Deck 10: End-Of-Life Issues

Question 1

An older person grieving the loss of her spouse says that she doesn't want to live anymore. What should this statement indicate to the nurse?
1) The patient is bargaining.
2) The patient may attempt suicide.
3) The patient is accepting the spouse's death.
4) The patient is denying that the spouse has died.

Answer 1

2

Question 2

An older patient who just lost her husband of 60 years is seen yelling at his picture, at the pictures of their children and grandchildren, and at the Bible in her hand. What should the nurse do?
1) Call her family members.
2) Call the physician for a restraint order.
3) Stay with her and allow her to be angry at the situation.
4) Check the medication log to see if she can have something for agitation.

Answer 2

3

Question 3

The family of a dying patient has been sitting at his bedside for hours, watching over the decreasing respirations. No one is speaking. What should the nurse say to the patient's son?
1) Encourage him to try to feed his father.
2) Encourage him to count the respirations to pass the time.
3) Encourage him to go home because this might be a long process.
4) Encourage him to talk to the patient because hearing is the last sense to go.

Answer 3

4

Question 4

An older patient tells the nurse that he does not want to create a living will because he does not want to die. How should the nurse respond to this patient?
1) "A living will is not a death sentence."
2) "That's probably a good idea. Don't tempt fate."
3) "I know what you mean. I don't have one either."
4) "Having a living will makes sure that you receive the care that you want when death approaches."

Question 5

The nurse is helping a patient think about things to include in a living will. What should the nurse suggest to the patient? Select all that apply.
1) Feeding tube
2) Breathing tube
3) Food and fluids
4) Pacemaker insertion
5) Mechanical ventilation

Question 6

While providing morning care to a terminally ill patient the nurse observes the nursing assistant laughing with the patient. What should the nurse do?
1) Explain to the assistant that death is not a laughing matter.
2) Suggest that laughter be limited because others are trying to rest.
3) Realize that the laughter is helping the patient soothe the eventual outcome.
4) Assign the assistant to other non-patient-related tasks because of inappropriate behavior.

Question 7

The spouse of a recently deceased older patient says that he does not really remember the funeral. Which stage of the grieving process is the spouse describing?
1) Shock
2) Denial
3) Despair
4) Depression

Question 8

During a home visit a terminally ill patient tells the nurse about his years in the Army and how he should have gone to "cooking and baking school" instead of becoming a military policeman. What should the nurse do during this story that indicates listening?
1) Say nothing.
2) Interrupt the patient to measure vital signs.
3) Remind the patient that time is limited for the visit.
4) Ask if the patient regrets not learning how to cook and bake.

Question 9

The spouse of a terminally ill patient asks why antibiotics are being prescribed for an infection when the patient is going to die anyway. How should the nurse respond?
1) "The infection could cause discomfort."
2) "The antibiotics will add days to the patient's life."
3) "Permitting the patient to die is a form of assisted suicide."
4) "I'll ask the physician why the medication was prescribed."

Question 10

The nurse desires to become a member of a hospice team. What should the nurse expect to do when providing hospice care?
1) Stay with the patient around-the-clock.
2) Encourage the patient to maintain independence.
3) Instruct the patient to stop eating food and fluids.
4) Provide support and education to family members.

Question 11

An older patient who lost her spouse a year ago is seen crying quietly in church during the singing of one hymn. What should this patient's behavior indicate?
1) The patient is unable to complete grieving.
2) The patient is denying that the death occurred.
3) The patient is in the depression phase of grieving.
4) The patient is in the acceptance phase of grieving.

Question 12

The nurse notes that a terminally ill patient has cold extremities despite being saturated with sweat. What should the nurse do?
1) Place the patient on a cooling blanket.
2) Place a fan in the room, angled to cool the patient's torso.
3) Change the gown and cover the arms and legs with a blanket.
4) Increase the room temperature and remove blankets from the patient.

Question 13

An older patient has a living will that clearly states no intubation, no IV hydration, and no feeding tube. As the end of life nears, the patient's daughter requests a feeding tube for the patient. What should the facility do?
1) Go to court to figure out what action to take.
2) Ask the patient's physician to make the decision.
3) Go along with the daughter and insert a feeding tube.
4) Refuse because the patient has clearly stated wishes in a legal document.

Question 14

A dying patient tells the nurse that he does not want any more renal dialysis treatments and just wants to be permitted to die. What should the nurse do with medications prescribed to control the patient's edema?
1) Mark them as refused.
2) Provide them to the patient.
3) Throw the medications in the trash.
4) Place the medications in another patient's medication drawer.