, NSG 430 Exam 1 – Adult Health Nursing II
Actual Questions & Answers (GCU) 100%
Guarantee Pass
Q1. 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: B. Anxiety about unfinished business
Rationale: 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.
Q2. 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: D. Difficulty coping
,Rationale: 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.
Q3. 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
D. Ask if the decision has been discussed with the patient's health care provider
Answer: D. Ask if the decision has been discussed with the patient's health care
provider
Rationale: A health care provider's order should be written describing the actions that
nurses should take if the patient requires CPR. 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.
Q4. The nurse is caring for an unresponsive terminally ill patient who has 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: C. Document the patient's respiratory pattern
Rationale: 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.
Q5. 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: C. These vital signs are an expected response now but will slow down later
Rationale: 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.
Q6. 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
B. Sit at the bedside and ask if there is anything the patient needs
C. Insist that family members remain at the bedside with the patient
D. Tell the patient that everything possible is being done to delay death
Answer: B. Sit at the bedside and ask if there is anything the patient needs
Rationale: Staying at the bedside and listening allows the patient to discuss any
unresolved issues or physical discomforts that should be addressed. Stating that no one
feels ready for death does not address the patient's concerns. Telling the patient that
everything is being done does not address the patient's fears about dying.
Actual Questions & Answers (GCU) 100%
Guarantee Pass
Q1. 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: B. Anxiety about unfinished business
Rationale: 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.
Q2. 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: D. Difficulty coping
,Rationale: 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.
Q3. 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
D. Ask if the decision has been discussed with the patient's health care provider
Answer: D. Ask if the decision has been discussed with the patient's health care
provider
Rationale: A health care provider's order should be written describing the actions that
nurses should take if the patient requires CPR. 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.
Q4. The nurse is caring for an unresponsive terminally ill patient who has 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: C. Document the patient's respiratory pattern
Rationale: 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.
Q5. 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: C. These vital signs are an expected response now but will slow down later
Rationale: 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.
Q6. 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
B. Sit at the bedside and ask if there is anything the patient needs
C. Insist that family members remain at the bedside with the patient
D. Tell the patient that everything possible is being done to delay death
Answer: B. Sit at the bedside and ask if there is anything the patient needs
Rationale: Staying at the bedside and listening allows the patient to discuss any
unresolved issues or physical discomforts that should be addressed. Stating that no one
feels ready for death does not address the patient's concerns. Telling the patient that
everything is being done does not address the patient's fears about dying.
