Deck 1: Nursing Care at the End-Of-Life: Introductory Concepts

Question 1

An elderly patient tells the nurse that unless he has surgery for an arthritic joint, he will not be able to continue driving and maintaining his home and garden. The nurse realizes this patient is describing his:

A) Lifestyle
B) Independence
C) Quality of life
D) Short-term goals

Answer 1

Quality of life

Question 2

The healthcare team has determined two different approaches to helping a patient's heart problem. Since the patient is receiving palliative care, which of the following should the team do next?

A) Tell the patient the best approach to helping his heart problem.
B) Discuss approaches with the patient so that the he can decide what he wants done.
C) Remind the patient that he is receiving palliative care and that one approach might be too aggressive considering his prognosis.
D) Tell the patient that there is only one way to help the heart problem instead of discussing all the possible solutions.

Answer 2

Discuss approaches with the patient so that the he can decide what he wants done.

Question 3

A patient, receiving palliative care for chronic lung disease, has a hip fracture. According to the principles of palliative care, the nurse realizes that which of the following will be done to help this patient?

A) Surgery or stabilization of the fractured hip.
B) Pain control for the fractured hip.
C) Comfort measures for the fractured hip.
D) No additional treatment for the fractured hip.

Answer 3

Surgery or stabilization of the fractured hip.

Question 4

A patient with heart failure and an irregular heart beat is demonstrating renal dysfunction caused by cardiac medications. The patient is otherwise healthy and has the desire to maintain a specific quality of life. Which of the following should be done to help this patient?

A) Suggest that the patient's desire to maintain a specific quality of life is unrealistic considering his age and health.
B) Tell the patient that renal dialysis is the best plan of care.
C) Remind the patient that he is elderly and he really doesn't have many options.
D) Discuss all possible treatment options so the patient can decide the option he wants.

Question 5

An elderly patient is seen crying quietly in her room. When being comforted by the nurse, the patient says that all she wants is to be able to hear well so that she can hear her grandchildren's laughter and the daily news report on the radio. Which of the following can the nurse do to assist this patient to have a better quality of life?

A) Coordinate appropriate healthcare providers to discuss the patient's hearing deficit and possible plans to achieve the patient's goal.
B) Discuss with the patient other ways to enjoy her grandchildren.
C) Remind the patient that hearing is often lost during the aging process.
D) Console the patient and document that the patient is depressed.

Question 6

The wife of a patient receiving palliative care thanks the nurse for "being there" while her husband was dying. The nurse realizes the wife is describing:

A) Counseling
B) Alleviation of suffering
C) The nurse providing comfort to the patient
D) Therapeutic presence

Question 7

A patient receiving palliative care tells the nurse that she knows she has become a burden because her daughter has quit her full time job and now works part time in order to be available to meet her mother's healthcare needs. The nurse realizes that which of the following quality-of-life dimensions need to be incorporated in this patient's plan of care?

A) Spiritual well-being
B) Physical well-being
C) Psychological well-being
D) Social well-being

Question 8

The nurse, providing palliative care, discusses with the patient ways to achieve a specific healthcare goal. The patient then tells the nurse which intervention he prefers. The nurse and patient's discussion exemplifies which of the following characteristics of palliative care?

A) Comfort
B) Communication and choice
C) Care
D) Creativity

Question 9

The family of a patient receiving palliative care is frustrated with the patient, because he continues to "order the family around" by "telling them what to do and how to do it." The nurse realizes the family is experiencing which of the following quality-of-life dimensions with the patient?

A) Social well-being
B) Physical well-being
C) Psychological well-being
D) Spiritual well-being

Question 10

A patient, planning to receive hospice care, tells the nurse that he is questioning his decision because he wants to take advantage of treatment options that might prolong his life and is afraid that hospice is a "death sentence." Which of the following responses should the nurse give this patient?

A) Unfortunately, once you agree to hospice, other treatment options are not available to you.
B) You can be discharged from hospice if you get better or if you want to try a treatment to cure the illness.
C) The chances of a new treatment becoming available are highly unlikely.
D) Maybe you need to understand the severity of your illness and your prognosis.

Question 11

The family of a patient receiving palliative care is concerned that he has developed a productive cough and at times appears confused by calling out to people who died years ago. The nurse realizes the patient is experiencing which of the following?

A) Temporary confusion because of the disease process
B) Death within a few weeks
C) Hazards of immobility and the need for increased activity
D) Imminent death

Question 12

A patient receiving hospice care is being admitted to the hospital for one week so that his wife can attend physician's appointments and rest. The nurse realizes that the patient will be receiving which level of hospice care?

A) In-patient respite care
B) Routine care
C) Continuous care
D) General inpatient care

Question 13

An elderly couple lives independently at home. The husband is having increasing arthritic pain and will be hospitalized for surgery. Wife needs assistance with applying a sleep apnea device at night. According to the principles of palliative care, which of the following will be planned for this family?

A) Determine whether the family is living in unsafe conditions and intervene to have both admitted to an assisted-living facility.
B) Communication with the wife's physician about her not being able to use the device for a week.
C) Coordinating the wife's admission to a long term care facility for the week while the husband has surgery.
D) Support for the wife each night for the application of the sleep apnea device at home.

Question 14

A patient tells the nurse that he wants to continue to do household chores but finds that he loses strength as the day goes on. Which of the following can the nurse do in assisting this patient to maintain his quality of life?

A) Help the patient understand that he needs to let go of some of his expectations.
B) Discuss which chores can be done by someone else considering that the patient is getting weaker every day.
C) Generate a list of household chores and discuss ways for them to be achieved during the time of day when the patient feels stronger.
D) Remind the patient that he isn't a teenager anymore and that weakness is just a part of getting old.

Question 15

A patient with a terminal illness tells the nurse that he does not want palliative care because he does not want to die as quickly as possible. Which of the following should the nurse respond to this patient?

A) Palliative care is for those patients whose life expectancy is about six months.
B) Palliative care does not speed up death.
C) You have to be in a resident facility to receive palliative care.
D) It is the best way to receive care since Medicare pays for all of the expenses.

Question 16

A patient receiving palliative care tells the nurse that she doesn't want to go to church anymore and has no appetite for food or drinks. The nurse realizes the patient is demonstrating:

A) Early signs of impending death
B) Depression
C) Loss of physical well-being
D) Loss of spiritual well-being

Question 17

A patient with a chronic debilitating illness has been diagnosed with terminal cancer. The nurse realizes that which of the following would need to be determined prior to discussing the plan of care for the patient?

A) Number of family members
B) Method of health care payment
C) Life expectancy
D) Place of residence

Question 18

The daughter of a dying patient asks the nurse if she could please wash her mother's face and hands and help dress her in a more comfortable gown. The nurse realizes the daughter's request is:

A) A way for the daughter to alleviate guilt over her mother's imminent death
B) A final gift of love to the patient.
C) The daughter's way of giving the nurse a break from providing care.
D) So she has something to do while waiting for her mother to die.

Question 19

The nurse is upset that a patient died before having the opportunity to visit with a friend one last time and thinks that she should have phoned the friend a day sooner. The patient did have a peaceful death despite not fulfilling his last request. Which of the following does this situation exemplify?

A) The inability to determine the exact time of death
B) Therapeutic presence
C) The nurse feels guilty and should value the efforts made and review what can be done in future situations.
D) The nurse being stressed over a situation that no one can control

Question 20

The family of a recently deceased patient thanks the nurse for helping their mother "die well." The nurse realizes the family is describing:

A) The nurse's satisfaction in knowing that everything possible was done for the patient.
B) Their perceived lack of support during the process.
C) Their goals were met.
D) Their belief that the patient's goals were met and that the patient died with dignity.