Question 1

A 20-year-old patient tells the nurse that he does not believe he has cancer and that the lab made a mistake with his blood-test results. The nurse realizes this patient is demonstrating which of the following?

Accepted Answer

A)   Acceptance
B)   Denial
C)   Anger
D)   Confusion B

Question 2

A terminally ill patient tells his son that the family has to realize that he is dying and begin to talk about it rather than pretending that it is not going to happen. The son responds by telling his father to stop talking about death and leaves the room. Which of the following does this conversation provide to the nurse?

Accepted Answer

A)   The patient was attempting to help the family understand that he is going to die, which might be a different expectation than that of the son
B)   The son is uncomfortable with death
C)   The patient and son have a difficult relationship
D)   The son does not have a good relationship with the other family members A

Question 3

A terminally ill patient tells the nurse that he needs help making his daughter understand that he is going to die since she is planning to take him home in a few days. Which of the following does this information provide to the nurse?

Accepted Answer

A)   The patient does not think his daughter is capable of caring for him at home
B)   The patient thinks he is sicker than he really is
C)   The patient does not understand that he is going to be discharged in a few days
D)   The patient and family member are not in the same stage of the grieving process D

Question 4

A terminally ill patient has many care needs. The patient's wife asks the nurse if there is something she can do to feel part of her husband's care. Which of the following would fulfill the patient's and wife's needs?

Accepted Answer

A)   Teaching her how to flush the indwelling urinary catheter
B)   Instructing the wife on how to administer intravenous medication
C)   Instructing the wife on how to safely provide food and fluids while preventing aspiration
D)   Teaching her how to change the patient's abdominal wound dressing

Question 5

A dying patient tells the nurse that she fears her children will forget her when she is gone. Which of the following can the nurse do to help this patient?

Accepted Answer

A)   Ask her what she would like done to ensure the children do not forget her
B)   Reassure her that the remaining family members will not permit that to occur
C)   Suggest the children visit with the patient as much as possible since the end is near
D)   Ask the patient if she wants her children to remember her as dying

Question 6

The 60-year-old daughter of an elderly patient tells the nurse that she is exhausted and regrets leaving her job to help her father at home. Which of the following can the nurse do to help this patient?

Accepted Answer

A)   Tell the daughter that her father will not live forever and that she can get on with her life later
B)   Remind the daughter that she is doing her duty
C)   Suggest that the daughter find a job so that she can get away each day
D)   Suggest the daughter take some time away from the parent and facilitate assistance for the patient while she is away

Question 7

A patient with a terminal illness is receiving a blood transfusion and physical therapy in preparation for discharge to his home. The nurse realizes that these treatments will provide which of the following for the patient?

Accepted Answer

A)   Speed the patient's discharge
B)   Delay the dying process
C)   Help the patient deny that he is dying
D)   Enhance the patient's quality of life

Question 8

The husband of a terminally ill patient is concerned that his 15-year-old daughter is angry with him that his wife is going to die. Which of the following should the nurse do to support the spouse?

Accepted Answer

A)   Tell him that the child will soon get over the death of the parent and things will be back to normal
B)   Encourage him to leave the child alone
C)   Remind him that children that age act unreasonably and getting upset will not help
D)   Explain that anger is a natural emotion at 15 and that the daughter needs to be reminded that one parent is still there to support and help her

Question 9

A terminally ill patient tells the nurse that she wants to die at home but her son and his family are unable to help with her care needs. The nurse should respond with which of the following?

Accepted Answer

A)   Having you at home might be disruptive for them at this time
B)   It sounds like your family is too busy to provide for you
C)   Since your son and his family are unable to care for you, they might feel that you are safer here in the hospital
D)   I'm sure that since everyone works, it would be hard for them to figure out how to care for you and maintain their responsibilities

Question 10

The son of a terminally ill patient tells the nurse that he is "afraid" to leave his mother's side since he does not want her to die while he is gone. Which of the following responses should the nurse give to this family member?

Accepted Answer

A)   She most likely will not die while you are gone, so please go and return as soon as possible
B)   It is important for you to balance your responsibilities with the needs of your mother
C)   It is probably best that you not leave her at this time
D)   She might we waiting for you to give her permission to die and you will do this if you go

Question 11

The father of a child dying after being hit by a moving vehicle is concerned that his wife is not going to take the child's prognosis very well. Which of the following responses should the nurse give the father?

Accepted Answer

A)   I will let you tell her the child's prognosis
B)   What are the cues that signal the amount of information she will be able to handle at this time?
C)   Someone needs to tell her that the child is not going to survive
D)   The physician can talk with her

Question 12

The mother of a 10-month-old baby, grieving the death of a close friend, is having difficulty addressing the baby's needs. Which of the following should the nurse do to assist the mother and child?

Accepted Answer

A)   Contact Children and Youth Services and see if the child can be temporarily placed with another family
B)   Find out if other adult family members can step in and help with the infant's care needs
C)   Discuss the issue with the mother and suggest that she realize that life goes on
D)   Remind the mother that she has responsibilities that cannot be ignored

Question 13

The parents of a dying child are having difficulty deciding when to discontinue life support. Which of the following can be done to assist these parents?

Accepted Answer

A)   Help the parents identify what would be in their child's best interest
B)   Ask the parents what they want
C)   Suggest that the decision be made soon so that they can resume their normal lives as soon as possible
D)   Encourage them to allow the dying process to occur naturally

Question 14

The nurse is caring for a patient who is experiencing the third trajectory of life. Which of the following should be included in this patient's plan of care?

Accepted Answer

A)   Assistance with home activities of daily living
B)   Palliative care
C)   Hospice care
D)   Treatment of sudden exacerbations of the illness

Question 15

The mother of a dying child is seen sitting in the lounge, quietly crying and saying "I don't know what I am going to do without her." The nurse realizes that which of the following is occurring with the mother?

Accepted Answer

A)   Inappropriate drama
B)   Effective coping
C)   Exaggerated response
D)   Anticipatory grieving

Question 16

The daughter of a terminally ill patient tells the nurse that she does not know what she is going to do with her life once her mother passes away since everything has revolved around her mother for years. Which of the following responses should the nurse give to this family member?

Accepted Answer

A)   I am sure that you will be lonely but that will pass
B)   It is important for you to take care of yourself and your responsibilities
C)   Will you be able to return to work or take up a hobby to pass the time?
D)   I am sure that your mother appreciated everything you have done to help her

Question 17

A dying patient tells the nurse he is sorry that he will not be able to see his daughter graduate from high school. Which of the following can the nurse suggest to this patient?

Accepted Answer

A)   Encourage the patient to not dwell on what he will be missing
B)   Write a letter to his daughter to be given to her on her graduation day
C)   Remind the patient that his energies should be focused on living each day as well as possible
D)   Remind the patient that children are resilient and what is important to a parent is not as important to a child

Question 18

A terminally ill patient tells his family that he has "had a good life" and wants everyone to enjoy theirs as well. The family members are quietly weeping and ask him if there is anything he would like or anyone he would like to see one last time. The nurse realizes this family is functioning as which of the following?

Accepted Answer

A)   A confused family
B)   A dysfunctional family
C)   A healthy family
D)   A relieved family

Question 19

A 10-year-old child with terminal cancer tells the nurse that he wants to flush his own port in preparation for the chemotherapy treatment. The nurse realizes the patient is functioning within which of Erickson's stages of development?

Accepted Answer

A)   Autonomy versus Shame
B)   Trust versus Mistrust
C)   Industry versus Inferiority
D)   Integrity versus Despair

Question 20

A dying child tells the nurse that once she "gets over this disease," she plans to go to Disney World and have a long, well-deserved vacation. The nurse realizes the patient is demonstrating:

Accepted Answer

A)   One final wish before death
B)   Delirium
C)   Confusion
D)   A focus on cure and continuing life

Exam 7: Caring for End-Of-Life Patients Across the Life Span