1. ADULT HEALTH NURSING ADVANCED EXAM
TEST BANK WITH QUESTIONS AND ANSWERS
2. In the past three to four decades, nursing has moved into the forefront in providing care for the dying.
Which phenomenon has most contributed to this increased focus of care of the dying?
A) Increased incidence of infections and acute illnesses
B) Increased focus of health care providers on disease prevention
C) Larger numbers of people dying in hospital settings
D) Demographic changes in the population - SOLUTION-D
3. A medical practioner who works in the specialty of palliative care frequently encounters issues and
situations that constitute ethical dilemmas. What issue has most often presented challenging ethical
issues, especially in the context of palliative care? A) The increase in cultural diversity in the United
States B) Staffing shortages in health care and questions concerning quality of care C) Increased costs
of health care coupled with inequalities in access D) Ability of technology to prolong life beyond
meaningful quality of life - SOLUTION-D
The medical practioner is caring for a patient who has been recently diagnosed with late stage
pancreatic cancer. The patient refuses to accept the diagnosis and refuses to adhere to treatment. What
is the most likely psychosocial purpose of this patients strategy? A) The patient may be trying to protect
loved ones from the emotional effects of the illness. B) The patient is being noncompliant in order to
assert power over caregivers. C) The patient may be skeptical of the benefits of the Western biomedical
model of health.
D) The patient thinks that treatment does not provide him comfort. - SOLUTION-A
,4. A medical practioner who sits on the hospitals ethics committee is reviewing a complex case that has
many of the hallmarks of assisted suicide. Which of the following would be an example of assisted
suicide? A) Administering a lethal dose of medication to a patient whose death is imminent B)
Administering a morphine infusion without assessing for respiratory depression C) Granting a patients
request not to initiate enteral feeding when the patient is unable to eat D) Neglecting to resuscitate a
patient with a do not resuscitate order - SOLUTION-A
5. A medical medical practioner is providing palliative care to a patient with a diagnosis of end-stage
chronic obstructive pulmonary disease (COPD). What is the primary goal of this medical practioners
care? A) To improve the patients and familys quality of life Test Bank - Brunner & Suddarth's Textbook of
Medical-Surgical Nursing 14e (Hinkle 2017) 320 B) To support aggressive and innovative treatments for
cure C) To provide physical support for the patient D) To help the patient develop a separate plan with
each discipline of the health care team - SOLUTION-A
After contributing to the care of several patients who died in the hospital, the medical practioner has
identified some lapses in the care that many of these patients received toward the end of their lives.
What have research studies identified as a potential deficiency in the care of the dying in hospital
settings? A) Families needs for information and support often go unmet. B) Patients are too sedated to
achieve adequate pain control. C) Patients are not given opportunities to communicate with caregivers.
D) Patients are ignored by the care team toward the end of life. - SOLUTION-A
An adult oncology patient has a diagnosis of bladder cancer with metastasis and the patient has asked
the medical practioner about the possibility of hospice care. Which principle is central to a hospice
setting? A) The patient and family should be viewed as a single unit of care. B) Persistent symptoms of
terminal illness should not be treated. C) Each member of the interdisciplinary team should develop an
individual plan of care. Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e
(Hinkle 2017) 321 D) Terminally ill patients should die in the hospital whenever possible. - SOLUTION-A
A clinic medical practioner is providing patient education prior to a patients scheduled palliative
radiotherapy to her spine. At the completion of the patient teaching, the patient continues to ask the
same questions that the medical practioner has already addressed. What is the plausible conclusion that
the medical practioner should draw from this?
A) The patient is not listening effectively. B) The patient is noncompliant with the plan of care. C) The
patient may have a low intelligence quotient or a cognitive deficit. D) The patient has not achieved the
desired learning outcomes. - SOLUTION-D
, The medical practioner is part of the health care team at an oncology center. A patient has been
diagnosed with leukemia and the prognosis is poor, but the patient is not yet aware of the prognosis.
How can the bad news best be conveyed to the patient? A) Family should be given the prognosis first. B)
The prognosis should be delivered with the patient at eye level. C) The physician should deliver the news
to the patient alone. D) The appointment should be scheduled at the end of the day - SOLUTION-B
A patient has just been told that her illness is terminal. The patient tearfully states, I cant believe I am
going to die. Why me? What is your best response? A) I know how you are feeling. B) You have lived a
long life. C) This must be very difficult for you. D) Life can be so unfair. - SOLUTION-C
The medical practioner has observed that an older adult patient with a diagnosis of end-stage renal
failure seems to prefer to have his eldest son make all of his health care decisions. While the family is
visiting, the patient explains to you that this is a cultural practice and very important to him. How should
you respond? A) Privately ask the son to allow the patient to make his own health care decisions. B)
Explain to the patient that he is responsible for his own decisions. C) Work with the team to negotiate
informed consent. D) Avoid divulging information to the eldest son - SOLUTION-C
One aspect of the medical practioners comprehensive assessment when caring for the terminally ill is
the assessment of hope. The medical practioner is assessing a patient with liver failure for the presence
of hope. What would the medical practioner identify as a hope-fostering category? A) Uplifting
memories B) Ignoring negative outcomes C) Envisioning one specific outcome D) Avoiding an actual or
potential threat - SOLUTION-A
A medical medical practioner is providing end-of-life care for a patient with metastatic bone cancer. The
medical practioner notes that the patient has been receiving oral analgesics for her pain with adequate
effect, but is now having difficulty swallowing the medication. What should the medical practioner do?
A) Request the physician to order analgesics by an alternative route. B) Crush the medication in order to
aid swallowing and absorption. C) Administer the patients medication with the meal tray. D) Administer
the medication rectally - SOLUTION-A
A 66-year-old patient is in a hospice receiving palliative care for lung cancer which has metastasized to
the patients liver and bones. For the past several hours, the patient has been experiencing dyspnea.
What nursing action is most appropriate to help to relive the dyspnea the patient is experiencing? Test
Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 324 A) Administer a
bolus of normal saline, as ordered. B) Initiate high-flow oxygen therapy. C) Administer high doses of
opioids. D) Administer bronchodilators and corticosteroids, as ordered - SOLUTION-D
TEST BANK WITH QUESTIONS AND ANSWERS
2. In the past three to four decades, nursing has moved into the forefront in providing care for the dying.
Which phenomenon has most contributed to this increased focus of care of the dying?
A) Increased incidence of infections and acute illnesses
B) Increased focus of health care providers on disease prevention
C) Larger numbers of people dying in hospital settings
D) Demographic changes in the population - SOLUTION-D
3. A medical practioner who works in the specialty of palliative care frequently encounters issues and
situations that constitute ethical dilemmas. What issue has most often presented challenging ethical
issues, especially in the context of palliative care? A) The increase in cultural diversity in the United
States B) Staffing shortages in health care and questions concerning quality of care C) Increased costs
of health care coupled with inequalities in access D) Ability of technology to prolong life beyond
meaningful quality of life - SOLUTION-D
The medical practioner is caring for a patient who has been recently diagnosed with late stage
pancreatic cancer. The patient refuses to accept the diagnosis and refuses to adhere to treatment. What
is the most likely psychosocial purpose of this patients strategy? A) The patient may be trying to protect
loved ones from the emotional effects of the illness. B) The patient is being noncompliant in order to
assert power over caregivers. C) The patient may be skeptical of the benefits of the Western biomedical
model of health.
D) The patient thinks that treatment does not provide him comfort. - SOLUTION-A
,4. A medical practioner who sits on the hospitals ethics committee is reviewing a complex case that has
many of the hallmarks of assisted suicide. Which of the following would be an example of assisted
suicide? A) Administering a lethal dose of medication to a patient whose death is imminent B)
Administering a morphine infusion without assessing for respiratory depression C) Granting a patients
request not to initiate enteral feeding when the patient is unable to eat D) Neglecting to resuscitate a
patient with a do not resuscitate order - SOLUTION-A
5. A medical medical practioner is providing palliative care to a patient with a diagnosis of end-stage
chronic obstructive pulmonary disease (COPD). What is the primary goal of this medical practioners
care? A) To improve the patients and familys quality of life Test Bank - Brunner & Suddarth's Textbook of
Medical-Surgical Nursing 14e (Hinkle 2017) 320 B) To support aggressive and innovative treatments for
cure C) To provide physical support for the patient D) To help the patient develop a separate plan with
each discipline of the health care team - SOLUTION-A
After contributing to the care of several patients who died in the hospital, the medical practioner has
identified some lapses in the care that many of these patients received toward the end of their lives.
What have research studies identified as a potential deficiency in the care of the dying in hospital
settings? A) Families needs for information and support often go unmet. B) Patients are too sedated to
achieve adequate pain control. C) Patients are not given opportunities to communicate with caregivers.
D) Patients are ignored by the care team toward the end of life. - SOLUTION-A
An adult oncology patient has a diagnosis of bladder cancer with metastasis and the patient has asked
the medical practioner about the possibility of hospice care. Which principle is central to a hospice
setting? A) The patient and family should be viewed as a single unit of care. B) Persistent symptoms of
terminal illness should not be treated. C) Each member of the interdisciplinary team should develop an
individual plan of care. Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e
(Hinkle 2017) 321 D) Terminally ill patients should die in the hospital whenever possible. - SOLUTION-A
A clinic medical practioner is providing patient education prior to a patients scheduled palliative
radiotherapy to her spine. At the completion of the patient teaching, the patient continues to ask the
same questions that the medical practioner has already addressed. What is the plausible conclusion that
the medical practioner should draw from this?
A) The patient is not listening effectively. B) The patient is noncompliant with the plan of care. C) The
patient may have a low intelligence quotient or a cognitive deficit. D) The patient has not achieved the
desired learning outcomes. - SOLUTION-D
, The medical practioner is part of the health care team at an oncology center. A patient has been
diagnosed with leukemia and the prognosis is poor, but the patient is not yet aware of the prognosis.
How can the bad news best be conveyed to the patient? A) Family should be given the prognosis first. B)
The prognosis should be delivered with the patient at eye level. C) The physician should deliver the news
to the patient alone. D) The appointment should be scheduled at the end of the day - SOLUTION-B
A patient has just been told that her illness is terminal. The patient tearfully states, I cant believe I am
going to die. Why me? What is your best response? A) I know how you are feeling. B) You have lived a
long life. C) This must be very difficult for you. D) Life can be so unfair. - SOLUTION-C
The medical practioner has observed that an older adult patient with a diagnosis of end-stage renal
failure seems to prefer to have his eldest son make all of his health care decisions. While the family is
visiting, the patient explains to you that this is a cultural practice and very important to him. How should
you respond? A) Privately ask the son to allow the patient to make his own health care decisions. B)
Explain to the patient that he is responsible for his own decisions. C) Work with the team to negotiate
informed consent. D) Avoid divulging information to the eldest son - SOLUTION-C
One aspect of the medical practioners comprehensive assessment when caring for the terminally ill is
the assessment of hope. The medical practioner is assessing a patient with liver failure for the presence
of hope. What would the medical practioner identify as a hope-fostering category? A) Uplifting
memories B) Ignoring negative outcomes C) Envisioning one specific outcome D) Avoiding an actual or
potential threat - SOLUTION-A
A medical medical practioner is providing end-of-life care for a patient with metastatic bone cancer. The
medical practioner notes that the patient has been receiving oral analgesics for her pain with adequate
effect, but is now having difficulty swallowing the medication. What should the medical practioner do?
A) Request the physician to order analgesics by an alternative route. B) Crush the medication in order to
aid swallowing and absorption. C) Administer the patients medication with the meal tray. D) Administer
the medication rectally - SOLUTION-A
A 66-year-old patient is in a hospice receiving palliative care for lung cancer which has metastasized to
the patients liver and bones. For the past several hours, the patient has been experiencing dyspnea.
What nursing action is most appropriate to help to relive the dyspnea the patient is experiencing? Test
Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 324 A) Administer a
bolus of normal saline, as ordered. B) Initiate high-flow oxygen therapy. C) Administer high doses of
opioids. D) Administer bronchodilators and corticosteroids, as ordered - SOLUTION-D
