Chapter 08: Concepts of Care for Patients at
End of Life
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is teaching a family member about various types of complementary
therapies that might be effective for relieving the dying client’s anxiety and
restlessness. Which statement made by the family member indicates understanding of
the nurse’s teaching?
a. “Maybe we should just hire an around-the-clock sitter to stay with
Grandmother.”
b. “I have some of her favorite hymns on a CD that I could bring for music
therapy.”
c. “I don’t think that she’ll need pain medication along with her herbal
treatments.”
d. “I will burn therapeutic incense in the room so we can stop the anxiety pills.”
ANS: B
Music therapy is a complementary therapy that may produce relaxation by quieting
the mind and removing a client’s inner restlessness. Hiring an around-the-clock sitter
does not demonstrate that the client’s family understands complementary therapies.
Complementary therapies are used in conjunction with traditional therapy.
Complementary therapy would not replace pain or anxiety medication but may help
decrease the need for these medications.
DIF: Applying TOP: Integrated Process: Teaching/Learning KEY: End-of-life
care, Nonpharmacologic comfort measures MSC: Client Needs
Category: Physiological Integrity: Basic Care and Comfort
, 2. A nurse is caring for a terminally ill client who has just died in a hospital setting with
family members at the bedside. Which action will the nurse take first?
a. Call for emergency assistance so that resuscitation procedures can begin.
b. Ask family members if they would like to spend time alone with the client.
c. Ensure the primary health care provider completed the death certificate.
d. Request family members to prepare the client’s body for the funeral home.
ANS: B
Before moving the client’s body to the funeral home, the nurse asks family members
if they would like to be alone with the client. Emergency assistance will not be
necessary. Although it is important to ensure that a death certificate has been
completed before the client is moved to the mortuary, the nurse first would ask family
members if they would like to be alone with the client. The client’s family would not
be expected to prepare the body for the funeral home but they could be asked if they
wish to provide some care such as brushing the hair.
DIF: Applying TOP: Integrated Process: Caring KEY: End-of-life
care, Postmortem care MSC: Client Needs Category: Psychosocial
Integrity
3. A nurse assesses a client who is dying. Which sign or symptoms does the nurse assess
to determine whether the client is near death?
a. Level of consciousness
b. Respiratory rate
c. Bowel sounds
d. Pain level on a 0-10 scale
ANS: B
Although all of these assessments would be performed during the dying process,
periods of apnea and Cheyne-Stokes respirations indicate that death is near. As
End of Life
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is teaching a family member about various types of complementary
therapies that might be effective for relieving the dying client’s anxiety and
restlessness. Which statement made by the family member indicates understanding of
the nurse’s teaching?
a. “Maybe we should just hire an around-the-clock sitter to stay with
Grandmother.”
b. “I have some of her favorite hymns on a CD that I could bring for music
therapy.”
c. “I don’t think that she’ll need pain medication along with her herbal
treatments.”
d. “I will burn therapeutic incense in the room so we can stop the anxiety pills.”
ANS: B
Music therapy is a complementary therapy that may produce relaxation by quieting
the mind and removing a client’s inner restlessness. Hiring an around-the-clock sitter
does not demonstrate that the client’s family understands complementary therapies.
Complementary therapies are used in conjunction with traditional therapy.
Complementary therapy would not replace pain or anxiety medication but may help
decrease the need for these medications.
DIF: Applying TOP: Integrated Process: Teaching/Learning KEY: End-of-life
care, Nonpharmacologic comfort measures MSC: Client Needs
Category: Physiological Integrity: Basic Care and Comfort
, 2. A nurse is caring for a terminally ill client who has just died in a hospital setting with
family members at the bedside. Which action will the nurse take first?
a. Call for emergency assistance so that resuscitation procedures can begin.
b. Ask family members if they would like to spend time alone with the client.
c. Ensure the primary health care provider completed the death certificate.
d. Request family members to prepare the client’s body for the funeral home.
ANS: B
Before moving the client’s body to the funeral home, the nurse asks family members
if they would like to be alone with the client. Emergency assistance will not be
necessary. Although it is important to ensure that a death certificate has been
completed before the client is moved to the mortuary, the nurse first would ask family
members if they would like to be alone with the client. The client’s family would not
be expected to prepare the body for the funeral home but they could be asked if they
wish to provide some care such as brushing the hair.
DIF: Applying TOP: Integrated Process: Caring KEY: End-of-life
care, Postmortem care MSC: Client Needs Category: Psychosocial
Integrity
3. A nurse assesses a client who is dying. Which sign or symptoms does the nurse assess
to determine whether the client is near death?
a. Level of consciousness
b. Respiratory rate
c. Bowel sounds
d. Pain level on a 0-10 scale
ANS: B
Although all of these assessments would be performed during the dying process,
periods of apnea and Cheyne-Stokes respirations indicate that death is near. As
