Question 1

When the parents of a child who is on life support ask what indicates brain death, the nurse responds that brain death occurs when:

Accepted Answer

A)  there have not been signals on the EKG. 
B)  no deep tendon reflexes can be stimulated. 
C)  there is an absence of EEG waves. 
D)  there have been no voluntary respirations for 5 minutes.

Question 2

When a patient chooses to die by refusing treatment that would prolong life, it is called _________________.

Accepted Answer

The answer of When a patient chooses to die by...

Question 3

A terminal patient in a skilled nursing home has stated that he does not want to get out of bed, because he is too tired and weak to sit in a chair. He sleeps on and off all day and night, his position is changed every 2 hours, and he is comfortable on his pain regimen. The next day the nurse will:

Accepted Answer

A)  assess his strength and desire to get out of bed, but permit him to remain in bed if he chooses, because that is his position of comfort. 
B)  encourage him to sit in the chair for an hour, because it is important to change his activity or he will get weaker from inactivity. 
C)  leave him in bed if he wishes, but have him do active exercises of his legs and arms to prevent further muscle weakness. 
D)  get him out of bed for an hour in the morning and afternoon and for a short time (15 minutes) before bedtime so that he does not sleep all day and stay awake at night.

Question 4

After a patient death, the nurse is preparing to perform postmortem care. The body is placed supine with the head raised so that:

Accepted Answer

A)  the deceased will appear to be sleeping. 
B)  blood will not pool in the face and cause discoloration. 
C)  movement of the deceased will be more convenient. 
D)  feces and urine will drain onto the bed pads.

Question 5

The nurse who adopts the Maciejewski theory of grief assesses for the reduction of grief after a period of ________ months.

Accepted Answer

The answer of The nurse who adopts the Maciejewski theory...

Question 6

Place the steps of postmortem care in their proper sequence. (Separate letters with a comma and space as follows: A, B, C, D, E.)

Accepted Answer

A)  Remove all tubing and equipment from the room. 
B)  Cleanse the body of all body fluids. 
C)  Position the body with the head of the bed raised 15 degrees. 
D)  Dress the deceased in a hospital gown and cover the deceased up to the chest. 
E)  Replace dentures.

Question 7

When the patient says, "I can die happily if I can live long enough to see my first grandchild that will be born next month." The nurse assesses that this patient is experiencing Kübler-Ross's stage of:

Accepted Answer

A)  denial. 
B)  bargaining. 
C)  anger. 
D)  depression.

Question 8

The family members of a young man, who is in the intensive care unit on life support after suffering irreversible brain damage resulting from a motorcycle accident, have been approached by the organ transplant team to consider organ donation. When they ask the nurse about this process, the nurse's best response would be:

Accepted Answer

A)  "There is a small cost to the family for the donation, but it is for a good cause." 
B)  "Often families are comforted by the knowledge that some good came from this tragedy." 
C)  "Because your son has been on life support, the only organs they can use would be his kidneys." 
D)  "Organ donation will probably delay the funeral."

Question 9

A patient who was admitted to hospice for comfort care of end-stage respiratory disease is asked what his hope is for his remaining life. He says, "I'm hoping for a miracle-that I will wake up one of these mornings and be able to breathe like when I was 20." The nurse would best respond:

Accepted Answer

A)  "That's not likely to happen. Is there something more realistic you are hoping for?" 
B)  "Your lungs are too damaged for you ever to breathe like you did when you were 20." 
C)  "It must be very tiring to have to struggle for every breath you take." 
D)  "Your miracle may be in the form of medication that will improve your comfort."

Question 10

Individuals move through the stages of grief at their own pace. When a person is "stuck" in a stage and cannot move forward, this is called _______________.

Accepted Answer

The answer of Individuals move through the stages of grief...

Question 11

A hospice patient is unable to tolerate food or fluids and has advance directives that indicate that he does not want IV fluids or tube feedings if he is unable to take oral feedings. His family is concerned that he will be very uncomfortable without food or fluids. The nurse should tell them that:

Accepted Answer

A)  once the patient is unconscious, his health care proxy can order IV fluids or tube feedings to prevent dehydration. 
B)  dehydration is painful, and medication can be given to overcome any pain. 
C)  IV fluids or a tube feeding would make the patient much more comfortable, and they should try to talk him into accepting them. 
D)  IV fluids or tube feeding would likely make the patient more uncomfortable, and dehydration has been shown to decrease pain and discomfort.

Question 12

A terminally ill patient is angry and belligerent. He yells at the nurses and his family for not coming quickly enough when he calls, and he states that he isn't receiving the care he needs. The nurse's most informative response would be:

Accepted Answer

A)  "Don't let him get away with this abuse. He doesn't need to yell at you." 
B)  "This may be how he feels best in dealing with this illness. You'll just have to ignore it." 
C)  "I'm afraid he is having a bad day and feels neglected." 
D)  "Anger is a reaction that dying people experience. You may be feeling some anger yourselves."

Question 13

The nurse discusses the grief theory of Maciejewski, which outlines the stages of grief as including: (Select all that apply.)

Accepted Answer

A)  yearning. 
B)  bargaining. 
C)  anger. 
D)  denial. 
E)  depression.

Exam 15: Loss, Grief, the Dying Patient, and Palliative Care