Question 1

Hospice care can be provided in which of the following settings? (Select all that apply. )

Accepted Answer

Because hospice is a philosophy of care,not necessarily a place,the services are sometimes provided at home,in freestanding hospice facilities,or in nursing home,extended care,or acute care settings.

Question 2

A new staff member is working with a patient who is dying.A nurse evaluates that this new employee requires additional teaching when he or she is observed:

Accepted Answer

Some cultures require silence at the time of death;others express grief with loud wailing,"falling out," or hysteria.Do not rush any grieving process.Give family members and friends a private place to gather.Allow them time to ask questions.This creates a safe environment for the grieving family.Questions provide information about how they are coping with loss and their needs.Ask family members if they have requests for preparation or viewing of the body (such as position of the body,special clothing,or shaving).Determine whether they wish to be present or assist with care of the body.This may provide closure for those who wish to assist with body preparation.

Question 3

An appropriate technique for the nurse to implement when caring for a patient's body after death is to:

Accepted Answer

Respect the individuality of the patient and family and support their right to have cultural or religious values and beliefs upheld.Identify and tag the body,leaving identification on the body as directed by agency policy to ensure proper identification of the body for delivery to the morgue or mortuary.After viewing,remove linens and gown,per agency policy.Place the body in a shroud provided by the agency.The shroud protects from injury to the skin,avoids exposure of the body,and provides a barrier against potentially contaminated body fluids.Removal of tubes and lines is contraindicated if an autopsy is planned.

Question 4

The patient is on a ventilator and has a heartbeat but has been declared "brain dead." The family has agreed to organ donation.The nurse realizes that which of the following organ donations would require that the patient be left on life support?

Accepted Answer

In the case of vital organ donation (e.g. ,heart,lungs,liver,pancreas,and kidneys),the patient must remain on life support until the organs are removed surgically.Tissues such as eyes,bone,and skin are commonly retrieved from deceased patients who are not on life support.

Question 5

The patient has a history of terminal cancer but is being admitted for treatment of a pressure ulcer.The patient's wife has been caring for him at home and refuses to discuss admission to a nursing home.The wife looks extremely tired and is near the point of exhaustion.What could the nurse suggest?

Accepted Answer

Hospice benefits include respite for family caregivers.The current plan of care may be the reason for the decubiti and may lead to the patient's wife becoming ill.Palliative and hospice care place a primary focus on the patient's values,quality of life,and care preferences.

Question 6

_____________ helps people live as well as possible through the dying process.

Accepted Answer

The answer of _____________ helps people live as well as...

Question 7

The nurse is preparing to assist the patient at the end stage of her life.To provide comfort for the patient in response to anticipated symptom development,the nurse plans to:

Accepted Answer

Have the patient identify what she wants to accomplish,and use strategies to conserve energy for meeting those goals.This provides the patient with a sense of well-being and purpose to meet important personal goals.Decreasing the patient's fluid intake may make the terminally ill patient more prone to dehydration and constipation.The nurse should take measures to help maintain oral intake,such as administering antiemetics,applying topical analgesics to oral lesions,and offering ice chips.The use of analgesics should not be limited.Controlling the terminally ill patient's level of pain is a primary concern in promoting comfort.Nausea,vomiting,and anorexia may increase the terminally ill patient's likelihood of inadequate nutrition.The nurse should serve smaller portions and bland foods,which may be more palatable.

Question 8

For a patient in the final stages of dying,a nurse expects to:

Accepted Answer

Poor circulation of body fluids,immobilization,and inability to expectorate secretions cause rattles and bubbling.Elevate the head with a pillow or raise the head of the bed;gently turn the head to the side to drain secretions.Coolness,color,and temperature change in the hands,arms,legs,and feet.Place socks on the feet.Cover with a light cotton blanket.Keep warm blankets on the patient.Decreased muscle tone and consciousness may lead to incontinence of urine and/or bowel.Change bedding as appropriate.Use an indwelling catheter for patient comfort.Do not force the patient to eat or drink;give ice chips,soft drinks,or juice,as possible.Provide mouth care.

Question 9

The nurse recognizes that anticipatory grieving can be most beneficial for a patient or family because it can:

Accepted Answer

The benefit of anticipatory grief is that it allows for a gradual disengagement from the loss.Anticipatory grief may help people move through the stages of grief,allowing time to grieve in private,to discuss the anticipated loss with others,and then to "let go" of the loved one.

Question 10

A nurse-initiated or independent activity for promotion of respiratory function in a terminally ill patient is to:

Accepted Answer

Position the patient in semi-Fowler's or Fowler's position.This promotes maximal ventilation,lung expansion,and drainage of secretions.Limiting fluids may not promote respiratory function,and unless a patient is on a fluid-restricted diet,the nurse should not do so.Reducing narcotic analgesic use is not a nurse-initiated activity to promote respiratory function.Respiratory rate should be assessed before narcotics are administered,to prevent further respiratory depression.Management of air hunger involves judicious administration of morphine and anxiolytics for relief of respiratory distress.The administration of bronchodilators would require a physician's order.It is not an independent nursing activity.

Question 11

Nurses provide _______________ that is defined as care of the body after death in a manner consistent with the patient's religious and cultural beliefs.

Accepted Answer

The answer of Nurses provide _______________ that is defined as...

Question 12

_______________ grief (symptoms lasting longer than 6 months)occurs when a person experiences significant distress related to the loss.

Accepted Answer

The answer of _______________ grief (symptoms lasting longer than 6...

Question 13

Before allowing the family of a deceased patient to view the body,the nurse should:

Accepted Answer

If the person wore dentures,reinsert them.If the mouth fails to close,and if it is culturally appropriate to close the mouth,place a rolled-up towel under the chin.Dentures maintain the patient's natural facial expression.Place a small pillow or a folded towel under the head.This prevents pooling of blood in the face and subsequent discoloration.Avoid placing one hand on top of the other.Placing one hand on top of the other can lead to discoloration of the skin.Remove soiled dressings and replace with clean gauze dressings.Use paper tape.Paper tape minimizes skin trauma.Changing dressings helps to control odors caused by microorganisms and creates a more acceptable appearance.

Question 14

The World Health Organization (2002)defines ___________ as an "approach that improves the quality of life of individuals and their families facing life-threatening illness,through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical,psychological,and spiritual problems."

Accepted Answer

The answer of The World Health Organization (2002)defines ___________ as...

Question 15

___________________ specify medical interventions that the patient does not want in certain situations,such as mechanical ventilation,and are used to communicate the care a patient wants,for example,pain relief to the fullest extent possible.

Accepted Answer

The answer of ___________________ specify medical interventions that the patient...

Question 16

After the death of a patient and before other nursing interventions are implemented,the nurse should:

Accepted Answer

Immediately after death and before other activities are begun,place the body in supine position,and elevate the head of the bed 30 degrees to decrease rigor mortis.Ask family members if they have requests for preparation or viewing of the body (such as position of the body,special clothing,and shaving).Determine whether they wish to be present or assist with care of the body.This provides closure for those who wish to assist with body preparation.

Question 17

The patient was a practicing Hindu when he died.Knowing this,the nurse realizes that:

Accepted Answer

With Hinduism,family members prefer to wash the body after death and are present to chant,pray,and use incense.In Buddhism,when the person has died,the body should be covered with a cotton sheet.Others should not touch the body,and the mouth and eyes of the deceased are left open.Christians in the Roman Catholic tradition often request sacraments of penance and anointing of the Sick and Holy Communion at the end of life.In Orthodox Judaism,a family member remains with the body until burial,which takes place within 24 hours,not on the Sabbath.

Question 18

Grief that occurs before an actual loss or death and involves gradual disengagement from what is being lost is known as which type of grief?

Accepted Answer

Grief that occurs before an actual loss or death and involved gradual disengagement from what is being lost is anticipatory grief.Normal or uncomplicated grief is evidenced by feelings,behaviors,and reactions associated with loss such as sadness,anger,crying,resentment,and loneliness.Complicated grief occurs when a person experiences distress related to the loss.

Question 19

When caring for a patient who is an appropriate candidate for organ or tissue donation,the nurse knows that requests for donation are:

Accepted Answer

A patient's choice regarding organ and tissue donation can be included in an advance directive.The 1986 Omnibus Budget Reconciliation Act (OBRA)requires that a patient's significant others be offered the option of organ and tissue donation;however,organ donation is voluntary.It is important for people to keep family members informed of their wishes regarding organ donation.Because of the sensitive nature of making requests for organ donation,professionals educated in organ procurement often assume that responsibility.They inform family members of their options for donation,provide information about costs (no cost to the family),and inform the family that donation does not delay funeral arrangements.

Question 20

Hospice benefits include which of the following? (Select all that apply. )

Accepted Answer

Hospice benefits include respite for family caregivers,limited hospitalization for acute symptom management,and bereavement care after death.Hospice does not provide financial assistance or funeral arrangements.

Quiz 17: Palliative Care