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.)

Accepted Answer

Hospice care is designed to provide comfort and support to individuals who are in the final phase of a terminal illness. It includes services from healthcare providers, nursing care, hospice aide services, and social worker services to manage symptoms and provide emotional, social, and spiritual support. Long-term in-client pain control is not specifically excluded, but the term as used might not directly correspond to typical hospice care services, which focus on comfort rather than long-term treatments.

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?

Accepted Answer

Heart disease is the leading cause of death globally, surpassing other conditions such as cerebrovascular disease, chronic lower respiratory disease, and diabetes mellitus.

Question 3

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

Accepted Answer

CMO stands for Comfort Measures Only, indicating that the focus of care is on palliative measures to relieve symptoms and improve quality of life, rather than curative treatments. Morphine for pain management is consistent with this approach.

Question 4

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

Accepted Answer

A living will primarily describes the client's wishes regarding treatment intended to sustain life, including instructions for situations where the individual may not be able to communicate their preferences directly due to illness or incapacity.

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.)

Accepted Answer

Palliative care focuses on providing relief from symptoms and improving quality of life. A foot massage (A) can provide comfort, administering analgesics (B) helps manage pain, clearing secretions (D) aids in breathing, and gentle stretching (E) helps maintain mobility. Kidney transplantation (C) is not part of palliative care, which is not curative.

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?

Accepted Answer

The client's behavior of staring out of a window in a stupor, having a face devoid of any emotion, and appearing withdrawn and distant is indicative of the numb shock phase of grief. This phase is characterized by a state of disbelief and numbness that often follows immediately after the loss of a loved one.

Question 7

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

Accepted Answer

The answer of The nurse cares for a client who...

Question 8

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

Accepted Answer

Donning gloves is a priority to protect the healthcare worker from potential exposure to bodily fluids and to maintain infection control practices.

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.)

Accepted Answer

Palliative care is appropriate for patients at any age who are living with a serious illness and need relief from symptoms and stress. The 92-year-old man who has just suffered a stroke, the 83-year-old woman with end-stage dementia, and the 12-year-old girl with terminal lymphoma are all facing life-limiting conditions for which palliative care is suitable. It aims to improve quality of life for both the patient and the family.

Question 10

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

Accepted Answer

Hospice care is most appropriate for patients who are expected to live 6 months or less and are not pursuing aggressive treatment. The client with brain cancer fits this criterion as they are expected to live 3 months and are not pursuing aggressive treatment.

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.)

Accepted Answer

Grimacing or strained facial expression, diaphoresis, and moaning or groaning at rest or movement are all signs that may indicate pain, especially in patients who may not be able to communicate their discomfort verbally. Slow heartbeat is not typically a sign of pain, and taking sips of water from a cup is not related to pain assessment.

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?

Accepted Answer

Somatic pain is often described as aching, throbbing, or stabbing, reflecting its origin from skin, bone, or deep tissue.

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?

Accepted Answer

Acetaminophen is typically the first-line treatment for mild to moderate pain due to its effectiveness and safety profile.

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?

Accepted Answer

The answer of The nurse cares for a hospice client...

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?

Accepted Answer

The maximum recommended amount of acetaminophen per day to avoid liver damage, especially for adults with normal liver function, is 4 grams (4,000 mg).

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?

Accepted Answer

Corticosteroids are considered adjuvant medications in the treatment of cancer pain, including end-stage prostate cancer. They can help reduce inflammation and swelling, thereby potentially decreasing pain and improving the effectiveness of other pain management strategies.

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?

Accepted Answer

Intraspinal administration can provide direct delivery of pain medication to the central nervous system, potentially offering more effective pain relief for severe pain when other routes have been inadequate.

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?

Accepted Answer

The sedative effects of opioid analgesics typically decrease as the body adjusts to the medication, usually within 24 to 48 hours. This timeframe allows for most patients to experience a reduction in the initial sedation caused by opioids as tolerance to this side effect develops.

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?

Accepted Answer

In Islamic tradition, it is common to place the body of a dying person so that it faces Mecca (Qibla). This is a significant religious practice for Muslims at the end of life. The other options do not specifically align with Islamic end-of-life customs.

Question 20

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

Accepted Answer

Lactulose is a hyperosmotic laxative that draws water into the colon, softening stools and promoting defecation.

Quiz 24: Palliative and End-Of-Life Care