Question: You are caring for a 73-year-old female on hospice with a terminal diagnosis who is near death. Family has called you to the room and state they are concerned about her loud, wet respirations. Which nursing interventions are appropriate at this time? Select all that apply.
Answer Options:
Reposition the patient onto one side to reduce gurgling, Perform frequent nasotracheal suctioning to remove the secretions, Administer a prescribed anticholinergic drug to dry the secretions, Auscultate lung sounds and notify the provider, Sit the patient up and make them cough and deep breathe to mobilize secretions, Place a small towel under the patient’s mouth to catch secretions
Answer: Reposition the patient onto one side to reduce gurgling, Administer a prescribed anticholinergic drug to dry the secretions
Question: A community outreach RN provides education about advance directives. Which statement by an attendee would indicate understanding?
Answer Options:
An advance directive cannot be changed or modified once it is filed in my health care record., I must have a lawyer or paralegal complete the advanced directive forms for it to be legal., An advance directive will allow me to designate someone to manage my finances., An advance directive provides guidance to health care professionals when I can no longer make decisions about life sustaining treatment.
Answer: An advance directive provides guidance to health care professionals when I can no longer make decisions about life sustaining treatment.
Question: The nurse is caring for a patient who has transitioned to comfort care in light of her worsening condition after being diagnosed with end stage cirrhosis. During assessment, the RN notes that the patient’s breathing will pause, then resume at a rapid rate, then pause, etc. How does the nurse interpret this respiratory assessment finding?
Answer Options:
Kussmaul respirations, Death rattle, Obstructive sleep apnea, Cheyne-Stokes respirations
Answer: Cheyne-Stokes respirations
Question: The nurse is teaching a patient’s family about common signs and symptoms of approaching death. What information does the nurse include?
Answer Options:
Insomnia, Seizures, Hunger, Pulmonary congestion and gurgling
Answer: D. Pulmonary congestion and gurgling
Question: The nurse is teaching a patient’s family about common signs and symptoms of approaching death. What information does the nurse include?
Answer Options:
Insomnia, Seizures, Hunger, Pulmonary congestion and gurgling
Answer: Pulmonary congestion and gurgling
Question: A new nurse is providing end of life care at a hospice facility. While discussing pain management, a family member inquires about the possibility of including cannabinoid-based medicines (eg., marijuana) in the treatment plan. Which of the following statements regarding use of cannabinoid-based medicines is incorrect?
Answer Options:
It is administered in place of (i.e., instead of) prescribed analgesics, It is important to be aware of state-specific laws, It is administered as an adjunct to (i.e., in addition to) prescribed analgesics, It is reported to address symptoms such as fatigue, anorexia, sleep problems, nausea, and vomiting.
Answer: A. It is administered in place of (i.e., instead of) prescribed analgesics
Question: The new graduate nurse is caring for a patient diagnosed with advanced, metastatic ovarian cancer. Prognosis is very poor and the patient has been told they have 4-6 weeks to live. The patient asks the nurse, “Am I eligible to receive hospice care?” Which is the best response by the nurse?
Answer Options:
It’s too soon to think about hospice. Are you interested in palliative care instead?, Hospice care can begin when life expectancy is six months or less., You must complete an advance directive in order to be eligible for hospice., Hospice care is for anyone who is going to die.
Answer: Hospice care can begin when life expectancy is six months or less.
Question: The nurse is caring for a patient with stage IV lung cancer who has requested palliative care. When is the patient considered to be eligible for palliative care?
Answer Options:
When the patient requires hospitalization, When curative treatment has been stopped, When a health care provider certifies patient has less than 6 months to live., At any stage of serious illness
Answer: At any stage of serious illness
Question: The nurse finds that a terminally ill patient is experiencing nausea and vomiting. Which is the most appropriate nursing action?
Answer Options:
Request an order for enteral nutrition support, Encourage frequent, large meals, No action is required as this is expected during last few days of life, Administer antiemetic agents as prescribed
Answer: Administer antiemetic agents as prescribed
Question: The nurse is caring for a patient who has transitioned to comfort care in light of her worsening condition after being diagnosed with end stage cirrhosis. During assessment, the RN notes that the patient’s breathing will pause, then resume at a rapid rate, then pause, etc. How does the nurse interpret this respiratory assessment finding?
Answer Options:
Kussmaul respirations, Death rattle, Obstructive sleep apnea, Cheyne-Stokes respirations
Answer: Cheyne-Stokes respirations
Question: The nurse is caring for a patient with stage IV lung cancer who has requested palliative care. When is the patient considered to be eligible for palliative care?
Answer Options:
When the patient requires hospitalization, When curative treatment has been stopped, When a health care provider certifies patient has less than 6 months to live., At any stage of serious illness
Answer: At any stage of serious illness
Question: The new graduate nurse is caring for a patient diagnosed with advanced, metastatic ovarian cancer. Prognosis is very poor and the patient has been told they have 4-6 weeks to live. The patient asks the nurse, “Am I eligible to receive hospice care?” Which is the best response by the nurse?
Answer Options:
It’s too soon to think about hospice. Are you interested in palliative care instead?, Hospice care can begin when life expectancy is six months or less., You must complete an advance directive in order to be eligible for hospice., Hospice care is for anyone who is going to die.
Answer: Hospice care can begin when life expectancy is six months or less.
Question: A nurse is preparing to care for a dying patient. Which of the following symptoms is most feared by terminally ill and dying patients?
Answer Options:
Nausea, Pain, Shortness of breath, Confusion
Answer: Pain
Question: The nurse is providing postmortem care. An autopsy is ordered by the attending provider. Which intervention in preparing the body would be incorrect?
Answer Options:
Use soap and water to bathe the body, Leave all tubing, catheters, and other medical devices in place, Change bed linens and use an absorbent under pad, Remove all tubing, catheters, and other medical devices
Answer: Remove all tubing, catheters, and other medical devices
Question: The nurse is providing postmortem care. An autopsy is ordered by the attending provider. Which intervention in preparing the body would be incorrect?
Answer Options:
Use soap and water to bathe the body, Leave all tubing, catheters, and other medical devices in place, Change bed linens and use an absorbent under pad, Remove all tubing, catheters, and other medical devices
Answer: Remove all tubing, catheters, and other medical devices
Question: The nurse is caring for a patient with stage IV lung cancer who has requested palliative care. When is the patient considered to be eligible for palliative care?
Answer Options:
When the patient requires hospitalization, When curative treatment has been stopped, When a health care provider certifies patient has less than 6 months to live., At any stage of serious illness
Answer: At any stage of serious illness
Question: The nurse is providing postmortem care. An autopsy is ordered by the attending provider. Which intervention in preparing the body would be incorrect?
Answer Options:
Use soap and water to bathe the body, Leave all tubing, catheters, and other medical devices in place, Change bed linens and use an absorbent under pad, Remove all tubing, catheters, and other medical devices
Answer: Remove all tubing, catheters, and other medical devices
Question: The nurse is caring for an 80-year-old terminally ill patient who is near death. During assessment the nurse notes that the patient is dyspneic and visibly uncomfortable. Which is the best treatment for this patient?
Answer Options:
Administer low-dose lorazepam, Administer 2 L of oxygen per nasal cannula, Administer morphine sulfate, Administer albuterol via a metered dose inhaler
Answer: C. Administer morphine sulfate
Question: The nurse is caring for a patient who has transitioned to comfort care in light of her worsening condition after being diagnosed with end stage cirrhosis. During assessment, the RN notes that the patient’s breathing will pause, then resume at a rapid rate, then pause, etc. How does the nurse interpret this respiratory assessment finding?
Answer Options:
Kussmaul respirations, Death rattle, Obstructive sleep apnea, Cheyne-Stokes respirations
Answer: Cheyne-Stokes respirations
Question: The nurse is teaching a patient’s family about common signs and symptoms of approaching death. What information does the nurse include?
Answer Options:
Insomnia, Seizures, Hunger, Pulmonary congestion and gurgling
Answer: Pulmonary congestion and gurgling
Question: The nurse is teaching a patient’s family about common signs and symptoms of approaching death. What information does the nurse include?
Answer Options:
Insomnia, Seizures, Hunger, Pulmonary congestion and gurgling
Answer: Pulmonary congestion and gurgling