Combined NSG 430 Adult Health Nursing II All Exams. Accurate Exam Questions with Rationalized Answers 100% Guarantee Pass Grand Canyon University

NSG 430 Adult Health Nursing II Combined NSG 430 Adult Health Nursing II All Exams. Accurate Exam Questions with Rationalized Answers 100% Guarantee Pass Grand Canyon University 1. A patient who has been diagnosed with inoperable lung cancer and has a poor prognosis plans a trip across the country to settle some issues with family members. The nurse recognizes that the patient is manifesting which psychosocial response? a. Protesting the unfairness of death b. Anxiety about unfinished business c. Fear of having lived a meaningless life d. Restlessness about the uncertain prognosis Answer Anxiety about unfinished business NSG 430 Adult Health Nursing II The patient's statement indicates that there is some unfinished family business that the patient would like to address before dying. There is no indication that the patient is protesting the prognosis, feels uncertain about the prognosis, or fears that life has been meaningless. 2. A patient with terminal cancer is being admitted to a family-centered inpatient hospice. The patient's spouse visits daily and cheerfully talks with the patient about wedding anniversary plans for the next year. When the nurse asks about any concerns, the spouse says, I'm busy at work, but otherwise things are fine. Which issue would the nurse identify as a concern in working with the patient's spouse? a. Fear b. Anxiety c. Hopelessness d. Difficulty coping Answer Difficulty coping The spouse's behavior and statements indicate the absence of anticipatory grieving, which may lead to impaired adjustment as the patient progresses toward death. The spouse does not appear to feel fearful, hopeless, or anxious NSG 430 Adult Health Nursing II 3. As the nurse admits a patient in end-stage renal disease to the hospital, the patient tells the nurse, If my heart or breathing stop, I do not want to be resuscitated. Which action should the nurse take first? a. Place a Do Not Resuscitate (DNR) notation in the patient's care plan. b. Invite the patient to add a notarized advance directive in the health record. c. Advise the patient to designate a person to make future health care decisions. Answer d. Ask if the decision has been discussed with the patient's health care provider. Ask if the decision has been discussed with the patient's health care provider. A health care provider's order should be written describing the actions that the nurses should take if the patient requires CPR, but the primary right to decide belongs to the patient or family. The nurse should document the patient's request but does not have the authority to place the DNR order in the care plan until it is prescribed by the HCP. A notarized advance directive may be completed but is not needed to establish the patient's wishes. The patient may need a durable power of attorney for health care (or the equivalent), but this does not address the patient's current concern with possible resuscitation. 4. The nurse is caring for an unresponsive terminally ill patient who has NSG 430 Adult Health Nursing II 20-second periods of apnea followed by periods of deep and rapid breathing. Which action would the nurse take? a. Suction the patient's mouth. b. Administer oxygen via face mask. c. Document the patient's respiratory pattern. d. Place the patient in high Fowler's position. Answer Document the patient's respiratory pattern Cheyne-Stokes respirations are characterized by periods of apnea alternating with deep and rapid breaths. This respiratory pattern is expected in the last days of life and is not position dependent. There is also no need for supplemental oxygen by face mask or suctioning the patient. 5. The nurse is caring for a dying adolescent patient who is comatose. The patient's parents are interested in organ donation and ask the nurse how the health care providers determine brain death. Which response by the nurse accurately describes brain death determination? a. If CPR does not restore a heartbeat, the brain cannot function any longer. b. Brain death has occurred if there is not any breathing or brainstem reflexes. c. Brain death has occurred if a person has flaccid muscles and does not awaken. 2 / 152 NSG 430 Adult Health Nursing II Answer d. If respiratory efforts cease and no apical pulse is audible, brain death is present. Brain death has occurred if there is not any breathing or brainstem reflexes. The diagnosis of brain death is based on irreversible loss of all brain functions, including brainstem functions that control respirations and brainstem reflexes. The other descriptions describe other clinical manifestations associated with death but are insufficient to declare a patient brain dead. 3 / 152 NSG 430 Adult Health Nursing II 6. A patient in hospice is manifesting a decrease in all body system functions except for a heart rate of 124 beats/min and a respiratory rate of 28 breaths/min. Which statement would be accurate for the nurse to make to the patient's family? a. These vital signs will continue to increase until death finally occurs. b. These vital signs demonstrate the body's ability to compensate and heal. c. These vital signs are an expected response now but will slow down later. d. These vital signs may indicate an improvement in the patient's condition. - Answer These vital signs are an expected response now but will slow down later. An increase in heart and respiratory rate may occur before the slowing of these functions in a dying patient. Heart and respiratory rate typically slow as the patient progresses further toward death. In a dying patient, high respiratory and pulse rates do not indicate improvement or compensation, and it would be inappropriate for the nurse to indicate this to the family 7. A young adult patient with metastatic cancer who is very close to death appears restless. The patient keeps repeating, I am not ready to die. Which action by the nurse would show respect for the patient? a. Remind the patient that no one feels ready for death.