Chapterg7:gEnd-of-
LifegCaregExamg1gtestgbank
1. Agnursegcaresgforgagdyinggclient.gWhichgmanifestationgofgdyinggshouldgthegnursegtreatgfirst?
a. Anorexia
b. Pain
c. Nausea
d. Hairgloss
Onlygsymptomsgthatgcausegdistressgforgagdyinggclientgshouldgbegtreated.gSuchgsymptomsgincludegpain,gnauseaga
ndgvomiting,gdyspnea,gandgagitation.gThesegproblemsginterferegwithgthegclient’sgcomfort.gEvengwhengsymptoms
,gsuchgasganorexiagorghairgloss,gdisturbgthegfamily,gtheygshouldgbegtreatedgonlygifgthegclientgisgdistressedgbygtheir
gpresence.gThegnursegshouldgtreatgthegclient’sgpaingfirst.
2. Agnursegplansgcaregforgagclientgwhogisgnearinggendgofglife.gWhichgquestiongshouldgthegnursegaskgwh
engdevelopinggthisgclient’sgplangofgcare?
a. “Isgyourgadvancegdirectivegupgtogdategandgnotarized?”
b. “Dogyougwantgtogbegatghomegatgthegendgofgyourglife?”
c. “Wouldgyouglikegagphysicalgtherapistgtogassistgyougwithgrange-of-motiongactivities?”
d. “Havegyourgchildrengdiscussedgresuscitationgwithgyourghealthgcaregprovider?”
Whengdevelopinggagplangofgcaregforgagdyinggclient,gconsiderationgshouldgbeggivengforgwheregthegclientgwantsgto
gdie.gAdvancegdirectivesgdognotgneedgtogbegnotarized.gAgphysicalgtherapistgwouldgnotgbeginvolvedgingend-of-
lifegcare.gThegclientgshouldgdiscussgresuscitationgwithgtheghealthgcaregprovidergandgchildren;gdo-not-
resuscitategstatusgshouldgbegthegclient’sgdecision,gnotgthegfamily’sgdecision.
3. Agnursegisgcaringgforgagclientgwhoghasglunggcancergandgisgdying.gWhichgprescriptiongshouldgthegnu
rsegquestion?
a. Morphineg10gmggsublingualgeveryg6ghoursgPRNgforgpainglevelggreatergthang5
b. Albuterolg(Proventil)gmeteredgdoseginhalergeveryg4ghoursgPRNgforgwheezes
c. Atropinegsolutiong1%gsublingualgeveryg4ghoursgPRNgforgexcessivegoralgsecretions
d. Sodiumgbiphosphateg(Fleet)genemagoncegagdaygPRNgforgimpactedgstool
Paingmedicationsgshouldgbegscheduledgaroundgthegclockgtogmaintaingcomfortgandgpreventgreoccurrencegofgpain.g
Thegothergmedicationsgaregappropriategforgthisgclient.
4. Agclientgtellsgthegnursegthat,gevengthoughgitghasgbeeng4gmonthsgsinceghergsister’sgdeath,gshegfrequen
tlygfindsgherselfgcryingguncontrollably.gHowgshouldgthegnursegrespond?
a. “Mostgpeoplegmovegongwithingagfewgmonths.gYougshouldgseegaggriefgcounselor.”
b. “Whenevergyougstartgtogcry,gdistractgyourselfgfromgthoughtsgofgyourgsister.”
c. “Yougshouldgtrygnotgtogcry.gI’mgsuregyourgsistergisgingagbettergplacegnow.”
d. “Yourgfeelingsgaregcompletelygnormalgandgmaygcontinuegforgaglonggtime.”
Frequentgcryinggisgnotgangabnormalgresponse.gThegnursegshouldgletgthegclientgknowgthatgthisgisgnormalgandgokay
.gAlthoughgthegclientgmaygbenefitgfromgtalkinggwithgaggriefgcounselor,gitgisgnotgunusualgforghergtogstillgbeggrievi
nggaftergagfewgmonths.gThegothergresponsesgaregnotgasgtherapeuticgbecausegtheygjustifygorgminimizegthegclient’s
gresponse.
, Chapterg7:gEnd-of-
LifegCaregExamg1gtestgbank
5. Aftergteachinggagclientgaboutgadvancegdirectives,gagnursegassessesgthegclient’sgunderstanding.gWhi
chgstatementgindicatesgthegclientgcorrectlygunderstandsgthegteaching?
a. “AngadvancegdirectivegwillgkeepgmygchildrengfromgsellinggmyghomegwhengI’mgold.”
b. “AngadvancegdirectivegwillgbegcompletedgasgsoongasgI’mgincapacitatedgandgcan’tgthinkgforgmyself.”
c. “AngadvancegdirectivegwillgspecifygwhatgIgwantgdonegwhengIgcangnoglongergmakegdecisionsgaboutghealthgcare
.”
d. “Angadvancegdirectivegwillgallowgmegtogkeepgmygmoneygoutgofgthegreachgofgmygfamily.”
Angadvancegdirectivegisgagwrittengdocumentgpreparedgbygagcompetentgindividualgthatgspecifiesgwhat,gifgany,gext
raordinarygactionsgagpersongwouldgwantgtakengwhenghegorgshegcangnoglongergmakegdecisionsgaboutgpersonalghe
althgcare.gItgdoesgnotgaddressgissuesgsuchgasgthegclient’sgresidencegorgfinancialgmatters.
6. Agnursegteachesgagclientgwhogisgconsideringgbeinggadmittedgtoghospice.gWhichgstatementgshouldgt
hegnursegincludegingthisgclient’sgteaching?
a. “Hospicegadmissionghasgspecificgcriteria.gYougmaygnotgbegagviablegcandidate,gsogwegwillglookgatgalternat
ivegplansgforgyourgdischarge.”
b. “Hospicegcaregfocusesgongagholisticgapproachgtoghealthgcare.gItgisgdesignedgnotgtoghastengdeath,gbutgrather
gtogrelievegsymptoms.”
c. “Hospicegcaregwillgnotghelpgwithgyourgsymptomsgofgdepression.gIgwillgrefergyougtogthegfacility’sgcounseli
nggservicesginstead.”
d. “Yougseemgtogbegexperiencinggsomegdifficultygwithgthisgstagegofgtheggrievinggprocess.gLet’sgtalkgaboutgy
ourgfeelings.”
Asgbothgagphilosophygandgagsystemgofgcare,ghospicegcaregusesganginterdisciplinarygapproachgtogassessgandgaddre
ssgthegholisticgneedsgofgclientsgandgfamiliesgtogfacilitategqualitygofglifegandgagpeacefulgdeath.gThisgholisticgappro
achgneitherghastensgnorgpostponesgdeathgbutgprovidesgreliefgofgsymptomsgexperiencedgbygthegdyinggclient.
7. Agnursegisgcaringgforgagdyinggclient.gThegclient’sgspousegstates,g“Igthinkghegisgchokinggtogdeath.”gH
owgshouldgthegnursegrespond?
a. “Dognotgworry.gThegchokinggsoundgisgnormalgduringgthegdyinggprocess.”
b. “Igwillgadministergmoregmorphinegtogkeepgyourghusbandgcomfortable.”
c. “Igcangaskgthegrespiratorygtherapistgtogsuctiongsecretionsgoutgthroughghisgnose.”
d. “Igwillghaveganothergnursegassistgmegtogturngyourghusbandgonghisgside.”
Thegchokinggsoundgorg“deathgrattle”gisgcommongingdyinggclients.gThegnursegshouldgacknowledgegthegspouse’sgc
oncernsgandgprovideginterventionsgthatgwillgreducegthegchokinggsounds.gRepositioninggthegclientgontogonegsideg
withgagtowelgundergthegmouthgtogcollectgsecretionsgisgthegbestgintervention.gThegnursegshouldgnotgminimizegtheg
spouse’sgconcerns.gMorphinegwillgassistgwithgcomfortgbutgwillgnotgdecreasegthegchokinggsounds.gNasotrachealgs
uctioninggisgnotgappropriategingagdyinggclient.
8. Thegnursegisgteachinggagfamilygmembergaboutgvariousgtypesgofgcomplementarygtherapiesgthatgmightg
begeffectivegforgrelievinggthegdyinggclient’sganxietygandgrestlessness.gWhichgstatementgmadegbygthegfam
ilygmembergindicatesgunderstandinggofgthegnurse’sgteaching?
a. “Maybegwegshouldgjustghiregangaround-the-clockgsittergtogstaygwithgGrandmother.”
b. “IghavegsomegofghergfavoriteghymnsgongagCDgthatgIgcouldgbringgforgmusicgtherapy.”
c. “Igdon’tgthinkgthatgshe’llgneedgpaingmedicationgalonggwithghergherbalgtreatments.”
d. “Igwillgburngtherapeuticgincensegingthegroomgsogwegcangstopgtheganxietygpills.”
Musicgtherapygisgagcomplementarygtherapygthatgmaygproducegrelaxationgbygquietinggthegmindgandgremovinggagc
lient’sginnergrestlessness.gHiringgangaround-the-clockgsittergdoesgnotgdemonstrategthatgthegclient’sgfamily
, Chapterg7:gEnd-of-
LifegCaregExamg1gtestgbank
understandsgcomplementarygtherapies.
, Chapterg7:gEnd-of-
LifegCaregExamg1gtestgbank
9. Agnursegisgcaringgforgagterminallygillgclientgwhoghasgjustgdiedgingaghospitalgsettinggwithgfamilygmemb
ersgatgthegbedside.gWhichgactiongshouldgthegnursegtakegfirst?
a. Callgforgemergencygassistancegsogthatgresuscitationgproceduresgcangbegin.
b. Askgfamilygmembersgifgtheygwouldglikegtogspendgtimegalonegwithgthegclient.
c. Ensuregthatgagdeathgcertificateghasgbeengcompletedgbygthegphysician.
d. Requestgfamilygmembersgtogpreparegthegclient’sgbodygforgthegfuneralghome.
Beforegmovinggthegclient’sgbodygtogthegfuneralghome,gthegnursegshouldgaskgfamilygmembersgifgtheygwouldglikeg
togbegalonegwithgthegclient.gEmergencygassistancegwillgnotgbegnecessary.gAlthoughgitgisgimportantgtogensuregthat
gagdeathgcertificateghasgbeengcompletedgbeforegthegclientgisgmovedgtogthegmortuary,gthegnursegfirstgshouldgaskgfa
milygmembersgifgtheygwouldglikegtogbegalonegwithgthegclient.gThegclient’sgfamilygshouldgnotgbegexpectedgtogpre
paregthegbodygforgthegfuneralghome.
10. Agnursegassessesgagclientgwhogisgdying.gWhichgmanifestationgofgagdyinggclientgshouldgthegnursegassess
gtogdeterminegwhethergthegclientgisgneargdeath?
a. Levelgofgconsciousness
b. Respiratorygrate
c. Bowelgsounds
d. Painglevelgongag0-to-10gscale
Althoughgallgofgthesegassessmentsgshouldgbegperformedgduringgthegdyinggprocess,gperiodsgofgapneagandgChey
ne-
gStrokesgrespirationsgindicategdeathgisgnear.gAsgperipheralgcirculationgdecreases,gthegclient’sglevelgofgconscious
nessgandgbowelgsoundsgdecrease,gandgthegclientgwouldgbegunablegtogprovidegagnumericgnumbergongagpaingscale
.gEvengwithgthesegothergsymptoms,gthegnursegshouldgcontinuegtogassessgrespiratorygrategthroughoutgthegdyinggp
rocess.gAsgthegrategdropsgsignificantlygandgbreathinggbecomesgagonal,gdeathgisgnear.
11. Agnursegisgcaringgforgagclientgwhogisgterminallygill.gThegclient’sgspousegstates,g“Igamgconcernedgbeca
useghegdoesgnotgwantgtogeat.”gHowgshouldgthegnursegrespond?
a. “Letghimgknowgthatgfoodgisgavailablegifghegwantsgit,gbutgdognotginsistgthatghegeat.”
b. “Agfeedinggtubegcangbegplacedgingthegnosegtogprovidegimportantgnutrients.”
c. “Forceghimgtogeatgevengifghegdoesgnotgfeelghungry,gorghegwillgdiegsooner.”
d. “Hegisggettinggallgthegnutrientsghegneedsgthroughghisgintravenousgcatheter.”
Whengfamilygmembersgunderstandgthatgthegclientgisgnotgsufferinggfromghungergandgisgnotg“starvinggtogdeath,”g
theygmaygallowgthegclientgtogdeterminegwhen,gwhat,gorgifgtogeat.gOften,gasgdeathgapproaches,gmetabolicgneedsg
decreasegandgclientsgdognotgfeelgthegsensationgofghunger.gForcinggthemgtogeatgfrustratesgthegclientgandgthegfami
ly.
12. Agnursegdiscussesginpatientghospicegwithgagclientgandgthegclient’sgfamily.gAgfamilygmembergexpres
sesgconcerngthatgherglovedgonegwillgreceivegonlygcustodialgcare.gHowgshouldgthegnursegrespond?
a. “Theggoalgofgpalliativegcaregisgtogprovidegtheggreatestgdegreegofgcomfortgpossiblegandghelpgthegdyinggpers
ongenjoygwhatevergtimegisgleft.”
b. “Palliativegcaregwillgreleasegyougfromgthegburdengofghavinggtogcaregforgsomeonegingtheghome.gItgdoesgnotgm
eangthatgcurativegtreatmentgwillgstop.”
c. “Agpalliativegcaregfacilitygisglikegagnursingghomegandgcostsglessgthangaghospitalgbecausegonlygpaingmedicati
onsgareggiven.”
d. “Yourgrelativegisgunawaregofghergsurroundingsgandgwillgnotgnoticegthegdifferencegbetweengherghomegan
dgagpalliativegcaregfacility.”
Palliativegcaregprovidesgangincreasedglevelgofgpersonalgcaregdesignedgtogmanagegsymptomgdistress.gThegfocusgis
LifegCaregExamg1gtestgbank
1. Agnursegcaresgforgagdyinggclient.gWhichgmanifestationgofgdyinggshouldgthegnursegtreatgfirst?
a. Anorexia
b. Pain
c. Nausea
d. Hairgloss
Onlygsymptomsgthatgcausegdistressgforgagdyinggclientgshouldgbegtreated.gSuchgsymptomsgincludegpain,gnauseaga
ndgvomiting,gdyspnea,gandgagitation.gThesegproblemsginterferegwithgthegclient’sgcomfort.gEvengwhengsymptoms
,gsuchgasganorexiagorghairgloss,gdisturbgthegfamily,gtheygshouldgbegtreatedgonlygifgthegclientgisgdistressedgbygtheir
gpresence.gThegnursegshouldgtreatgthegclient’sgpaingfirst.
2. Agnursegplansgcaregforgagclientgwhogisgnearinggendgofglife.gWhichgquestiongshouldgthegnursegaskgwh
engdevelopinggthisgclient’sgplangofgcare?
a. “Isgyourgadvancegdirectivegupgtogdategandgnotarized?”
b. “Dogyougwantgtogbegatghomegatgthegendgofgyourglife?”
c. “Wouldgyouglikegagphysicalgtherapistgtogassistgyougwithgrange-of-motiongactivities?”
d. “Havegyourgchildrengdiscussedgresuscitationgwithgyourghealthgcaregprovider?”
Whengdevelopinggagplangofgcaregforgagdyinggclient,gconsiderationgshouldgbeggivengforgwheregthegclientgwantsgto
gdie.gAdvancegdirectivesgdognotgneedgtogbegnotarized.gAgphysicalgtherapistgwouldgnotgbeginvolvedgingend-of-
lifegcare.gThegclientgshouldgdiscussgresuscitationgwithgtheghealthgcaregprovidergandgchildren;gdo-not-
resuscitategstatusgshouldgbegthegclient’sgdecision,gnotgthegfamily’sgdecision.
3. Agnursegisgcaringgforgagclientgwhoghasglunggcancergandgisgdying.gWhichgprescriptiongshouldgthegnu
rsegquestion?
a. Morphineg10gmggsublingualgeveryg6ghoursgPRNgforgpainglevelggreatergthang5
b. Albuterolg(Proventil)gmeteredgdoseginhalergeveryg4ghoursgPRNgforgwheezes
c. Atropinegsolutiong1%gsublingualgeveryg4ghoursgPRNgforgexcessivegoralgsecretions
d. Sodiumgbiphosphateg(Fleet)genemagoncegagdaygPRNgforgimpactedgstool
Paingmedicationsgshouldgbegscheduledgaroundgthegclockgtogmaintaingcomfortgandgpreventgreoccurrencegofgpain.g
Thegothergmedicationsgaregappropriategforgthisgclient.
4. Agclientgtellsgthegnursegthat,gevengthoughgitghasgbeeng4gmonthsgsinceghergsister’sgdeath,gshegfrequen
tlygfindsgherselfgcryingguncontrollably.gHowgshouldgthegnursegrespond?
a. “Mostgpeoplegmovegongwithingagfewgmonths.gYougshouldgseegaggriefgcounselor.”
b. “Whenevergyougstartgtogcry,gdistractgyourselfgfromgthoughtsgofgyourgsister.”
c. “Yougshouldgtrygnotgtogcry.gI’mgsuregyourgsistergisgingagbettergplacegnow.”
d. “Yourgfeelingsgaregcompletelygnormalgandgmaygcontinuegforgaglonggtime.”
Frequentgcryinggisgnotgangabnormalgresponse.gThegnursegshouldgletgthegclientgknowgthatgthisgisgnormalgandgokay
.gAlthoughgthegclientgmaygbenefitgfromgtalkinggwithgaggriefgcounselor,gitgisgnotgunusualgforghergtogstillgbeggrievi
nggaftergagfewgmonths.gThegothergresponsesgaregnotgasgtherapeuticgbecausegtheygjustifygorgminimizegthegclient’s
gresponse.
, Chapterg7:gEnd-of-
LifegCaregExamg1gtestgbank
5. Aftergteachinggagclientgaboutgadvancegdirectives,gagnursegassessesgthegclient’sgunderstanding.gWhi
chgstatementgindicatesgthegclientgcorrectlygunderstandsgthegteaching?
a. “AngadvancegdirectivegwillgkeepgmygchildrengfromgsellinggmyghomegwhengI’mgold.”
b. “AngadvancegdirectivegwillgbegcompletedgasgsoongasgI’mgincapacitatedgandgcan’tgthinkgforgmyself.”
c. “AngadvancegdirectivegwillgspecifygwhatgIgwantgdonegwhengIgcangnoglongergmakegdecisionsgaboutghealthgcare
.”
d. “Angadvancegdirectivegwillgallowgmegtogkeepgmygmoneygoutgofgthegreachgofgmygfamily.”
Angadvancegdirectivegisgagwrittengdocumentgpreparedgbygagcompetentgindividualgthatgspecifiesgwhat,gifgany,gext
raordinarygactionsgagpersongwouldgwantgtakengwhenghegorgshegcangnoglongergmakegdecisionsgaboutgpersonalghe
althgcare.gItgdoesgnotgaddressgissuesgsuchgasgthegclient’sgresidencegorgfinancialgmatters.
6. Agnursegteachesgagclientgwhogisgconsideringgbeinggadmittedgtoghospice.gWhichgstatementgshouldgt
hegnursegincludegingthisgclient’sgteaching?
a. “Hospicegadmissionghasgspecificgcriteria.gYougmaygnotgbegagviablegcandidate,gsogwegwillglookgatgalternat
ivegplansgforgyourgdischarge.”
b. “Hospicegcaregfocusesgongagholisticgapproachgtoghealthgcare.gItgisgdesignedgnotgtoghastengdeath,gbutgrather
gtogrelievegsymptoms.”
c. “Hospicegcaregwillgnotghelpgwithgyourgsymptomsgofgdepression.gIgwillgrefergyougtogthegfacility’sgcounseli
nggservicesginstead.”
d. “Yougseemgtogbegexperiencinggsomegdifficultygwithgthisgstagegofgtheggrievinggprocess.gLet’sgtalkgaboutgy
ourgfeelings.”
Asgbothgagphilosophygandgagsystemgofgcare,ghospicegcaregusesganginterdisciplinarygapproachgtogassessgandgaddre
ssgthegholisticgneedsgofgclientsgandgfamiliesgtogfacilitategqualitygofglifegandgagpeacefulgdeath.gThisgholisticgappro
achgneitherghastensgnorgpostponesgdeathgbutgprovidesgreliefgofgsymptomsgexperiencedgbygthegdyinggclient.
7. Agnursegisgcaringgforgagdyinggclient.gThegclient’sgspousegstates,g“Igthinkghegisgchokinggtogdeath.”gH
owgshouldgthegnursegrespond?
a. “Dognotgworry.gThegchokinggsoundgisgnormalgduringgthegdyinggprocess.”
b. “Igwillgadministergmoregmorphinegtogkeepgyourghusbandgcomfortable.”
c. “Igcangaskgthegrespiratorygtherapistgtogsuctiongsecretionsgoutgthroughghisgnose.”
d. “Igwillghaveganothergnursegassistgmegtogturngyourghusbandgonghisgside.”
Thegchokinggsoundgorg“deathgrattle”gisgcommongingdyinggclients.gThegnursegshouldgacknowledgegthegspouse’sgc
oncernsgandgprovideginterventionsgthatgwillgreducegthegchokinggsounds.gRepositioninggthegclientgontogonegsideg
withgagtowelgundergthegmouthgtogcollectgsecretionsgisgthegbestgintervention.gThegnursegshouldgnotgminimizegtheg
spouse’sgconcerns.gMorphinegwillgassistgwithgcomfortgbutgwillgnotgdecreasegthegchokinggsounds.gNasotrachealgs
uctioninggisgnotgappropriategingagdyinggclient.
8. Thegnursegisgteachinggagfamilygmembergaboutgvariousgtypesgofgcomplementarygtherapiesgthatgmightg
begeffectivegforgrelievinggthegdyinggclient’sganxietygandgrestlessness.gWhichgstatementgmadegbygthegfam
ilygmembergindicatesgunderstandinggofgthegnurse’sgteaching?
a. “Maybegwegshouldgjustghiregangaround-the-clockgsittergtogstaygwithgGrandmother.”
b. “IghavegsomegofghergfavoriteghymnsgongagCDgthatgIgcouldgbringgforgmusicgtherapy.”
c. “Igdon’tgthinkgthatgshe’llgneedgpaingmedicationgalonggwithghergherbalgtreatments.”
d. “Igwillgburngtherapeuticgincensegingthegroomgsogwegcangstopgtheganxietygpills.”
Musicgtherapygisgagcomplementarygtherapygthatgmaygproducegrelaxationgbygquietinggthegmindgandgremovinggagc
lient’sginnergrestlessness.gHiringgangaround-the-clockgsittergdoesgnotgdemonstrategthatgthegclient’sgfamily
, Chapterg7:gEnd-of-
LifegCaregExamg1gtestgbank
understandsgcomplementarygtherapies.
, Chapterg7:gEnd-of-
LifegCaregExamg1gtestgbank
9. Agnursegisgcaringgforgagterminallygillgclientgwhoghasgjustgdiedgingaghospitalgsettinggwithgfamilygmemb
ersgatgthegbedside.gWhichgactiongshouldgthegnursegtakegfirst?
a. Callgforgemergencygassistancegsogthatgresuscitationgproceduresgcangbegin.
b. Askgfamilygmembersgifgtheygwouldglikegtogspendgtimegalonegwithgthegclient.
c. Ensuregthatgagdeathgcertificateghasgbeengcompletedgbygthegphysician.
d. Requestgfamilygmembersgtogpreparegthegclient’sgbodygforgthegfuneralghome.
Beforegmovinggthegclient’sgbodygtogthegfuneralghome,gthegnursegshouldgaskgfamilygmembersgifgtheygwouldglikeg
togbegalonegwithgthegclient.gEmergencygassistancegwillgnotgbegnecessary.gAlthoughgitgisgimportantgtogensuregthat
gagdeathgcertificateghasgbeengcompletedgbeforegthegclientgisgmovedgtogthegmortuary,gthegnursegfirstgshouldgaskgfa
milygmembersgifgtheygwouldglikegtogbegalonegwithgthegclient.gThegclient’sgfamilygshouldgnotgbegexpectedgtogpre
paregthegbodygforgthegfuneralghome.
10. Agnursegassessesgagclientgwhogisgdying.gWhichgmanifestationgofgagdyinggclientgshouldgthegnursegassess
gtogdeterminegwhethergthegclientgisgneargdeath?
a. Levelgofgconsciousness
b. Respiratorygrate
c. Bowelgsounds
d. Painglevelgongag0-to-10gscale
Althoughgallgofgthesegassessmentsgshouldgbegperformedgduringgthegdyinggprocess,gperiodsgofgapneagandgChey
ne-
gStrokesgrespirationsgindicategdeathgisgnear.gAsgperipheralgcirculationgdecreases,gthegclient’sglevelgofgconscious
nessgandgbowelgsoundsgdecrease,gandgthegclientgwouldgbegunablegtogprovidegagnumericgnumbergongagpaingscale
.gEvengwithgthesegothergsymptoms,gthegnursegshouldgcontinuegtogassessgrespiratorygrategthroughoutgthegdyinggp
rocess.gAsgthegrategdropsgsignificantlygandgbreathinggbecomesgagonal,gdeathgisgnear.
11. Agnursegisgcaringgforgagclientgwhogisgterminallygill.gThegclient’sgspousegstates,g“Igamgconcernedgbeca
useghegdoesgnotgwantgtogeat.”gHowgshouldgthegnursegrespond?
a. “Letghimgknowgthatgfoodgisgavailablegifghegwantsgit,gbutgdognotginsistgthatghegeat.”
b. “Agfeedinggtubegcangbegplacedgingthegnosegtogprovidegimportantgnutrients.”
c. “Forceghimgtogeatgevengifghegdoesgnotgfeelghungry,gorghegwillgdiegsooner.”
d. “Hegisggettinggallgthegnutrientsghegneedsgthroughghisgintravenousgcatheter.”
Whengfamilygmembersgunderstandgthatgthegclientgisgnotgsufferinggfromghungergandgisgnotg“starvinggtogdeath,”g
theygmaygallowgthegclientgtogdeterminegwhen,gwhat,gorgifgtogeat.gOften,gasgdeathgapproaches,gmetabolicgneedsg
decreasegandgclientsgdognotgfeelgthegsensationgofghunger.gForcinggthemgtogeatgfrustratesgthegclientgandgthegfami
ly.
12. Agnursegdiscussesginpatientghospicegwithgagclientgandgthegclient’sgfamily.gAgfamilygmembergexpres
sesgconcerngthatgherglovedgonegwillgreceivegonlygcustodialgcare.gHowgshouldgthegnursegrespond?
a. “Theggoalgofgpalliativegcaregisgtogprovidegtheggreatestgdegreegofgcomfortgpossiblegandghelpgthegdyinggpers
ongenjoygwhatevergtimegisgleft.”
b. “Palliativegcaregwillgreleasegyougfromgthegburdengofghavinggtogcaregforgsomeonegingtheghome.gItgdoesgnotgm
eangthatgcurativegtreatmentgwillgstop.”
c. “Agpalliativegcaregfacilitygisglikegagnursingghomegandgcostsglessgthangaghospitalgbecausegonlygpaingmedicati
onsgareggiven.”
d. “Yourgrelativegisgunawaregofghergsurroundingsgandgwillgnotgnoticegthegdifferencegbetweengherghomegan
dgagpalliativegcaregfacility.”
Palliativegcaregprovidesgangincreasedglevelgofgpersonalgcaregdesignedgtogmanagegsymptomgdistress.gThegfocusgis
