Question: A patient diagnosed with metastatic brain cancer says, “I’m dying, but I’m still living. I want to be in control as long as I can.” Which reply shows the nurse was actively listening? a. “Our staff will do their best to help you feel comfortable.” b. “Most people do not know how to help and are afraid of death.” c. “Although your body is frail, your mind and spirit are healthy.” d. “You want people to stop focusing on your weaknesses.”
Answer Choices:
Answer: C – “Although your body is frail, your mind and spirit are healthy.”
Question: A terminally ill patient says, “I know I’m not going to get well, but still.” and the patient’s voice trails off. Which response by the nurse is therapeutic? a. “What do you hope for?” b. “No, you’re not going to get well.” c. “Do you have questions about what is happening?” d. “I’m happy you are being realistic about your future.”
Answer Choices:
Answer: A – “What do you hope for?”
Question: A woman whose husband is terminally ill says, “I don’t want to cry in front of him. I don’t want him to know how soon death will occur or how sad I am.” Which response by the nurse would be most therapeutic? a. “I’m glad you are protecting him at a time when he is so vulnerable.” b. “He might be more comforted than disturbed by your tears.” c. “It’s important for you to know that time is running out.” d. “You definitely need to be honest about your feelings.”
Answer Choices:
Answer: B – “He might be more comforted than disturbed by your tears.”
Question: A family of a terminally ill patient asks the nurse, “What can we say when our family member mentions death is coming soon?” Which response could the nurse suggest? a. “We think you will be around for a long time.” b. “We don’t want you to give up trying to get well.” c. “We don’t think we’re ready to talk about this yet.” d. “We feel so sad when we think of life without you.”
Answer Choices:
Answer: D – “We feel so sad when we think of life without you.”
Question: As death approaches, a patient diagnosed with acquired immunodeficiency syndrome (AIDS) says, “I don’t want to see a lot of visitors anymore. Just my parents and my sibling can come in for a while each day.” What action should the nurse take?
Answer Choices:
Answer: The nurse should respect the patient’s wishes regarding visitations and ensure that the visiting policy is updated to reflect the patient’s preferences.
Question: A nurse manager notices that a staff member spends minimal time with a patient diagnosed with AIDS who is terminally ill. The patient says, “I’m having intense emotional reactions to this illness. Sometimes I feel angry, but other times I feel afraid or abandoned.” The nurse manager can correctly hypothesize that the most likely reason for the staff member’s avoidance is triggered by what?
Answer Choices:
A. Fear of infection transmission.
B. Feelings of inadequacy in dealing with complex emotional needs.
C. Belief that the patient needs time alone with family and friends.
D. Knowledge that the patient’s former lifestyle included high-risk behaviors.
Answer: B – Feelings of inadequacy in dealing with complex emotional needs.
Question: A terminally ill patient tells the nurse, “Life has been good. I am proud of my education. I overcame adversity with willpower. I always gave my best and expected things to turn out well. I intend to die as I lived: optimistically.” The nurse planning care for this patient recognizes a critical need to focus on maintaining the patient’s state of mind by:
Answer Choices:
A. Providing aggressive pain and symptom management.
B. Helping the patient reassess and explore existing conflicts.
C. Assisting the patient to focus on the meaning in life and death.
D. Supporting the patient’s use of personal resources to meet challenges.
Answer: D – Supporting the patient’s use of personal resources to meet challenges.
Question: The partner of a patient in hospice care tells the nurse, “The care provided by the aide and other family members is inadequate, so I must do everything myself. Can’t anyone do anything right?” How best should the palliative care nurse respond?
Answer Choices:
A. Providing teaching about anticipatory grieving.
B. Assigning new personnel to the patient’s care.
C. Arranging hospitalization for the patient.
D. Refer the partner for crisis counseling.
Answer: A – Providing teaching about anticipatory grieving.
Question: An individual was killed during a store robbery 2 weeks ago. The widowed spouse, who was diagnosed 6 years ago with schizoaffective disorder, cries spontaneously when talking about the death. Which is the nurse’s most therapeutic comment?
Answer Choices:
A. “I’m worried about how much you’re crying. You grief over your spouse’s death has gone on too long.”
B. “The unexpected death of your spouse must be painful. I’m glad you’re able to talk to me about your feelings.”
C. “This loss is harder to accept because of your mental illness. Let’s refer you for a partial hospitalization program.”
D. “Your crying shows you aren’t coping well. I made an appointment for you to see the psychiatrist for medication adjustment.”
Answer: B – “The unexpected death of your spouse must be painful. I’m glad you’re able to talk to me about your feelings.”
Question: Children of a widowed parent confer with the nurse; their surviving parent repeatedly relates the details of finding the deceased parent not breathing, performing cardiopulmonary resuscitation, going to the hospital by ambulance, and seeing the pronouncement of death. The family asks, “What can we do?” How should the nurse best counsel the family?
Answer Choices:
A. Encouraging them to share their own feelings with the surviving parent and ask for the retelling to stop.
B. Support the ideas that retelling the story should be limited to once daily to avoid unnecessary stimulation.
C. Share with them that retelling memories is to be expected as part of the aging process.
D. Reassure them that repeating the story is a helpful and a necessary part of grieving process.
Answer: D – Reassure them that repeating the story is a helpful and a necessary part of grieving
Question: A widow grieving her husband’s sudden and unexpected death tells the nurse, “I’m not feeling well. Yesterday, I saw my husband walk through the door, stop, and smile at me. Then he just faded away.” Which is the nurse’s most appropriate action? Assess for recent substance abuse. Suggest a referral to the mental health clinic. Arrange for an evaluation for antidepressant medication. Counsel the widow that visualizations are a normal part of grieving.
Answer Choices:
Answer: D – Counsel the widow that visualizations are a normal part of grieving.
Question: A nurse cared for a terminally ill patient for over a month and always looked forward to spending time with the patient. When the patient died, the nurse experienced sadness and felt mildly depressed. Eventually, the nurse explains these feelings to a mentor. What should be the mentor’s focus should counseling the nurse? Implementing stress-reduction strategies Seeking therapy for dysfunctional grief Discussing the experience of disenfranchised grief Considering taking a leave of absence to pursue healing
Answer Choices:
Answer: C – Discussing the experience of disenfranchised grief
Question: (Multiple Response): Which actions by a nurse contribute to protecting the rights of patients who are terminally ill? (Select all that apply.) Maintain hope for a positive prognosis. Hug the patient when sadness is expressed. Offer choices that promote personal control. Provide interventions that convey respect. Support the patient’s quest for spiritual growth.
Answer Choices:
Answer: A – Maintain hope for a positive prognosis. C – Offer choices that promote personal control. D – Provide interventions that convey respect. E – Support the patient’s quest for spiritual growth.
Question: A 5-year-old child moves and talks constantly. The child awakens before the parents every morning. The child attends kindergarten, but the teacher reports difficulty handling the behavior. What is this child’s most likely problem? a. Tic disorder b. Oppositional defiant disorder (ODD) c. Intellectual development disorder (IDD) d. Attention-deficit/hyperactivity disorder (ADHD)
Answer Choices:
Answer: D – Attention-deficit/hyperactivity disorder (ADHD)
Question: A 5-year-old child diagnosed with attention-deficit/hyperactivity disorder (ADHD) bounces out of a chair in the waiting room, runs across the room, and begins to slap another child. What is the nurse’s best action? a. Call for emergency assistance from another staff member. b. Instruct the parents to take the child home immediately. c. Direct this child to stop, and then comfort the other child. d. Take the child into another room with toys to act out feelings.
Answer Choices:
Answer: D – Take the child into another room with toys to act out feelings.
Question: A desired outcome for a 12-year-old diagnosed with oppositional defiant disorder (ODD) is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care? a. Bibliotherapy b. Music therapy c. Social skills groups d. Behavior modification
Answer Choices:
Answer: C – Social skills groups
Question: A child diagnosed with attention-deficit/hyperactivity disorder (ADHD) is going to begin medication therapy. The nurse should plan to teach the family about which combination of medications? a. Central nervous system stimulants and nonstimulants b. Antihypertensive agents c. Monoamine oxidase inhibitors (MAOIs) d. Anxiolytic medications
Answer Choices:
Answer: A – Central nervous system stimulants and nonstimulants
Question: A nurse will prepare teaching materials regarding which medication for the parents of a child diagnosed with enuresis? a. Haloperidol b. Desmopressin c. Methylphenidate d. Carbamazepine
Answer Choices:
Answer: B – Desmopressin
Question: Shortly after a 15-year-old’s parents announce a plan to divorce, the adolescent stops participating in sports, sits alone at lunch, and avoids former friends. The adolescent says, “All the other kids have families. If my parents loved me, then they would stay together.” Which nursing intervention is most appropriate?
Answer Choices:
A. Develop a plan for activities of daily living.
B. Communicate disbelief relative to the adolescent’s feelings.
C. Assist the adolescent to differentiate reality from perceptions.
D. Assess and document the adolescent’s level of depression daily.
Answer: C
Question: When group therapy is to be used as a treatment modality, the nurse should suggest placing a 9-year-old in a group that focuses on what?
Answer Choices:
A. Play activities exclusively.
B. Group discussion exclusively.
C. Talk focused on a specific issue.
D. Play and then talk about the play.
Answer: D