C HAPTER 15: L OSS , G RIEF , AND E ND - OF -L IFE
C ARE
Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th
Edition
MULTIPLE CHOICE
1. The nurse can assess Cheyne -Stokes respiration by its characteristics of
respirations that are:
a. harsh and rattling.
b. wheezing and l abored.
c. shallow followed by periods of apnea.
d. long periods of apnea followed by a hiccoughing breath.
ANS: C
Cheyne-Stokes respirations become more and more shallow followed
by periods of apnea, and then respirations resume.
DIF: Cognitive Level: Compre hension REF: p. 208
OBJ: Theory #5 TOP: The Dying Process KEY:
Nursing Process Step: Assessment MSC: NCLEX:
Physiological Integrity: Basic Care and Comfort
2. When a patient admitted for terminal care is asked by the admitting nurse,
“What has your doctor told you about your illness?” the patient states,
, “She says that I have a terminal illness, but I know she’s wrong.” The
nurse recognizes that:
a. the patient has a doctor who does not tell patients when they have a
terminal illness.
b. the patient is in denial and is unable to consciousl y admit what he
has been told by the doctor.
c. the patient needs to be told that he doesn’t have long to live so that
he can make his final arrangements.
d. she will have to avoid all conversation that refers to his disease or
symptoms so as not to increase his anxiety.
ANS: B
The patient’s statement indicates Kübler Ross’s stage of denial in
which patients will not accept information and buffer themselves from
information that may be painful.
DIF: Cognitive Level: Anal ysis REF: p. 201|Table 15 -1
OBJ: Theory #1 TOP: Denial Phase KEY: Nursing
Process Step: Assessment MSC: NCLEX: Psychosocial
Integrit y: Coping and Adaptation
3. A terminal patient asks the nurse if he could be given a deliberate
overdose of medication tha t would “end this.” According to the Code for
Nurses, the nurse’s most ethical response would be:
a. “Bringing on your death in this manner would be a subject you
should discuss with your famil y and primary care provider.”
b. “I can contact the primary care prov ider and request an order for a
drug that could be used as you request.”
c. “I cannot ethicall y give you a deliberate overdose.”
d. “Let me have a while to consider your request.”
, ANS: C
The position of the American Nurses Association (ANA) expressl y
states that active euthanasia and assisted suicide are considered a
violation of the ANA’s Code for Nurses.
DIF: Cognitive Level: Application REF: p. 210 OBJ:
Theory #7 TOP: Assisted Suicide KEY: Nursing Process
Step: Implementation MSC: NCLEX: Physiologi cal
Integrit y: Basic Care and Comfort
4. A patient who is terminall y ill has been unable to maintain good nutrition
because of nausea and anorexia and has lost a great deal of weight. He is
now unable to change his position in bed and needs frequent perineal care
because of urinary incontinence. The nurse planning his care would
include in the plan of care to:
a. coax him to eat high -calorie, high-fat food.
b. provide laxatives and stool softeners to prevent constipation.
c. contact the primary care provider for an or der for tube feeding.
d. provide him with an air pressure mattress.
ANS: D
Provision of an air pressure mattress will help preserve the patient’s
skin integrit y that the weight loss, inactivit y, poor nutritional intake,
and incontinence have caused.
C ARE
Williams: deWit's Fundamental Concepts and Skills for Nursing, 5th
Edition
MULTIPLE CHOICE
1. The nurse can assess Cheyne -Stokes respiration by its characteristics of
respirations that are:
a. harsh and rattling.
b. wheezing and l abored.
c. shallow followed by periods of apnea.
d. long periods of apnea followed by a hiccoughing breath.
ANS: C
Cheyne-Stokes respirations become more and more shallow followed
by periods of apnea, and then respirations resume.
DIF: Cognitive Level: Compre hension REF: p. 208
OBJ: Theory #5 TOP: The Dying Process KEY:
Nursing Process Step: Assessment MSC: NCLEX:
Physiological Integrity: Basic Care and Comfort
2. When a patient admitted for terminal care is asked by the admitting nurse,
“What has your doctor told you about your illness?” the patient states,
, “She says that I have a terminal illness, but I know she’s wrong.” The
nurse recognizes that:
a. the patient has a doctor who does not tell patients when they have a
terminal illness.
b. the patient is in denial and is unable to consciousl y admit what he
has been told by the doctor.
c. the patient needs to be told that he doesn’t have long to live so that
he can make his final arrangements.
d. she will have to avoid all conversation that refers to his disease or
symptoms so as not to increase his anxiety.
ANS: B
The patient’s statement indicates Kübler Ross’s stage of denial in
which patients will not accept information and buffer themselves from
information that may be painful.
DIF: Cognitive Level: Anal ysis REF: p. 201|Table 15 -1
OBJ: Theory #1 TOP: Denial Phase KEY: Nursing
Process Step: Assessment MSC: NCLEX: Psychosocial
Integrit y: Coping and Adaptation
3. A terminal patient asks the nurse if he could be given a deliberate
overdose of medication tha t would “end this.” According to the Code for
Nurses, the nurse’s most ethical response would be:
a. “Bringing on your death in this manner would be a subject you
should discuss with your famil y and primary care provider.”
b. “I can contact the primary care prov ider and request an order for a
drug that could be used as you request.”
c. “I cannot ethicall y give you a deliberate overdose.”
d. “Let me have a while to consider your request.”
, ANS: C
The position of the American Nurses Association (ANA) expressl y
states that active euthanasia and assisted suicide are considered a
violation of the ANA’s Code for Nurses.
DIF: Cognitive Level: Application REF: p. 210 OBJ:
Theory #7 TOP: Assisted Suicide KEY: Nursing Process
Step: Implementation MSC: NCLEX: Physiologi cal
Integrit y: Basic Care and Comfort
4. A patient who is terminall y ill has been unable to maintain good nutrition
because of nausea and anorexia and has lost a great deal of weight. He is
now unable to change his position in bed and needs frequent perineal care
because of urinary incontinence. The nurse planning his care would
include in the plan of care to:
a. coax him to eat high -calorie, high-fat food.
b. provide laxatives and stool softeners to prevent constipation.
c. contact the primary care provider for an or der for tube feeding.
d. provide him with an air pressure mattress.
ANS: D
Provision of an air pressure mattress will help preserve the patient’s
skin integrit y that the weight loss, inactivit y, poor nutritional intake,
and incontinence have caused.
