,NSG3130/NSG 3130 Exam 4 | Fundamental Concepts &
Skills II | Galen College | 2026/2027 Updated (PDF)
1. What is the primary distinction between palliative care and hospice care for a patient with a serious
illness?
A) Palliative care is only provided in inpatient settings, while hospice care is provided at home
B) Palliative care can be delivered alongside curative treatment, while hospice care focuses exclusively
on comfort when curative treatments have ceased
C) Palliative care is for patients with cancer, while hospice care is for patients with all other terminal
illnesses
D) Palliative care is provided by physicians, while hospice care is provided by nurses
Correct Answer: Palliative care can be delivered alongside curative treatment, while hospice care
focuses exclusively on comfort when curative treatments have ceased
Rationale: Palliative care is appropriate at any stage of a serious illness and can be provided
concurrently with curative therapies. Hospice care is a specific type of palliative care for patients with
a terminal prognosis who are no longer pursuing curative treatment. The settings and providers
overlap significantly between the two.
2. A patient who is dying tells the nurse, "I don't understand why this is happening to me. It's not
fair." This statement is most characteristic of which stage of grief according to Kübler-Ross?
A) Denial
B) Anger
C) Bargaining
D) Depression
Correct Answer: Anger
Rationale: The patient's expression of unfairness and questioning reflects anger, which is the second
stage in Kübler-Ross's model. This stage often involves feelings of rage, envy, and resentment directed
at others, a higher power, or the situation itself. Denial involves refusing to accept the reality,
,bargaining involves attempting to negotiate a different outcome, and depression involves deep
sadness.
3. A nurse is caring for a patient who is in the acceptance stage of dying. Which nursing action is most
appropriate to support the patient during this stage?
A) Encourage the patient to fight the illness and maintain hope
B) Allow the patient to have quiet time and be present to provide support as needed
C) Redirect the patient's focus to positive aspects of life
D) Refer the patient for psychological counseling to address their acceptance
Correct Answer: Allow the patient to have quiet time and be present to provide support as needed
Rationale: In the acceptance stage, the patient has come to terms with their mortality and may desire
peace and quiet. The nurse should respect this need for solitude while remaining available to provide
comfort and support. Encouraging the patient to fight or redirecting their focus dismisses their
emotional state.
4. A nurse is assessing a patient's response to a recent diagnosis of a chronic illness. The patient
states, "I know this is serious, but maybe if I eat healthier and exercise, it will go away." This
statement is an example of which stage of grief?
A) Denial
B) Anger
C) Bargaining
D) Depression
Correct Answer: Bargaining
Rationale: Bargaining is characterized by making promises or deals in an attempt to postpone or alter
the outcome of a loss. The patient's statement about changing lifestyle habits to make the illness "go
away" reflects an attempt to negotiate a different outcome. Denial involves refusing to accept the
diagnosis, anger involves blame, and depression involves sadness and hopelessness.
, 5. A patient who is grieving the loss of a spouse is experiencing persistent difficulty sleeping, loss of
appetite, and an inability to perform daily activities six months after the death. This presentation is
most consistent with which type of grief?
A) Normal grief
B) Anticipatory grief
C) Disenfranchised grief
D) Complicated grief
Correct Answer: Complicated grief
Rationale: Complicated grief is characterized by prolonged, intense grief that significantly impairs
functioning and does not improve over time. Normal grief, while painful, allows the person to
eventually adapt. Anticipatory grief occurs before the actual loss, and disenfranchised grief is not
socially recognized or supported.
6. The nurse is providing care to a patient whose spouse recently died. The patient states, "I keep
thinking I see my husband in the hallway." Which response by the nurse is most appropriate?
A) "It sounds like you are having hallucinations. I should notify the provider."
B) "Seeing your husband is a normal part of the grieving process for many people."
C) "You need to focus on the reality that your husband is no longer with us."
D) "Would you like me to prescribe a medication to help you sleep?"
Correct Answer: "Seeing your husband is a normal part of the grieving process for many people."
Rationale: Transient sensory perceptions of the deceased, such as hearing their voice or seeing them,
are common and considered a normal part of the grieving process. The nurse should normalize this
experience without pathologizing it. Notifying the provider or suggesting medication is unnecessary,
and confronting the patient's experience is not therapeutic.
7. A nurse is caring for a patient who is actively dying. The patient's family is present and appears
anxious. Which nursing intervention is the priority for supporting the family?
A) Provide the family with detailed information about the physiological signs of impending death
Skills II | Galen College | 2026/2027 Updated (PDF)
1. What is the primary distinction between palliative care and hospice care for a patient with a serious
illness?
A) Palliative care is only provided in inpatient settings, while hospice care is provided at home
B) Palliative care can be delivered alongside curative treatment, while hospice care focuses exclusively
on comfort when curative treatments have ceased
C) Palliative care is for patients with cancer, while hospice care is for patients with all other terminal
illnesses
D) Palliative care is provided by physicians, while hospice care is provided by nurses
Correct Answer: Palliative care can be delivered alongside curative treatment, while hospice care
focuses exclusively on comfort when curative treatments have ceased
Rationale: Palliative care is appropriate at any stage of a serious illness and can be provided
concurrently with curative therapies. Hospice care is a specific type of palliative care for patients with
a terminal prognosis who are no longer pursuing curative treatment. The settings and providers
overlap significantly between the two.
2. A patient who is dying tells the nurse, "I don't understand why this is happening to me. It's not
fair." This statement is most characteristic of which stage of grief according to Kübler-Ross?
A) Denial
B) Anger
C) Bargaining
D) Depression
Correct Answer: Anger
Rationale: The patient's expression of unfairness and questioning reflects anger, which is the second
stage in Kübler-Ross's model. This stage often involves feelings of rage, envy, and resentment directed
at others, a higher power, or the situation itself. Denial involves refusing to accept the reality,
,bargaining involves attempting to negotiate a different outcome, and depression involves deep
sadness.
3. A nurse is caring for a patient who is in the acceptance stage of dying. Which nursing action is most
appropriate to support the patient during this stage?
A) Encourage the patient to fight the illness and maintain hope
B) Allow the patient to have quiet time and be present to provide support as needed
C) Redirect the patient's focus to positive aspects of life
D) Refer the patient for psychological counseling to address their acceptance
Correct Answer: Allow the patient to have quiet time and be present to provide support as needed
Rationale: In the acceptance stage, the patient has come to terms with their mortality and may desire
peace and quiet. The nurse should respect this need for solitude while remaining available to provide
comfort and support. Encouraging the patient to fight or redirecting their focus dismisses their
emotional state.
4. A nurse is assessing a patient's response to a recent diagnosis of a chronic illness. The patient
states, "I know this is serious, but maybe if I eat healthier and exercise, it will go away." This
statement is an example of which stage of grief?
A) Denial
B) Anger
C) Bargaining
D) Depression
Correct Answer: Bargaining
Rationale: Bargaining is characterized by making promises or deals in an attempt to postpone or alter
the outcome of a loss. The patient's statement about changing lifestyle habits to make the illness "go
away" reflects an attempt to negotiate a different outcome. Denial involves refusing to accept the
diagnosis, anger involves blame, and depression involves sadness and hopelessness.
, 5. A patient who is grieving the loss of a spouse is experiencing persistent difficulty sleeping, loss of
appetite, and an inability to perform daily activities six months after the death. This presentation is
most consistent with which type of grief?
A) Normal grief
B) Anticipatory grief
C) Disenfranchised grief
D) Complicated grief
Correct Answer: Complicated grief
Rationale: Complicated grief is characterized by prolonged, intense grief that significantly impairs
functioning and does not improve over time. Normal grief, while painful, allows the person to
eventually adapt. Anticipatory grief occurs before the actual loss, and disenfranchised grief is not
socially recognized or supported.
6. The nurse is providing care to a patient whose spouse recently died. The patient states, "I keep
thinking I see my husband in the hallway." Which response by the nurse is most appropriate?
A) "It sounds like you are having hallucinations. I should notify the provider."
B) "Seeing your husband is a normal part of the grieving process for many people."
C) "You need to focus on the reality that your husband is no longer with us."
D) "Would you like me to prescribe a medication to help you sleep?"
Correct Answer: "Seeing your husband is a normal part of the grieving process for many people."
Rationale: Transient sensory perceptions of the deceased, such as hearing their voice or seeing them,
are common and considered a normal part of the grieving process. The nurse should normalize this
experience without pathologizing it. Notifying the provider or suggesting medication is unnecessary,
and confronting the patient's experience is not therapeutic.
7. A nurse is caring for a patient who is actively dying. The patient's family is present and appears
anxious. Which nursing intervention is the priority for supporting the family?
A) Provide the family with detailed information about the physiological signs of impending death
