Nrnp6531 Loss, Death, and End-of-Life Care

Nrnp6531 Loss, Death, and End-of-Life Care 1. How should a nurse position the body after the death of a patient? a. Prone b. Supine c. On the side d. In Fowler position ANS: B The body should be placed in the supine position, with the arms at the sides or with the hands across the abdomen. DIF: Cognitive Level: Knowledge REF: p. 377-378 OBJ: 1 TOP: Positioning after Death KEY: Nursing Process Step: Implementation 2. According to Strauss and Glaser, three states of awareness of terminal illness have been identified. What do these states include? a. Denial, anger, and depression b. Shock, yearning, and anguish c. Avoidance, confrontation, and accommodation d. Closed awareness, mutual pretense, and open awareness ANS: D Strauss and Glaser have identified three states of awareness: closed awareness, mutual pretense, and open awareness. DIF: Cognitive Level: Knowledge REF: p. 378 OBJ: 2 TOP: Awareness of Terminal Illness KEY: Nursing Process Step: Implementation 3. When planning the care of a patient who is terminally ill, a nurse should include the prevention of pain and relief from discomfort. What should the nurse implement when administering pain medication? a. Narcotics have the potential for addiction. b. Pain medication must be given before the pain becomes unbearable. c. Pain medication should be given no more often than every 6 hours. d. Narcotics must be given as needed only. ANS: B Pain control must be consistent to provide constant relief rather than waiting until the pain is unbearable and then trying to relieve it. Addiction to narcotics is of little concern. DIF: Cognitive Level: Application REF: p. 372-373 OBJ: 5 TOP: Pain Control KEY: Nursing Process Step: Planning 4. What is one of the most important interventions for a nurse to implement when caring for a patient who is terminally ill? a. Touching and listening to the patient b. Encouraging the patient to express any regrets c. Assessing for signs and symptoms of impending death d. Talking to the patient about how other patients have handled the dying process ANS: A The simple presence of someone provides support and comfort. Neither words nor actions are necessary unless the patient requires something. Holding hands, touching, and listening are quality nursing responses. DIF: Cognitive Level: Application REF: p. 373 OBJ: 5 TOP: Fear of Loneliness KEY: Nursing Process Step: Implementation 5. A nurse is assessing a patient who is terminally ill for clinical signs of impending death. What should the nurse expect when assessing the patient's respirations? a. Deep, clear breath sounds b. Noisy, wet-sounding respirations c. Even, unlabored respirations d. Shallow, clear breath sounds ANS: B Breathing may sound wet and noisy. Noisy, wet-sounding respirations, termed the death rattle, are a response based on mouth breathing and accumulation of mucus in the upper airways. DIF: Cognitive Level: Comprehension REF: p. 373 OBJ: 2 TOP: Respiratory Changes KEY: Nursing Process Step: Assessment 6. What is believed to be the last sense to remain intact during the death process? a. Touch b. Sight c. Smell d. Hearing ANS: D Hearing is commonly believed to be the last sense to remain intact during the death process. DIF: Cognitive Level: Knowledge REF: p. 373 OBJ: 4 TOP: Sensory Changes KEY: Nursing Process Step: Implementation 7. A patient's family asks a nurse what to expect when the patient dies. What is the most accurate response by the nurse? a. His heart will stop, and then later he will quit breathing. b. His respirations will cease first, and then the heart stops beating within a few minutes. c. His heartbeat and br