Question 1

The family of a client with a terminal illness hesitates to agree to palliative care because of not wanting to give up on a possible cure. How should the nurse respond while also including a principle of palliative care?

Accepted Answer

A)   "Most people don't realize that palliative care means there is no cure."
B)   "There will not be another opportunity if palliative care is refused now."
C)   "The client can continue to receive treatment intended to cure the disease."
D)   "Palliative care and curative treatments cannot be provided at the same time." C

Question 2

The nurse helps the family decide whether a 13-year-old sibling should be present during the death of a younger brother. Which aspect should the nurse keep in mind when the family is making this decision?

Accepted Answer

A)   Hospital visiting hours' policy
B)   Reason for the child to be dying
C)   Developmental age of the sibling
D)   Quality of the relationship between the children
E)   Cultural practices within the family regarding death and dying C,D,E

Question 3

The family of a client nearing end-of-life asks if they can leave to get dinner. Which client observation causes the nurse to suggest that the family wait a while longer before leaving the client?

Accepted Answer

A)   Cheyne-Stokes respiration pattern
B)   Apneic periods of 15 to 30 seconds
C)   Shallow respirations at 30 per minute
D)   Use of neck and shoulder muscles to breathe B

Question 4

The spouse of a client nearing death is concerned because the client's breathing is "so noisy." How should the nurse refer to the client's respiratory status when talking with the spouse?

Accepted Answer

A)   Pneumonia
B)   Congestion
C)   Death rattle
D)   Fluid in the lungs

Question 5

The nurse providing palliative care to a client with a terminal illness is experiencing moral distress. Which situation most likely caused the nurse to experience this emotional response? Select all that apply.

Accepted Answer

A)   The nurse continues to provide chemotherapy to the client upon the family's request.
B)   The nurse is unable to relieve dyspnea because of a fear of overmedicating the client.
C)   The team members decide to withhold routine fluids unless the client is thirsty.
D)   Another health care provider suggested that another course of treatment might "do the trick."
E)   The adult children want everything possible done yet the client is exhausted and wants it to end.

Question 6

The staff development trainer is preparing an educational program for nurses who provide palliative care. Which suggestion should the trainer make to encourage a trusting relationship between the nurse and family? Select all that apply.

Accepted Answer

A)   Maintain a nonjudgmental approach when providing care
B)   Listen to the family's experience with illness and suffering
C)   Acknowledge the strengths of the individual family members
D)   Encourage the family to take a break and permit the nurse to provide care
E)   Demonstrate compassion by showing an understanding of the family's suffering

Question 7

A client assigned to a student nurse for care dies shortly after the student completes morning care. What should the nurse do to support the student at this time?

Accepted Answer

A)   Suggest the student leave the clinical area
B)   Encourage the student to participate in postmortem care
C)   Talk with the student about the experience and answer any questions
D)   Assign the student to another client for the remainder of the clinical day

Question 8

The hospice nurse learns that the spouse of a client with end-stage Alzheimer's disease has been the primary caregiver without assistance for the past 3 years. What are the risks to this spouse? Select all thatapply.

Accepted Answer

A)   Guilt
B)   Depression
C)   Ambivalence
D)   Lack of personal care
E)   Feelings of helplessness

Question 9

The nurse suspects that a client receiving palliative care is nearing end-of-life. What did the nurse assess to make this clinical determination? Select all that apply.

Accepted Answer

A)   Sleeping more often
B)   Refusing to eat
C)   Inability to swallow
D)   Asking to talk with a pastor
E)   Talking with a deceased spouse

Question 10

An interprofessional team meeting is scheduled to discuss the care needs for a client with a terminal illness. What should the nurse expect when participating in this meeting? Select all that apply.

Accepted Answer

A)   Control is centralized.
B)   Client goals direct care.
C)   Focus is on problem solving.
D)   Client's family can be in attendance.
E)   Decisions are made by the team leader.

Question 11

The family of a client receiving palliative care for a terminal illness hesitate to call for the nurse since all staff seem to be too busy to address the client's needs. Which action should the nurse take to improve the connection with the family?

Accepted Answer

A)   Vary the number and type of caregivers who respond to the client's needs
B)   Enter the room and stand or sit at the bedside to talk with the client and family
C)   Provide the family with reading material that explains the role of palliative care
D)   Attend to infusions and environmental issues while talking with the client and family

Exam 10: Families in Palliative and End-of-Life Care