NURS 104 EXAM 2
QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS)|ALREADY GRADED A+|NEWEST
VERSION
QUESTIONS AND ANSWERS
Which of the following statements about comfort care is accurate?
a. Withholding and withdrawing life-sustaining treatment are distinctly different in the
eyes of the legal community.
b. Each procedure should be evaluated for its effect on the patient's comfort before being
implemented.
c. Only the patient can determine what constitutes comfort care for him or her.
d. Withdrawing life-sustaining treatments is considered euthanasia in most states..
ANSWER - b. Each procedure should be evaluated for its effect on the patient's comfort
before being implemented.
The goal of comfort care is to provide only treatments that do not cause pain or other
discomfort to the patient.
_____ is a powerful influence when the decision-making process is dealing with recovery or
a peaceful death.
a. Hope
,b. Religion
c. Culture
d. Ethics. ANSWER - a. Hope
Hope is a powerful influence on decision making, and a shift from hope for recovery to hope
for a peaceful death should be guided by clinicians with exemplary communication skills.
Ethics, religion, and culture can influence the decision process regarding care and end-of-
life decisions.
The patient's condition has deteriorated to the point where she can no longer make
decisions about her own care. Which of the following nursing interventions would be most
appropriate?
a. Obtain a verbal DNR order from the physician.
b. Continue caring for the patient as originally ordered because she obviously wanted this.
c. Consult the hospital attorney for recommendations on how to proceed.
d. Discuss with the family what the patient's wishes would be if she could make those
decisions herself.. ANSWER - d. Discuss with the family what the patient's wishes would be
if she could make those decisions herself.
If the patient is not able to make end-of-life decisions for herself, her family members should
be approached to discuss the next steps because they may have insight into what her wishes
would be.
The two basic ethical principles underlying the provision of health care are
a. beneficence and nonmaleficence.
b. veracity and beneficence.
c. fidelity and nonmaleficence.
d. veracity and fidelity.. ANSWER - a. beneficence and nonmaleficence.
The two basic ethical principles underlying the provision of health care are beneficence and
nonmaleficence.
A patient was admitted to the critical care unit several weeks ago with an acute myocardial
infarction and subsequently underwent coronary artery bypass grafting surgery. Since a
cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram
shows no meaningful brain activity. The patient does not have an advance directive. Which
,of the following statements would be the best way to approach the family regarding his
ongoing care?
a. "I will refer this case to the hospital ethics committee, and they will contact you when
they have a decision."
b. "What do you want to do about the patient's care at this point?"
c. "Dr. Smith believes that there is no hope at this point and recommends DNR status."
d. "What would the patient want if he knew he were in this situation?". ANSWER - d.
"What would the patient want if he knew he were in this situation?"
Approaching the family and asking what they know about the patient's wishes and
preferences is the best way to begin this discussion. Emotional support for the patient and
the family is important as they discuss advance care planning in the critical care setting.
A patient was admitted to the critical care unit several weeks ago with an acute myocardial
infarction and subsequently underwent coronary artery bypass grafting surgery. Since a
cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram
shows no meaningful brain activity. After a family conference, the physician orders a DNR
order, and palliative care is begun. This means:
a. the patient will continue to receive the same aggressive treatment short of resuscitation if
he has another cardiac arrest.
b. all treatment will be stopped, and the patient will be allowed to die.
c. all attempts will be made to keep the patient comfortable without prolonging his life.
d. the patient will be immediately transferred to hospice.. ANSWER - c. all attempts will be
made to keep the patient comfortable without prolonging his life.
When palliative care is begun, the primary goal is to keep the patient comfortable by
continuing assessments and
managing symptoms that might cause pain, anxiety, or distress.
A patient was admitted to the critical care unit several weeks ago with an acute myocardial
infarction and subsequently underwent coronary artery bypass grafting surgery. Since a
cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram
shows no meaningful brain activity. The patient is placed on a morphine drip to alleviate
suspected operative pain and assist in sedation. The patient continues to grimace and fight
the ventilator. What nursing intervention would be appropriate?
, a. Increase the morphine dosage until no signs of pain or discomfort are present.
b. Increase the morphine drip, but if the patient's respiratory rate drops below 10
breaths/min, return to the original dosage.
c. Gradually decrease the morphine and switch to Versed to avoid respiratory depression.
d. Ask the family to leave the room because their presence is causing undue stress to the
patient.. ANSWER - a. Increase the morphine dosage until no signs of pain or discomfort
are present.
Even though opiates can cause respiratory depression, the goal in palliative care is to
alleviate pain and suffering. A bolus dose of morphine (2-10 mg IV) and a continuous
morphine infusion at 50% of the bolus dose per hour is recommended. Because many critical
care patients are not conscious, assessment of pain and other symptoms becomes more
difficult. Gélinas and colleagues recommended using signs of body movements,
neuromuscular signs, facial expressions, or responses to physical examination for pain
assessment in patients with altered consciousness.
A patient was admitted to the critical care unit several weeks ago with an acute myocardial
infarction and subsequently underwent coronary artery bypass grafting surgery. Since a
cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram
shows no meaningful brain activity. The decision is made to remove the patient from the
ventilator. Which of the following statements is most accurate?
a. The cardiac monitor should be left on so everyone will know when the patient has died.
b. Opioids, sedatives, and neuromuscular blocking agents should be discontinued just before
removing the ventilator.
c. The family and health care team should decide the best method for removing the
ventilator: terminal wean versus immediate extubation.
d. If terminal weaning is selected, the family should be sent to the waiting room until the
ventilator has actually been removed.. ANSWER - c. The family and health care team
should decide the best method for removing the ventilator: terminal wean versus immediate
extubation.
The choice of terminal wean as opposed to extubation is based on considerations of access
for suctioning, appearance of the patient for the family, how long the patient will survive off
the ventilator, and whether the patient has the ability to communicate with loved ones at
the bedside.
A patient was admitted to the critical care unit after having a CVA and MI. The patient has
poor activity tolerance, falls in and out of consciousness, and has poor verbal skills. The
patient has been resuscitated four times in the past 6 hours. The patient does not have
QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS)|ALREADY GRADED A+|NEWEST
VERSION
QUESTIONS AND ANSWERS
Which of the following statements about comfort care is accurate?
a. Withholding and withdrawing life-sustaining treatment are distinctly different in the
eyes of the legal community.
b. Each procedure should be evaluated for its effect on the patient's comfort before being
implemented.
c. Only the patient can determine what constitutes comfort care for him or her.
d. Withdrawing life-sustaining treatments is considered euthanasia in most states..
ANSWER - b. Each procedure should be evaluated for its effect on the patient's comfort
before being implemented.
The goal of comfort care is to provide only treatments that do not cause pain or other
discomfort to the patient.
_____ is a powerful influence when the decision-making process is dealing with recovery or
a peaceful death.
a. Hope
,b. Religion
c. Culture
d. Ethics. ANSWER - a. Hope
Hope is a powerful influence on decision making, and a shift from hope for recovery to hope
for a peaceful death should be guided by clinicians with exemplary communication skills.
Ethics, religion, and culture can influence the decision process regarding care and end-of-
life decisions.
The patient's condition has deteriorated to the point where she can no longer make
decisions about her own care. Which of the following nursing interventions would be most
appropriate?
a. Obtain a verbal DNR order from the physician.
b. Continue caring for the patient as originally ordered because she obviously wanted this.
c. Consult the hospital attorney for recommendations on how to proceed.
d. Discuss with the family what the patient's wishes would be if she could make those
decisions herself.. ANSWER - d. Discuss with the family what the patient's wishes would be
if she could make those decisions herself.
If the patient is not able to make end-of-life decisions for herself, her family members should
be approached to discuss the next steps because they may have insight into what her wishes
would be.
The two basic ethical principles underlying the provision of health care are
a. beneficence and nonmaleficence.
b. veracity and beneficence.
c. fidelity and nonmaleficence.
d. veracity and fidelity.. ANSWER - a. beneficence and nonmaleficence.
The two basic ethical principles underlying the provision of health care are beneficence and
nonmaleficence.
A patient was admitted to the critical care unit several weeks ago with an acute myocardial
infarction and subsequently underwent coronary artery bypass grafting surgery. Since a
cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram
shows no meaningful brain activity. The patient does not have an advance directive. Which
,of the following statements would be the best way to approach the family regarding his
ongoing care?
a. "I will refer this case to the hospital ethics committee, and they will contact you when
they have a decision."
b. "What do you want to do about the patient's care at this point?"
c. "Dr. Smith believes that there is no hope at this point and recommends DNR status."
d. "What would the patient want if he knew he were in this situation?". ANSWER - d.
"What would the patient want if he knew he were in this situation?"
Approaching the family and asking what they know about the patient's wishes and
preferences is the best way to begin this discussion. Emotional support for the patient and
the family is important as they discuss advance care planning in the critical care setting.
A patient was admitted to the critical care unit several weeks ago with an acute myocardial
infarction and subsequently underwent coronary artery bypass grafting surgery. Since a
cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram
shows no meaningful brain activity. After a family conference, the physician orders a DNR
order, and palliative care is begun. This means:
a. the patient will continue to receive the same aggressive treatment short of resuscitation if
he has another cardiac arrest.
b. all treatment will be stopped, and the patient will be allowed to die.
c. all attempts will be made to keep the patient comfortable without prolonging his life.
d. the patient will be immediately transferred to hospice.. ANSWER - c. all attempts will be
made to keep the patient comfortable without prolonging his life.
When palliative care is begun, the primary goal is to keep the patient comfortable by
continuing assessments and
managing symptoms that might cause pain, anxiety, or distress.
A patient was admitted to the critical care unit several weeks ago with an acute myocardial
infarction and subsequently underwent coronary artery bypass grafting surgery. Since a
cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram
shows no meaningful brain activity. The patient is placed on a morphine drip to alleviate
suspected operative pain and assist in sedation. The patient continues to grimace and fight
the ventilator. What nursing intervention would be appropriate?
, a. Increase the morphine dosage until no signs of pain or discomfort are present.
b. Increase the morphine drip, but if the patient's respiratory rate drops below 10
breaths/min, return to the original dosage.
c. Gradually decrease the morphine and switch to Versed to avoid respiratory depression.
d. Ask the family to leave the room because their presence is causing undue stress to the
patient.. ANSWER - a. Increase the morphine dosage until no signs of pain or discomfort
are present.
Even though opiates can cause respiratory depression, the goal in palliative care is to
alleviate pain and suffering. A bolus dose of morphine (2-10 mg IV) and a continuous
morphine infusion at 50% of the bolus dose per hour is recommended. Because many critical
care patients are not conscious, assessment of pain and other symptoms becomes more
difficult. Gélinas and colleagues recommended using signs of body movements,
neuromuscular signs, facial expressions, or responses to physical examination for pain
assessment in patients with altered consciousness.
A patient was admitted to the critical care unit several weeks ago with an acute myocardial
infarction and subsequently underwent coronary artery bypass grafting surgery. Since a
cardiac arrest 5 days ago, the patient has been unresponsive. An electroencephalogram
shows no meaningful brain activity. The decision is made to remove the patient from the
ventilator. Which of the following statements is most accurate?
a. The cardiac monitor should be left on so everyone will know when the patient has died.
b. Opioids, sedatives, and neuromuscular blocking agents should be discontinued just before
removing the ventilator.
c. The family and health care team should decide the best method for removing the
ventilator: terminal wean versus immediate extubation.
d. If terminal weaning is selected, the family should be sent to the waiting room until the
ventilator has actually been removed.. ANSWER - c. The family and health care team
should decide the best method for removing the ventilator: terminal wean versus immediate
extubation.
The choice of terminal wean as opposed to extubation is based on considerations of access
for suctioning, appearance of the patient for the family, how long the patient will survive off
the ventilator, and whether the patient has the ability to communicate with loved ones at
the bedside.
A patient was admitted to the critical care unit after having a CVA and MI. The patient has
poor activity tolerance, falls in and out of consciousness, and has poor verbal skills. The
patient has been resuscitated four times in the past 6 hours. The patient does not have
