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Chapter 09 Palliative Care at End of Life questions with answers.
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Chapter 09 Palliative Care at End of Life questions with answers.
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Chapter 09 Palliative Care at End of Lifequestions with answers.
1. The nurse cares for a terminally ill patient who has 20-second periods of apnea followed by periods of
deep and rapid breathing. Which action by the nurse would be most appropriate?
a. Suction the patient.
b. Administer oxygen via face mask.
c. Place the patient in high Fowlers position.
d. Document the respirations as Cheyne-Stokes. ANS - ANS: D
Cheyne-Stokes respirations are characterized by periods of apnea alternating with deep and rapid
breaths. Cheyne-Stokes respirations are expected in the last days of life. There is also no need for
supplemental oxygen by face mask or suctioning the patient. Raising the head of the bed slightly and/or
turning the patient on the side may promote comfort. There is no need to place the patient in high
Fowlers position.
DIF: Cognitive Level: Apply (application) REF: 131
TOP: Nursing Process: Assessment
2. The nurse cares for an adolescent patient who is dying. The patients parents are interested in organ
donation and ask the nurse how the decision about brain death is made. Which response by the nurse is
most appropriate?
a. Brain death occurs if a person is flaccid and unresponsive.
b. If CPR is ineffective in restoring a heartbeat, the brain cannot function.
, c. Brain death has occurred if there is no breathing and certain reflexes are absent.
d. If respiratory efforts cease and no apical pulse is audible, brain death is present. ANS - ANS: C
The diagnosis of brain death is based on irreversible loss of all brain functions, including brainstem
functions that control respirations and brainstem reflexes. The other descriptions describe other clinical
manifestations associated with death but are insufficient to declare a patient brain dead.
DIF: Cognitive Level: Apply (application) REF: 131
TOP: Nursing Process: Assessment
3. A hospice patient is manifesting a decrease in all body system functions except for a heart rate of 124
and a respiratory rate of 28. Which statement, if made by the nurse to the patients family member, is
most
appropriate?
a. These symptoms will continue to increase until death finally occurs.
b. These symptoms are a normal response before these functions decrease.
c. These symptoms indicate a reflex response to the slowing of other body systems.
d. These symptoms may be associated with an improvement in the patients condition. ANS - ANS: B
An increase in heart and respiratory rate may occur before the slowing of these functions in the dying
patient. Heart and respiratory rate typically slow as the patient progresses further toward death. In a
dying patient, high respiratory and pulse rates do not indicate improvement, and it would be
inappropriate for the nurse to indicate this to the family. The changes in pulse and respirations are not
reflex responses.
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