Palliative Care NCLEX Questions and Answers -MED SURG FINAL

Palliative Care NCLEX Questions and Answers -MED SURG FINAL A 67-year-old woman was recently diagnosed with inoperable pancreatic cancer. Before the diagnosis she was very active in her neighborhood association. Her husband is concerned because his wife is staying at home and missing her usual community activities. Which common EOL psychologic manifestation is she most likely demonstrating? A) Peacefulness B) Decreased socialization C) Decreased decision making D) Anxiety about unfinished business - ANS -B A nurse has been working full time with terminally ill patients for 3 years. He has been experiencing irritability and mixed emotions when expressing sadness since four of his patients died on the same day. To optimize the quality of his nursing care, he should examine his own A Full-time work schedule. B) Past feelings toward death. C) Patterns for dealing with grief. D) Demands for involvement in patient care. - ANS -C A tearful patient tells the nurse that her brother (who is in prison) just received a diagnosis of terminal metastatic lung cancer. She is worried that her brother will die in pain and alone. What is the nurse's best response? A) "It's too bad that they don't have hospice services in prison." B) "I'm sure the prison will let him out if they know he is dying." C) "Maybe if he had not committed a crime, he wouldn't be in this situation." D) "Many prisons offer health care services, including hospice and palliative care." - ANS -D An 80-year-old female patient is receiving palliative care for heart failure. The primary purpose(s) of her receiving palliative care is (are) to (select all that apply) A) Improve her quality of life. B) Assess her coping ability with disease. C) Have time to teach patient and family about disease. D) Focus on reducing the severity of disease symptoms. E) Provide care that the family is unwilling or unable to give. - ANS -A, D For the past 5 years Tom has repeatedly asked his mother to donate his deceased father's belongings to charity, but his mother has refused. She sits in the bedroom closet, crying and talking to her long-dead husband. What type of grief is Tom's mother experiencing? A) Adaptive grief B) Disruptive grief C) Anticipatory grief D) Prolonged grief disorder - ANS -D The children caregivers of an older patient whose death is imminent have not left the bedside for the past 36 hours. In the nurse's assessment of the family, what findings indicate the potential for an abnormal grief reaction to occur (select all that apply)? A) Family cannot express their feelings to one another. B) Dying patient is becoming more restless and agitated C). A family member is going through a difficult divorce. D) Family talks with and reassures the patient at frequent intervals. E) Siblings who were estranged from each other have now reunited. - ANS -A, C The family attorney informed a patient's adult children and wife that the patient did not have an advance directive after he suffered a serious stroke. Who is responsible for making the decision about EOL measures when the patient cannot communicate his or her specific wishes? A) Notary and attorney B) Physician and family C) Wife and adult children D) Physician and nursing staff - ANS -C The home health nurse visits a 40-year-old patient with metastatic breast cancer who is receiving palliative care. The patient is experiencing pain at a level of 7 (0-10 point scale). In prioritizing activities for the visit, what should the nurse do first? A) Auscultate for breath sounds. B) Administer PRN pain medication. C) Check pressure points for skin breakdown. D) Ask family about patient's food and fluid intake. - ANS -B The hospice nurse visits with the wife of a dying patient. The nurse is most concerned if the patient's wife makes which statement? A) "I don't think that I can live without my husband to take care of me." B) "I wonder if expressing my sadness makes my husband feel worse." C) "We have shared so much that it is hard to realize that I will be alone." D) "I don't feel guilty about leaving him to go to lunch with my friends." - ANS -A Normal reactions to loss include the statements in options b, c, and d. Option a indicates an abnormal grief reaction and possible suicidal thinking. The nurse explains to a patient with advanced cancer about the differences between hospice and palliative care. Which statement, if made by the patient, indicates that teaching was effective? A) "Hospice care is not available if I am in the hospital." B) "Palliative care provides better methods of pain control." C) "Hospice care will help me and my family prepare for death."