Question 1

The nurse is providing care to a patient who has just been told about a terminal illness. The patient states, "I don't believe that doctor. I am going to get a second opinion." Which stage of the grieving process is the patient exhibiting?

Accepted Answer

A)  Denial 
B)  Anger 
C)  Bargaining 
D)  Depression

Question 2

The nurse is providing care to an African American patient who is near death. Which family responses to death does the nurse anticipate based on culture?

Accepted Answer

A)  Family members collapse when learning about the loved one's death. 
B)  Family members may limit social calls after the death of their loved one. 
C)  Family members may participate in Shiva. 
D)  Family members may develop psychosomatic symptoms.

Question 3

The home hospice nurse is conducting a review of systems during the health history interview. Which assessment question will allow the nurse to plan for the delivery of necessary supplies?

Accepted Answer

A)  "Is the patient having trouble swallowing?" 
B)  "Is the patient able to verbally communicate?" 
C)  "Is the patient incontinent?" 
D)  "Is the patient eating or drinking at least once per day?"

Question 4

The nurse is providing care to a terminal patient who is experiencing pain. The patient is unable to take oral medication. Which routes does the nurse prepare to administer pain medications to this patient? Select all that apply.

Accepted Answer

A)  Sublingual 
B)  Rectal 
C)  Enteral 
D)  Intramuscular 
E)  Intravenous

Question 5

When conducting a review of systems as part of the health history interview, the nurse notes that the patient is immobile. Which question is the priority when planning hospital care to reduce the risk of impaired skin integrity?

Accepted Answer

A)  "Do you have a pressure-reducing mattress at home?" 
B)  "How often do you turn the patient?" 
C)  "What and how often is the patient eating?" 
D)  "Have you told the doctor that the patient is having problems walking?"

Question 6

The nurse is assessing a terminal patient who is near death for mottling. Which locations will the nurse inspect for this clinical manifestation early in the dying process? Select all that apply.

Accepted Answer

A)  Toes 
B)  Feet 
C)  Knees 
D)  Lips 
E)  Face

Question 7

The nurse knocks on the door of a terminal patient's room to conduct a shift assessment. When the nurse enters, the patient's daughter yells, "Just get out of here. I don't have much time left with her. Leave us alone!" Which response by the nurse is most appropriate?

Accepted Answer

A)  Asking the daughter to leave the room to perform the assessment 
B)  Calling security to escort the daughter to the waiting room 
C)  Telling the daughter that it is ok to be angry but it is not okay to yell at those caring for her mom 
D)  Yelling at the daughter and the patient that this is inappropriate behavior and it will not be tolerated

Question 8

The nurse is providing care to a patient who is terminally ill with lung cancer. During the administration of the prescribed chemotherapy the patient states, "I am ok with this diagnosis as long as I get to see my daughter graduate from college at the end of the month." Based on this data, which coping mechanism is the patient using?

Accepted Answer

A)  Isolation 
B)  Denial 
C)  Depression 
D)  Bargaining

Question 9

The nurse is providing care to a patient with terminal cancer. The patient prefers to be alone and asks, "What's the use of living?" Based on this data, which coping mechanism is the patient exhibiting?

Accepted Answer

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

Question 10

During a hospice home care visit the caregiver states, "My mom has stopped eating. Should we consider tube feedings?" Based on this conversation with the caregiver, which response by the nurse is appropriate?

Accepted Answer

A)  "I will speak to the doctor about an order for tube feedings." 
B)  "Did your mom want to have tube feedings?" 
C)  "A decrease in appetite is normal in the dying process." 
D)  "A feeding tube is not going to prolong your mom's life."

Question 11

The nurse is providing home hospice care to a terminal patient. The caregiver states, "My dad has not had a bowel movement in several days. Can you call the doctor for a stool softener?" Which response by the nurse is appropriate?

Accepted Answer

A)  "Constipation is better than diarrhea; count your blessings." 
B)  "How much is your dad eating?" 
C)  "Constipation is a common side effect when prescribed narcotics.' 
D)  "A stool softener is not appropriate; I will ask for a stimulant."

Question 12

The nurse is conducting an admission assessment for a terminal patient. The patient's caregiver is assisting with the health history. Which question asked during the family history should the nurse direct at the caregiver?

Accepted Answer

A)  "Have you ever provided care to a patient who is dying?" 
B)  "Do you have Medical Power of Attorney?" 
C)  "Who will be helping you provide care to your family member?" 
D)  "Do you work full-time outside of the home?"

Question 13

The nurse assesses a dying patient and documents terminal restlessness. Which clinical manifestations did the nurse observe? Select all that apply.

Accepted Answer

A)  Having flaccid extremities 
B)  Seeing deceased family members 
C)  Attempting to get out of bed 
D)  Exhibiting confusion 
E)  Being noncommunicative

Question 14

Which statement best describes the timing of death?

Accepted Answer

A)  "Death occurs after a long battle with cancer." 
B)  "Death can occur as a result of accident or injury." 
C)  "Death can occur anytime during the life cycle." 
D)  "Death is not grieved when it occurs after a long life."

Question 15

The nurse is providing care to a patient who is diagnosed with terminal liver cancer. The patient does not talk much but has asked family members to hold her hand when visiting. Which stage of Kubler-Ross' grieving process is the patient experiencing?

Accepted Answer

A)  Depression 
B)  Bargaining 
C)  Acceptance 
D)  Isolation

Question 16

The nurse is providing care to a patient who has just learned of a terminal illness. Which resource is most appropriate for the nurse to use in this situation?

Accepted Answer

A)  Hospital chaplain 
B)  Primary healthcare practitioner 
C)  Hospice provider 
D)  Physical therapist

Question 17

Which healthcare provider typically initiates a do-not-resuscitate discussion with a patient who is terminally ill?

Accepted Answer

A)  Chaplain 
B)  Social worker 
C)  Physical therapist 
D)  Nurse

Exam 27: Assessing the Dying Patient