Deck 24: Palliative and End-Of-Life Care

Question 1

Hospice care includes services that are reasonable and necessary for the comfort and management of a terminal illness. Which services might be included? (Select all that apply.)

A) Healthcare provider services
B) Nursing care
C) Long-term in-client pain control
D) Hospice aide services
E) Social worker services

Answer 1

Healthcare provider services
Nursing care
Hospice aide services
Social worker services

Question 2

A nursing student is preparing a report for a class detailing the various causes of death. Which leading cause of death should the student point out?

A) Cerebrovascular disease
B) Chronic lower respiratory disease
C) Diabetes mellitus
D) Heart disease

Answer 2

Heart disease

Question 3

The chart of a client with brain cancer notes "CMO." Which intervention should the nurse most expect this client to receive?

A) Chemotherapy for killing the cancer cells
B) Radiotherapy for reducing the size of the tumor
C) Morphine for pain management
D) Antibiotic to fight off an infection

Answer 3

Morphine for pain management

Question 4

The nurse ensures that each client has a living will. What is the basic purpose for this document?

A) Describes the client's wishes regarding treatment intended to sustain life
B) Designates someone to make medical decisions for the client if he or she is unable to do so
C) Permits someone access to the client's finances
D) Ensures appropriate end-of-life care

Question 5

The nurse provides palliative care to a client with end-stage renal disease and a chronic upper respiratory infection. Which interventions should the nurse ensure are included in this type of care? (Select all that apply.)

A) Providing the client with a foot massage
B) Administering ordered analgesics
C) Assisting with a kidney transplantation
D) Clearing secretions from the client's airway for easier breathing
E) Gently stretching the client's arms and legs to preserve range of motion

Question 6

The nurse cares for a client whose husband of 50 years died last week. The nurse arrives at her home to find her staring out of a window in a stupor, her face devoid of any emotion. When the nurse speaks with her, the client seems withdrawn and distant. Which phase of grief should the nurse most suspect this client to be in?

A) Numb shock
B) Emotional turmoil
C) Reorganization
D) Resolution

Question 7

The nurse cares for a client who is near death. For which change, indicating that death is imminent, should the nurse anticipate?

A) Deep breaths with periods of apnea
B) Mottling of upper extremities
C) Skin cool and dusky
D) Signs of respiratory alkalosis

Question 8

A client has just been pronounced dead. Which action should be prioritized?

A) Remove all tubes
B) Don gloves
C) Grasp the eyelashes and gently pull the lids down
D) Insert the dentures into the mouth

Question 9

The nurse works with a variety of clients at a general hospital in a rural area. For which clients would it be most appropriate to administer palliative care? (Select all that apply.)

A) 92-year-old man who has just suffered a stroke
B) 83-year-old woman with end-stage dementia
C) 12-year-old girl with terminal lymphoma
D) 74-year-old man with osteoarthritis
E) 54-year-old woman with high blood pressure

Question 10

The nurse cares for many clients who have serious illnesses. Which client is the best candidate for hospice care?

A) Brain cancer who is expected to live 3 months and who is not pursuing aggressive treatment
B) Congestive heart failure who is expected to live 9 months and who is not pursuing aggressive treatment
C) Lung cancer who is expected to live 1 month and who is pursuing radiation therapy
D) Stroke who is expected to live only a few more hours unless emergency brain surgery can remove a clot

Question 11

Pain and symptom control are crucial to the delivery of quality end-of-life care. For which signs of pain should the nurse carefully assess? (Select all that apply.)

A) Grimacing or strained facial expression
B) Slow heartbeat
C) Diaphoresis
D) Moaning or groaning at rest or movement
E) Taking sips of water from a cup

Question 12

Pain at the end of life is complex and multifactorial, and prevalence varies according to diagnosis and other factors. How is somatic pain typically depicted?

A) Burning, electrical, or tingling
B) Gnawing, cramping, or aching
C) Aching, throbbing, or stabbing
D) Electrical, cramping, throbbing

Question 13

The nurse cares for a client who has a laceration on her arm and reports moderate aching, throbbing pain from the injury. Which medication should the nurse expect to be ordered first for this client?

A) Acetaminophen
B) Ibuprofen
C) Opioids
D) Anticonvulsants

Question 14

The nurse cares for a hospice client who reports pain from nerve damage related to diabetic neuropathy. She rates the pain at 9 out of 10. Which medication should she expect the healthcare provider to order for this client?

A) Antidepressant
B) Muscle relaxant
C) Low doses of opioid
D) High doses of opioid

Question 15

A client has been prescribed a nonopioid analgesic for mild-to-moderate pain. The client has normal liver function. What is the maximum recommended amount of acetaminophen for this client to take per day to avoid liver damage?

A) 2 g
B) 3 g
C) 4 g
D) 5 g

Question 16

A client is receiving adjuvant medications to increase the effectiveness to treat the pain associated with end-stage prostate cancer. Which exemplifies an adjuvant medication?

A) Opioids
B) Corticosteroids
C) Antihistamines
D) Antivirals

Question 17

A client has not been able to receive adequate pain control with several different medications that have been administered and is experiencing severe pain. What route of administration might be tried at this time?

A) Intraspinal
B) Intravenous
C) Rectal
D) Transdermal

Question 18

A client has been prescribed opioid analgesics. The client asks the nurse how long before the sedation will subside. Which is the best response from the nurse?

A) 24 to 48 hours
B) 48 to72 hours
C) 72 to 96 hour
D) 1 week

Question 19

A Muslim client is receiving end-of-life care. As death approaches, what special considerations should the nurse take in the care of this client?

A) Speak with the family about arrangements for cremation
B) Schedule a visit from the chaplain for special rites
C) Arrange for grief counseling for the client
D) Place the client in a special position

Question 20

A dying client with inadequate fluid intake is experiencing constipation. What would be an appropriate nursing intervention for this client?

A) Administer psyllium
B) Tap water enema
C) Administer lactulose
D) Apricot juice

Question 21

The nurse cares for a client whose husband of 50 years died a year ago. Which behavior by the client would most indicate the reorganization phase of grief has been reached?

A) Joins a book club to get out of the house and meet new people
B) Expresses no emotions regarding the loss of her husband
C) Begins crying on a daily basis
D) Experiences panic attacks regularly