10/16/24, 1:33 HESI Evolve case study
PM hospice
NUR2214C
Case Study – Hospice
Meet the Client
Community/public health nurses often make visits to client’s homes. Home visiting nursing services are
offered to new parents, children with special needs, and their families, older homebound adults, and
client’s discharged home from the hospital who require ongoing care. Palliative and hospice care are
often delivered by nurses working in the community. The goal of palliative and hospice care is to
support the client and family though the dying process.
Section 1
1. A primary care provider makes a referral to the nurse. Which statement by the client
indicates an understanding of palliative care?
• Treatments and medications will be utilized to control my pain and increase my
comfort. Interventions will be utilized to control pain, to increase comfort, and to
improve quality of life and quality of death for the client and family.
During the initial visit, the nurse explains the purpose of palliative and hospice nursing care to the client
and their family.
2. When talking with the family, what information should the nurse include? (SATA)
• The care provided is client and family focused.
• Hospice nurses regard dying as a normal process.
• Bereavement follow-up is provided after the client’s death.
• Interdisciplinary care focuses on symptom management.
Section 2
The nurse completes a comprehensive assessment of the client and family.
3. In conducting a home visit with a new client, which problem should the hospice nurse
address first?
• The problem that the client identifies as the first priority, the problem that most
concerns the client. Highest value should be placed on the problem the client identifies
as the first priority.
The client tells the nurse that they are worried about falling in the bathroom when bathing or
showering. The nurse assesses the client’s ability to perform activities of daily living.
4. Which action should the nurse take first when addressing the client’s fear of falling in
the shower?
• Determine if safety equipment is needed for bathing or showering. Safety is the
first priority to protect the client from injury. The facility used for bathing and
showering should be inspected by the nurse.
After assessing the client’s abilities, the nurse determines that a shower chair is needed. The nurse
collaborates with the primary healthcare provider to obtain a prescription for the durable medical
equipment. The nurse explores with the family whether they can assist with the client’s care. The nurse
about:bl 1
, 10/16/24, 1:33 HESI Evolve case study
PM hospice
offers them referrals to community resources and assists them to access public assistance if the client is
eligible for services.
5. The client qualifies for in-home county support services and the family hire a home care
aide. Which information about the client’s care should the nurse convey to the home care
aide?
• Place hygienic supplies within the client’s reach when the client is using the
shower chair. This will promote independence and decrease the risk for falls.
Section 3
During the initial assessment, the nurse asks the client about their family. The client cries and reports
they have two daughters, ages 19 and 15, and a 12-year-old son. The 15-year-old is having the hardest
time with the client’s prognosis. She seems irritable and angry when she is with the client and has
recently been disruptive in school.
6. How should the nurse respond to the client about their family concerns?
• Anger is part of the grieving process. I would suggest you encourage her to talk
about her feelings. A variety of strong emotions may be experienced during the
grieving process. Family members should be encouraged to talk about their feelings
of grief.
The nurse revises the family’s plan of care.
7. Based on the client’s concern about their daughter, which nursing diagnosis should the
nurse add to the plan of care?
• Anticipatory grieving related to potential loss of parent. Grieving for the client’s death is
still anticipatory at this time.
Section 4
The nurse has worked with hospice clients for 5 years and has experience communicating
therapeutically with the dying client. The nurse explains some of the common expressions of grief and
asks what the client has experienced.
8. The nurse schedule a home visit with the family unit to discuss common expressions of grief.
What information should the nurse include during the discussion about the grieving
process? (SATA)
• It is common to have several emotional responses to grief and loss.
• Grief is a normal reaction to loss.
• Grief includes both physiological and psychological responses.
• Grief is a complex and intense emotional experience.
9. The nurse observes the client’s emotional responses when discussing their desires about death.
Which emotional response is uncommon?
• Confusion and disorientation. These are not common responses to grief and the nurse
should assess the client for delirium or possible dementia.
10. Which technique should the nurse use when communicating with the client about their
terminal illness?
• Respect the client’s pattern of communication and ways of dealing with stress. The
nurse should respect the client’s readiness to talk about and deal with the illness while
offering support when needed.
about:bl 2
PM hospice
NUR2214C
Case Study – Hospice
Meet the Client
Community/public health nurses often make visits to client’s homes. Home visiting nursing services are
offered to new parents, children with special needs, and their families, older homebound adults, and
client’s discharged home from the hospital who require ongoing care. Palliative and hospice care are
often delivered by nurses working in the community. The goal of palliative and hospice care is to
support the client and family though the dying process.
Section 1
1. A primary care provider makes a referral to the nurse. Which statement by the client
indicates an understanding of palliative care?
• Treatments and medications will be utilized to control my pain and increase my
comfort. Interventions will be utilized to control pain, to increase comfort, and to
improve quality of life and quality of death for the client and family.
During the initial visit, the nurse explains the purpose of palliative and hospice nursing care to the client
and their family.
2. When talking with the family, what information should the nurse include? (SATA)
• The care provided is client and family focused.
• Hospice nurses regard dying as a normal process.
• Bereavement follow-up is provided after the client’s death.
• Interdisciplinary care focuses on symptom management.
Section 2
The nurse completes a comprehensive assessment of the client and family.
3. In conducting a home visit with a new client, which problem should the hospice nurse
address first?
• The problem that the client identifies as the first priority, the problem that most
concerns the client. Highest value should be placed on the problem the client identifies
as the first priority.
The client tells the nurse that they are worried about falling in the bathroom when bathing or
showering. The nurse assesses the client’s ability to perform activities of daily living.
4. Which action should the nurse take first when addressing the client’s fear of falling in
the shower?
• Determine if safety equipment is needed for bathing or showering. Safety is the
first priority to protect the client from injury. The facility used for bathing and
showering should be inspected by the nurse.
After assessing the client’s abilities, the nurse determines that a shower chair is needed. The nurse
collaborates with the primary healthcare provider to obtain a prescription for the durable medical
equipment. The nurse explores with the family whether they can assist with the client’s care. The nurse
about:bl 1
, 10/16/24, 1:33 HESI Evolve case study
PM hospice
offers them referrals to community resources and assists them to access public assistance if the client is
eligible for services.
5. The client qualifies for in-home county support services and the family hire a home care
aide. Which information about the client’s care should the nurse convey to the home care
aide?
• Place hygienic supplies within the client’s reach when the client is using the
shower chair. This will promote independence and decrease the risk for falls.
Section 3
During the initial assessment, the nurse asks the client about their family. The client cries and reports
they have two daughters, ages 19 and 15, and a 12-year-old son. The 15-year-old is having the hardest
time with the client’s prognosis. She seems irritable and angry when she is with the client and has
recently been disruptive in school.
6. How should the nurse respond to the client about their family concerns?
• Anger is part of the grieving process. I would suggest you encourage her to talk
about her feelings. A variety of strong emotions may be experienced during the
grieving process. Family members should be encouraged to talk about their feelings
of grief.
The nurse revises the family’s plan of care.
7. Based on the client’s concern about their daughter, which nursing diagnosis should the
nurse add to the plan of care?
• Anticipatory grieving related to potential loss of parent. Grieving for the client’s death is
still anticipatory at this time.
Section 4
The nurse has worked with hospice clients for 5 years and has experience communicating
therapeutically with the dying client. The nurse explains some of the common expressions of grief and
asks what the client has experienced.
8. The nurse schedule a home visit with the family unit to discuss common expressions of grief.
What information should the nurse include during the discussion about the grieving
process? (SATA)
• It is common to have several emotional responses to grief and loss.
• Grief is a normal reaction to loss.
• Grief includes both physiological and psychological responses.
• Grief is a complex and intense emotional experience.
9. The nurse observes the client’s emotional responses when discussing their desires about death.
Which emotional response is uncommon?
• Confusion and disorientation. These are not common responses to grief and the nurse
should assess the client for delirium or possible dementia.
10. Which technique should the nurse use when communicating with the client about their
terminal illness?
• Respect the client’s pattern of communication and ways of dealing with stress. The
nurse should respect the client’s readiness to talk about and deal with the illness while
offering support when needed.
about:bl 2
