill patient says,"I feel that death is just around the corner," the most appropriate response would be:

Accepted Answer

Health-care professionals need to provide an atmosphere in which the patient is able to freely verbalize feelings about death.

Question 9

When the treatment for a 12-year-old child with terminal cancer needs to shift from cure to palliation,the health-care worker reminds the family it is important that they should:

Accepted Answer

Truthfulness and explanations in age-appropriate terms will help the child to better communicate his needs and feelings.

Question 10

Patients and families progress through various stages of reactions when a diagnosis of a terminal illness is made.After the helplessness phase,a period of adjustment usually follows.This phase is characterized by:

Accepted Answer

Although some patients and families never progress beyond the shock and denial stage,most go through stages of the grieving process.Anger and guilt usually follow denial,and some patients will regress to anger from time to time even though they may have reached a level of acceptance of the diagnosis.

Question 11

The school-age siblings of a dying child should be:

Accepted Answer

Siblings should be included as much as possible in the plan of care for the dying child,so they do not feel abandoned or punished or develop a sense of sibling rivalry and,later,guilt feelings.

Question 12

When caring for a terminally ill patient,health-care workers are permitted to provide interventions that:

Accepted Answer

Analgesics,particularly opioids,should be administered around the clock to prevent pain,with dosage and schedule adjustments made as needed to maintain maximum comfort.This often requires very large doses of medication given at more frequent intervals,in accordance with the patient's wishes.

Question 13

When parents ask if their school-age child should attend the funeral of their grandmother,the health-care worker would base a response on the understanding that attendance will:

Accepted Answer

Attendance at funerals helps the school-age child to realize that death is permanent and provides closure.Sharing this moment of deep significance with parents helps children deal with their own feelings of sorrow and grief.

Question 14

The health-care worker assesses a normal response in a dying 8-year-old boy who says:

Accepted Answer

The school-age child may fear separation from family but envision continuation of life in another form.

Question 15

The document naming the person or persons who should make health-care decisions if a patient cannot make informed decisions for him- or herself is the:

Accepted Answer

The durable power of attorney for health care names the person who is to make medical decisions for the patient if the patient is unable to do so.

Question 16

The health-care worker caring for a dying 78-year-old Hispanic woman understands that in Hispanic families when death is near,the family will:

Accepted Answer

In the Hispanic culture,pregnant women and children are prohibited to be in contact with the dying person.The shaman is the holy man revered by the Native Americans.Hispanics feel DNR orders are not acceptable,and the eldest child is usually responsible for health-care decisions.

Question 17

A dying patient becomes withdrawn and verbally uncommunicative.Relatives try to cheer him up,which is most indicative of:

Accepted Answer

Most dying persons are aware of the reality of their conditions.Open acknowledgment and open communication provide support during this difficult time not only to the patient,but to family,friends,and caregivers.

Question 18

The best practice in promoting quality of life for a terminally ill 10-year-old child would be:

Accepted Answer

An important understanding about quality of life for a child with a terminal illness is that they can participate in age-appropriate activities as normal,healthy children do.Attending school,even if it must be part time,helps the child and family cope with the illness.

Question 19

The health-care worker can support grieving families at the time of death by:

Accepted Answer

One of the roles of the health-care worker at the time of death is to provide support to grieving families.Providing privacy and time with the loved one after death allows family members an opportunity to see and touch the deceased,often for the last time.

Question 20

The grieving mother whose adolescent son died last week tells the home health-care worker that her 5-year-old has begun to wet the bed.The health-care worker's most helpful response would be:

Accepted Answer

Regression is to be expected in the preschooler after a traumatic event such as death.

Quiz 15: Planning for the End of Life