Page 1 of 167
NSG 430 FINAL EXAM (2026/2027) |
ADULT HEALTH NURSING II | GRAND
CANYON UNIVERSITY
PRACTICE QUESTION BANK – 250+
QUESTIONS WITH VERIFIED ANSWERS &
DETAILED RATIONALES
# SECTION I: INTRODUCTION TO ADVANCED ADULT HEALTH NURSING
## Palliative & End-of-Life Care
### Question 1
A nurse is caring for a patient with end-stage chronic obstructive pulmonary disease (COPD)
who has been admitted for symptom management. The patient asks, "What is the difference
between palliative care and hospice care?" Which response by the nurse is most accurate?
A. "Palliative care is only for patients who are expected to live less than six months, while
hospice care is for any serious illness."
B. "Palliative care focuses on comfort and symptom management and can begin at the time of
diagnosis, while hospice care is for patients with a life expectancy of six months or less who
have forgone curative treatments."
C. "Palliative care and hospice care are the same thing; the terms are used interchangeably."
,Page 2 of 167
D. "Hospice care is provided in a hospital setting only, while palliative care is provided in the
home."
**Correct Answer: B**
**Rationale:** Palliative care is active holistic care for individuals with serious health-related
suffering from severe illness. It can begin during curative or restorative healthcare and extends
into end-of-life care. Hospice care is a subcategory of palliative care where curative care is
forgone and requires physician certification of a life expectancy of less than six months. Options
A, C, and D are incorrect because they misrepresent the definitions and settings of palliative and
hospice care.
---
### Question 2
A patient with terminal cancer is being admitted to a family-centered inpatient hospice unit. 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." The nurse should recognize that the spouse is most likely
demonstrating which behavior?
A. Adaptive coping
B. Difficulty coping
C. Anticipatory grief
D. Denial
**Correct Answer: B**
**Rationale:** The spouse's behavior of avoiding the reality of the patient's condition and
focusing on future plans that are unlikely to occur, combined with deflection when asked about
concerns, indicates difficulty coping with the impending loss. Adaptive coping would involve
,Page 3 of 167
acknowledging the situation and seeking appropriate support. Anticipatory grief involves
mourning the impending loss, while denial is a defense mechanism that may be temporarily
protective but the spouse's deflection suggests difficulty coping rather than simple denial.
---
### Question 3
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
**Correct Answer: B**
**Rationale:** The patient's statement indicates that there is unfinished family business the
patient would like to address before dying. The patient's actions demonstrate a desire for closure
and resolution of relationships, which is characteristic of anxiety about unfinished business.
There is no indication that the patient is protesting the prognosis, feels uncertain about the
prognosis, or fears a meaningless life.
---
### Question 4
A nurse is caring for a patient with a life-altering illness. Which goal is most consistent with the
principles of palliative care?
, Page 4 of 167
A. To hasten death to prevent prolonged suffering
B. To postpone death through aggressive medical interventions
C. To neither hasten nor postpone death, recognizing dying as a natural process
D. To focus exclusively on the patient's physical symptoms
**Correct Answer: C**
**Rationale:** Palliative care recognizes dying as a natural process and aims to neither hasten
nor postpone death. The goals include providing relief from pain and other symptoms,
maximizing quality of life, providing psychosocial and spiritual care, and helping patients and
families determine goals of care. Options A, B, and D are incorrect because they misrepresent the
core principles of palliative care.
---
### Question 5
Which assessment finding would the nurse most likely observe in a patient who is actively
dying?
A. Increased appetite and thirst
B. Cheyne-Stokes respirations
C. Hypertension and tachycardia
D. Warm, dry skin
**Correct Answer: B**
**Rationale:** Cheyne-Stokes respirations (a pattern of gradually increasing and then
decreasing depth of respirations followed by a period of apnea) are commonly observed in
patients who are actively dying. Other signs of active dying include decreased appetite and thirst,
NSG 430 FINAL EXAM (2026/2027) |
ADULT HEALTH NURSING II | GRAND
CANYON UNIVERSITY
PRACTICE QUESTION BANK – 250+
QUESTIONS WITH VERIFIED ANSWERS &
DETAILED RATIONALES
# SECTION I: INTRODUCTION TO ADVANCED ADULT HEALTH NURSING
## Palliative & End-of-Life Care
### Question 1
A nurse is caring for a patient with end-stage chronic obstructive pulmonary disease (COPD)
who has been admitted for symptom management. The patient asks, "What is the difference
between palliative care and hospice care?" Which response by the nurse is most accurate?
A. "Palliative care is only for patients who are expected to live less than six months, while
hospice care is for any serious illness."
B. "Palliative care focuses on comfort and symptom management and can begin at the time of
diagnosis, while hospice care is for patients with a life expectancy of six months or less who
have forgone curative treatments."
C. "Palliative care and hospice care are the same thing; the terms are used interchangeably."
,Page 2 of 167
D. "Hospice care is provided in a hospital setting only, while palliative care is provided in the
home."
**Correct Answer: B**
**Rationale:** Palliative care is active holistic care for individuals with serious health-related
suffering from severe illness. It can begin during curative or restorative healthcare and extends
into end-of-life care. Hospice care is a subcategory of palliative care where curative care is
forgone and requires physician certification of a life expectancy of less than six months. Options
A, C, and D are incorrect because they misrepresent the definitions and settings of palliative and
hospice care.
---
### Question 2
A patient with terminal cancer is being admitted to a family-centered inpatient hospice unit. 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." The nurse should recognize that the spouse is most likely
demonstrating which behavior?
A. Adaptive coping
B. Difficulty coping
C. Anticipatory grief
D. Denial
**Correct Answer: B**
**Rationale:** The spouse's behavior of avoiding the reality of the patient's condition and
focusing on future plans that are unlikely to occur, combined with deflection when asked about
concerns, indicates difficulty coping with the impending loss. Adaptive coping would involve
,Page 3 of 167
acknowledging the situation and seeking appropriate support. Anticipatory grief involves
mourning the impending loss, while denial is a defense mechanism that may be temporarily
protective but the spouse's deflection suggests difficulty coping rather than simple denial.
---
### Question 3
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
**Correct Answer: B**
**Rationale:** The patient's statement indicates that there is unfinished family business the
patient would like to address before dying. The patient's actions demonstrate a desire for closure
and resolution of relationships, which is characteristic of anxiety about unfinished business.
There is no indication that the patient is protesting the prognosis, feels uncertain about the
prognosis, or fears a meaningless life.
---
### Question 4
A nurse is caring for a patient with a life-altering illness. Which goal is most consistent with the
principles of palliative care?
, Page 4 of 167
A. To hasten death to prevent prolonged suffering
B. To postpone death through aggressive medical interventions
C. To neither hasten nor postpone death, recognizing dying as a natural process
D. To focus exclusively on the patient's physical symptoms
**Correct Answer: C**
**Rationale:** Palliative care recognizes dying as a natural process and aims to neither hasten
nor postpone death. The goals include providing relief from pain and other symptoms,
maximizing quality of life, providing psychosocial and spiritual care, and helping patients and
families determine goals of care. Options A, B, and D are incorrect because they misrepresent the
core principles of palliative care.
---
### Question 5
Which assessment finding would the nurse most likely observe in a patient who is actively
dying?
A. Increased appetite and thirst
B. Cheyne-Stokes respirations
C. Hypertension and tachycardia
D. Warm, dry skin
**Correct Answer: B**
**Rationale:** Cheyne-Stokes respirations (a pattern of gradually increasing and then
decreasing depth of respirations followed by a period of apnea) are commonly observed in
patients who are actively dying. Other signs of active dying include decreased appetite and thirst,
